Dr. Gary Leach, Female Urology, Non-accredited fellowship at Tower Urology, Institute for Continence

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Dr. Gary Leach, Female Urology, Non-accredited fellowship at Tower Urology, Institute for Continence

Since people have been asking, these are some relevant points regarding Dr. Gary Leach’s female urology fellowship at Tower Urology, Institute for Continence


  • Apprenticeship style training with Dr. Leach, who has had over 30 years of experience in this field after his training with Dr. Raz at UCLA. He knows his stuff!
  • Dr. Leach is a good guy: affable, a great sense of humor, and honestly concerned in his patient’s best interest.
  • You get autonomy in the operating room if Dr. Leach trusts you, he relies a lot on your clinical judgment when taking care of his patients.
  • You will become well versed in all aspects of voiding dysfunction, including interstim which involves reprogramming and office PNE placements.
  • Since you perform most of the urodynamics for the office, you will excel in interpreting them and become well verse with troubleshooting any issues in the Laborie machine.
  • You have opportunities to operate with the other Tower associates to get robotic exposure.
  • You will be supplied with many articles from Dr. Leach to review and keep up to date.
  • The location: Beverly Hills, California.


  • You take private practice group call in a group with 10 attending. You take 8 calls a month. Up to 4 of these calls are ER calls (from a total of 8 ER calls for the group). You take calls two weekends a month.
  • You don’t see your own patients in clinic. You operate, or you perform urodynamics. You can join Dr. Leach when not performing urodynamics and shadow him in clinic to see his patients.
  • Dr. Leach doesn’t use the robot.
  • No formal didactics.
  • Even though you are Dr. Leach’s female fellow, you are an associate with Tower Urology, and when the other staff can’t see consults in the hospital, they are sent your way.
  • 2 weeks of vacation
  • Income less than a PGY 5
  • Non-accredited Fellowship 
Not recommended

I talked to a few former fellows and decided against applying here. The common complaint in the past has been the significant amount of call coverage, including all holidays, not being compensated appropriately for their contribution, and being treated like a practice employee by their office manager. 

Anonymous (not verified)

50k/year, daily UroD, most emergency call for the practice, 10 d vacation…

My fellows, ask not what your fellowship can do for you, ask what you can do for your private practice.

AnonymousMD (not verified)
Not recommended

The problem with the Tower Urology model for fellowship is that it lends itself to fellow exploitation. The clinic manager owns the fellow and although the fellow works with Dr. Leach, they are utilized by the practice in order to maximize profits and alleviate the associate attending call in ways that have nothing to do with female urology. There are many people in the call pool but the fellow takes the majority of both the call and the emergency room call. Fellow preferences take a back seat and each of the two weeks’ vacation are planned according to practice convenience. In addition to urodynamics being performed in the clinic every day with Dr. Leach, which is a valuable part of the learning process, the practice sets up a weekly urodynamic procedure day dedicated to perform urodynamics for everyone else despite the availability of other staff being trained to perform the procedure. 

Furthermore, on days when there are no activities in the clinic or the operating room scheduled for the fellow, the practice manager will actually schedule more urodynamics at different times, again, maximizing fellow productivity while disregarding research, self-directed learning time, or all the extra hours and weekends spent on call.

To be frank, the experience in the practice makes you feel lousy and taken advantage of, which is a recurring sentiment among former fellows. No one wants to feel oppressed after a decade + obtaining your urology degree ... IMO, not good, and therefore, not recommended.