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FELLOWSHIPS IN THE DIVISON OF UROLOGY


The UCDSOM Division of Urology currently offers two fellowship programs focusing on different areas of subspeciality training. The first fellowship is in Male Reconstruction directed by Dr. Brian Flynn.  The fellowship in Pediatric Urology is directed by Dr. Duncan Wilcox.  Please click on the appropriate tab to obtain additional information on each of the fellowship training programs.

The Genitourinary (GU) Reconstructive Surgery Fellowship at the University of Colorado School of Medicine is a one-year clinical fellowship under the directorship of Brian J. Flynn MD, Professor of Surgery in the Division of Urology. Dr. Flynn started the fellowship in 2008. The fellowship’s focus is both male and female reconstructive Urology. We are one of the few remaining programs that are committed to training fellows in all aspects of GU reconstruction that includes male and female GU reconstruction. This philosophy originates from “old-school” of reconstruction built by Richard Turner-Warwick, George Webster and Gerald Jordan.


In 2012, GURS started a match in GU Reconstructive Surgery and we have participated in the match and have received a letter of good standing each year the GURS match has existed. In 2012, Dr. Ty Higuchi joined the CU reconstructive urology program and brought additional expertise in urethral, penile and neurogenic reconstruction as well as adding transitional urology to the program.


The CU Reconstructive Urology fellowship has been committed to meeting the curriculum standards to a GURS based curriculum. We consistently perform in the top 50% in the majority of the index cases.  Additionally, the GU reconstructive fellowship overlaps partially with what is now known considered FPMRS/SUFU index cases. The fellows do have some flexibility on case selection based on their own individual experience, interest and future job aspirations. 


 This clinical fellowship includes a graduated experience focusing on GU reconstruction. This includes pre-operative evaluation, intraoperative management and post-operative care. The fellow will be quite familiar with reconstructive surgery of the ureter, bladder, urethra and penis.  The fellow will spend 90% of his/her time functioning as a fellow under the directorship of 2-4 faculty members, spending the majority of time with 2 faculty members.  The remaining 10% of his/her time will be spent independently. The fellow will have four of his/her own clinics per month and have the ability to schedule minor cases that come from these clinics.  The fellow will have 1-2 days per month of research time. This time is flexible based on the fellow’s research interest and productivity.  We will support the fellow’s participation at two national meetings per year to present their research activities.

 

Pre-requisites For Admission 
The fellowship is open to both “U.S. citizens” and “non-U.S. citizens” who are qualified to obtain a full medical license in the State of Colorado and have completed all 3 steps of USMLE. Additionally, the applicant must have completed an accredited Urology Residency in the United States and be board eligible in Urology. The applicant must have a letter of support from their Program Director attesting to the successful completion of the urology training program and recommending them for the fellowship. Two additional letters of recommendation are required.

 

One trainee per year will be accepted into the 1-year clinical fellowship-training program.

There maybe opportunity of a 1-year research fellowship or 1-3 month observerships, especially for international fellows. This will usually require extramural funding.  To date we have had international scholars visit from Canada, Brazil, Mexico, China, Korea, Italy, Russia and Jordan.

 

Fellowship training in Genitourinary Reconstructive Surgery is now determined according to a match process through the Society of Genitourinary Reconstructive Surgeons and the American Urological Association.  If you are interested in learning more about the match process, please check out the GURS website at: https://www.auanet.org/secured/malereconstruction/applicant.cfm.

 

Please note: Residents/Fellows in University of Colorado training program must be a U.S. citizen, lawful permanent resident, refugee, asylee, or possess the appropriate documentation to allow the resident/fellow to legally train at the University of Colorado School of Medicine.

 

Learning Objectives 

1.    Management of anterior and posterior urethral stricture disease

2.    Male incontinence surgery – AUS and male sling

3.    Bladder reconstruction and continent urinary diversion– Augmentation, Mitrofanoff, bladder neck closure, Indiana Pouch

4.    Ureteral reconstruction – pyeloplasty, re-implant, psoas hitch, ileal ureter

5.    Robotic upper and lower urinary tract reconstruction

6.    Penile reconstruction and prosthetic surgery

7.    Management of neurogenic bladder and voiding Dysfunction – Botox, Interstim, TURP, PVP

8.    Recto-urethral fistula surgery

9.    Neurourology and Urodynamics

10.  Complex female pelvic medicine – Complications of pelvic surgery vesicovaginal & urethrovaginal fistula surgery, urethral diverticulectomy, surgery for recurrent SUI and POP

 

Overall Program Goals
At the end of this fellowship in Genitourinary Reconstructive Surgery, the fellow will have obtained knowledge in the core reconstructive urologic procedures. The fellow will be knowledgeable especially in the following areas:

 

Male Reconstructive Surgery

 - Management of urethral stricture disease including urethroplasty and substitution urethroplasty using grafts and flaps (both local flaps as well as extra-genital flaps)

 - The management of male stress urinary incontinence and proficiency in artificial urinary sphincter and male sling implantation

 - The fellow will be proficient in management of urethro-cutaneous as well as rectal-urethral fistula surgery

 Bladder and Ureteral Reconstruction

 - The fellow will demonstrate knowledge in ureteral reconstruction and be adept in the full array of reconstructive procedures including ureteral re-implantation, uretero-ureterostomy, transuretero-ureterostomy, ileal uretero substitution, boari flap, and pyeloplasty (both open and laparoscopic)

 - Bladder reconstruction including bladder augmentation, creation of catherizable urinary stomas, urinary diversion

 Robotic Reconstructive Urology

The fellow will be exposed to robotic surgery and has the opportunity to log 50 - 75 robotic cases in a single year. The fellow case log is more than double the robotic exposure that a fellow would receive at any other GU reconstructive surgery program. Approximately half of the procedures are FPMRS cases (Fistula surgery, RALS, graft removal from the LUT) and the other 50% are upper urinary tract reconstruction (ureteral recon and pyeloplasty) and lower urinary tract reconstruction (bladder augmentation, mitrofanoff, bladder neck closure, cystectomy with urinary diversion).  Robotic GU reconstruction is an exciting area of growth in our field.  These cases are lengthy, technically demanding procedures.  Minimally Invasive Urology and FPMRS are excelling in GU Robotic reconstructive surgery while GURS fellowships are lagging behind.  We are committed to training our fellows in bot open and robotic cases.

 Complex Female Pelvic Medicine

Complex female pelvic medicine is a term our fellows coined recently and is reflective of the tertiary FPMRS practice we have at the University of Colorado.  This includes management of patients with complications from pelvic surgery, fistula, ureteral obstruction, urethral stricture, recurrent stress incontinence and prolapse.  Fellows will have exposure to both the clinic procedures as well as minor and major procedures we perform.

 Research

The fellow will be involved in all related clinical research activities. The fellow will be able to select three (3) new or ongoing projects. The expectations for these projects will be completion by years end in the form of a manuscript that is prepared for publication in a peer-reviewed journal. Additionally, the research will be presented at a local as well as a national urologic meeting.

 

Program Summary
In short, the fellowship is a mix of major abdominal reconstructive surgery as well as male and female reconstruction.  Dr. Flynn performs approximately 500 cases per year. The fellow will participate in approximately half of these cases, specifically the cases involving male reconstruction. These cases occur at the University of Colorado Hospital (85%), Denver Health Trauma Center (10%) and Children’s Hospital Colorado (5%).   The fellow will have attending privileges and will have their own clinic (4 clinics per month) and cases of his/her own where he/she will function as the staff (approximately 4-8 cases per month). As the year progresses he/she will function as the staff on some combined cases. We do a number on large reconstructive cases especially in the 2nd half of the year (3-5 per month).

 

Brian J. Flynn, M.D.
Co-Director of UCH Women’s Pelvic Health and Surgery Clinic

Fellowship Director of Genitourinary Reconstructive Surgery
Professor of Surgery/Urology
University of Colorado Denver, Division of Urology

Academic Office One Bldg

12631 East 17th Ave., Box C319, room L15-5602

Aurora, CO 80045
Academic Office: (303) 724-2712
Fax: (303) 724-2818

Email: Brian.Flynn@UCDenver.edu

 

 Useful websites

http://www.sufuorg.com
http://www.societygurs.org
http://www.augs.org
http://www.auanet.org
http://www.siu-urology.org

 

 Faculty

Brian J. Flynn, MD       Professor of Surgery/Urology

Ty Higuchi, MD            Assistant Professor of Surgery/Urology

Janine Oliver, MD       Assistant Professor of Surgery/Urology

 

  Fellow Roster

Year

Name

Medical School

Residency

Post-Fellowship

​2017-2018

​Michael A. Avallone, MD

​ University of Miami

​Medical College of Wisconsin

 

​2016-2017

​Lisa M. Parrillo, MD

​Eastern Virginia Medical School

​University. of Pennsylvania

​​

​2015-2016

​Stephen A. Blakely, MD

​Univ. of Maryland

​SUNY Upstate Medical University

​​SUNY Upstate, Assistant Professor

​2014-2015

​Kirk M. Anderson, MD

​Loma Linda Univ.

​Loma Linda University

Sacramento, CA

Sutter Health

2013-2014​

​Andrew P. Windsperger, MD

​University of Minnesota

​University of Kansas

St. Cloud, Minnesota

Private practice

2012-2013

Ketul S. Shah, MD

Univ. of Mumbai, Bombay,  India

Ohio State University

Columbus, OH

Private practice

2011-2012

Dmitriy Nikolavsky, MD

Wayne State Univ.

Beaumont Hospital

Royal Oak, MI

SUNY Upstate, Assistant Professor

2010-2011

David A. Hadley, MD

Loma Linda Univ.

University of Utah

Twin Falls, ID

Private practice

2009-2010

Christopher R. Knopick, MD

Northwestern Univ.

Wayne State University

San Francisco, CA

Attending-Kaiser

2008-2009

Ryan P. Terlecki, MD

Wayne State Univ.

Wayne State University

Univ. Wake Forest

Associate Professor

 

TO APPLY:
Applications for a fellowship position must be submitted through the Genitourinary Reconstructive Surgery Fellowship Match through the AUA.  Information on the application process can be found at the GURS website at 
www.societygurs.org/fellowship​.   

 

In addition to applying on-line, applicants are required to forward a copy of their GURS application and all supporting documentation via e-mail to the Fellowship Coordinator, Ashley Lane, at ashley.2.lane@ucdenver.edu

CU Deadline: December 31, 1.5 years before the potential start date

Required documentation includes:

        ·         Copy of GURS application

·         Curriculum Vitae

·         Medical School Transcripts

·         Letter of Recommendation from Residency Program Director

·         Three (3) Additional Letters of Recommendation

 

Interviews are typically held in February and March.  Please feel free to contact Ashley Lane via e-mail at ashley.2.lane@ucdenver.edu with questions or to request additional information.​

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The Fellowship in Pediatric Urology has been accredited by the ACGME and the University of Colorado School of Medicine Office of Graduate Medical Education.

The Pediatric Urology Fellowship Program seeks to recruit the best candidates and provide them the educational foundation for a successful career. We seek to prepare our fellows for their lifelong educational and professional journey in Pediatric Urology by:

  • Sharing knowledge from the dedicated faculty
  • Developing surgical and patient care skills in an environment fostering progressive responsibility in patient management under appropriate supervision
  • Teaching that will help them appraise and improve their own patient care, assess and assimilate new scientific knowledge, and contribute through research to the science of the profession
  • Demonstrating interpersonal and communication skills necessary to effectively interact with patients, peers, and others
  • Promoting professional ideals and adherence to ethical principles
  • Preparing future Pediatric Urologists to effectively interact in an increasingly complex health care system
  • Graduates will be expected to sit for the subspeciality exam in Pediatric Urology, this requires the successful completion of a two year ACGME approved Pediatric Urology fellowship


Specific Goals and Objectives — Year 1


Goals

The first year of the program is ACGME approved and spent entirely involved in clinical care. The aim of this year is to prepare the resident for a career either in Academic or Private Practice in Pediatric Urology. We are concentrating on producing ethically and morally considerate doctors who have excellent clinical skills and experience in their chosen field.


Objectives

At the end of this clinical year, you should be able to:

  • Perform general and disease specific history and physical examinations.
  • Order appropriate radiological investigations and interpret them, in order to make an accurate clinical diagnosis
  • Decide on the most appropriate treatment management for the child, including the timing of and nature of surgical intervention
  • Counsel and educate parents and patients about their medical condition and the treatment options available
  • Appropriately take a consent from families and provide appropriate information to the patient
  • Understand the role of urodynamics and biofeedback
  • Perform competently the majority of Pediatric Urological procedures, including but not limited to:
    • Penile Surgery — Circumcision, Hypospadias and Epispadias
    • Groin Surgery — Hydroceles, Hernia, Orchiopexy, Varicocelectomy, Exploration for Torsion
    • Kidney Procedures — Pyeloplasty, Heminephrectomy, Nephrectomy
    • Ureteric Procedures — Ureteric anastomosis, Ureteric Reimplant
    • Bladder Procedures — Bladder Augmentation, Appendico-vesicostomy, Bladder diverticulum, Urachal excision
    • Laparoscopic and Robotic Procedures — Orchiopexy, Nephrectomy, Heminephrectomy, Pyeloplasties
    • Endoscopic Procedures — Cystoscopy , Ablation Posterior Urethral Valves, Excision Ureteroceles,Ureteroscopy
  • Manage patients with stone disease
  • Manage patients with oncological problems including: Wilms tumor, Rhadomyosarcoma and Testicluar tumors
  • Manage pre- and post-operative patients
  • Understand surgical complications and appropriately manage them
  • Critically review and evaluate newly presented and published research
  • Present at a National Meeting
  • Produce a manuscript for publication
  • Perform a departmental quality improvement project that may be combined with a research project
  • Accurately code Pediatric Urology work for reimbursement

 


Specific Goals and Objectives — Year 2


Goals

The second year of the residency is not approved by the ACGME, but it is required by the AUA who since 2008 has made a 2-year fellowship mandatory for taking the subspecialty exam. This second year will be mainly spent in research. The aim of this year is to introduce you to laboratory and clinically based research, under the careful guidance of the faculty. This will enable you to critically appraise published research and to design and complete research projects. It is also planned that the fellow will spend one day a week in clinical practice, where the fellow will be able to have more autonomy but will always have attending back up. The aim is to ease the transition from resident to independent physician.


Objectives

  • Design a specific laboratory based research project or clinical research project
  • Collect and correctly analyze data for a research presentation
  • Present using Power point at least one project at Grand Rounds
  • Present using Power point one project at a National Meeting.
  • Produce and submit a manuscript for publication in a peer-reviewed journal
  • Transition into an independent physician

 


Current Research


Clinical studies include:

  • Racial differences in care provided for infants born with prenatally detected hydronephrosis
  • Complications following commonly performed pediatric urology procedures
  • Transitional care for spina bifada patients into adulthood

Laboratory Studies include:

  • Effect of bladder obstruction on bladder development
  • Cross talk and sensitization of bladder and bowel neural pathways
  • Urine biomarkers for urinary obstruction

 


Pediatric Urology Team

The Pediatric Urology Team is a group of dedicated health care professionals who provide exceptional care for pediatric and adolescent paatients with urologic dysfunction. Please click on the names below to see their individual bios.



The Pediatric Urology team has a very full practice including general pediatric urology clinics, specialty clinics, surgical cases, teaching, and research. Click here to view a block schedule of the Pediatric Urology providers.


Fellows

2017-2019  Jonathan Walker, MD

2016-2018  Amanda Saltzman, MD

2015-2017  Alonso Carrasco Jr., MD

2014-2016  Brian T. Caldwell, MD

2013-2015  Erin C. Grantham, MD

2012-2014  David J. Chalmers, MD

2011-2013  Amy Hou, MD


How to apply to the Pediatric Urology Fellowship

Click here to access the Pediatric Urology Fellowship Universal Application Form. Applications are now being accepted for a fellowship beginning July 1, 2018 and should be e-mailed to the Program Director, Duncan Wilcox, at urology.urology@childrenscolorado.org.

Deadline for applications is March 1st 2017. One-day interviews will be scheduled on April 7th and 28th. Interested applicants are expected to register for the Pediatric Urology Fellowship Match through the American Urological Association. Our AUA Pediatric Fellowship Program Match Number is #00000611. 

AUA Pediatric Urology Fellowship Match Dates/Deadlines

   AUA Registration Open - November 2016

   Registration Deadline - May 19, 2017

   Rank List Deadline - June 6, 2017

   Match Results Released - June 26, 2017

Additional information on the match can be found on the AUA website.

If you need additional information or have questions regarding the Pediatric Urology Fellowship at the University of Colorado, please contact the Fellowship Coordinator, Melissa Gray at 720-777-6846.