Women's Pelvic Medicine
The Female Pelvic Medicine and Reconstructive Surgery Fellowship Program at UCSD - Kaiser Permanente, San Diego is a joint training program developed by Dr. Charles Nager at the University of California, San Diego and Dr. Karl Luber at Kaiser Permanente, San Diego in 2000. The educational objective is to train the next generation of leaders in urogynecology and reconstructive pelvic surgery. While there is a very strong clinical component to the fellowship, the focus is to prepare graduates for careers in academic medicine and teaching. The fellow will be welcome to participate in ongoing research, but he/she will also be encouraged to develop his/her own ideas and to plan, execute, analyze, and report on these subjects. Presentations are expected at the American Urogynecological Society meeting. The fellowship is accredited by the American Board of Obstetrics and Gynecology and the American Board of Urology. As such, the fellowship program length is 3 years for ob/gyn residency graduates, and 2 years for urology residency graduates.
Overview
The fellowship is jointly (50/50) shared and funded by UCSD and Kaiser Permanente, San Diego. This combined program takes advantage of the strengths of each institution and diversifies the educational experience and training of the fellow with broad exposure to several faculty members. It is expected that the fellow will spend approximately 50% of their clinical time at UCSD and 50% of their clinical time at Kaiser. The clinical experience will be approximately 50% ambulatory and 50% operative. The diverse faculty provide training in the full spectrum of incontinence and prolapse surgical procedures including open, vaginal, laparoscopic, and robotic approaches.
Faculty
Dr. Nager completed his residency in Ob/Gyn at UCSD in 1986 and then after a preceptorship in 1987 with Dr. Donald Ostergard became the Director of the UCSD Urogynecology Clinic. He completed a fellowship in urogynecology in 1997 at St. George's Hospital with Professor Stuart Stanton. He is director of the Division of Female Pelvic Medicine and Reconstructive Surgery in the UCSD Department of Reproductive Medicine (OB/Gyn).
Dr. Shawn Menefee completed a fellowship in urogynecology at Louisiana State University and was director of the Urogynecology Division at the Naval Medical Center, San Diego before joining Kaiser Permanente, San Diego.
Dr. Karl Luber completed a fellowship in urogynecology with Dr. Donald Ostergard at Long Beach Memorial Hospital and was the previous division director at Kaiser Permanente, San Diego.
Dr. Mimi Lukacz completed the three-year fellowship at UCSD/Kaiser in 6/2003 and joined Dr. Nager at UCSD at that time.
Dr. Michael Albo is a UCSD urologist who completed a Female Urology fellowship with Dr. Shlomo Raz at UCLA in 1994. He co-directs (with Dr. Nager) the UCSD Women's Pelvic Medicine Center.
Dr. Emily Whitcomb, completed the three year fellowship at UCSD/Kaiser in June of 2009 and joined Drs. Menefee and Luber at Kaiser Permanente, San Diego.
Other faculty include Sonia Ramamoorthy, MD (Colorectal Surgery, UCSD) and Dr. Lynn Weston (Colorectal Surgery, Kaiser).
Fellowship Rotation Schedules
There is one fellow in each year of training. Each year of training is divided into three (3), four (4) month long rotations. These rotations are:
- UCSD - a predominantly clinical rotation- 4 months- On this rotation there will be 2 days spent in the office, 2 days in the OR and 1 day of Research/Education. The fellow will be working with Drs. Nager, Lukacz, and Albo.
- Kaiser - a predominantly clinical rotation - 4 months - On this rotation there will be 2 days spent in the office, 2 days in the OR and 1 day of Research/Education. The fellows will be working with Drs. Menefee, Luber, Whitcomb and Kaiser laparoscopy faculty.
- Research and off -service rotations - ( 3 months research, 1 month off service elective) The elective rotations will be:
- Year 1 - UCSD Urology
- Year 2 - UCSD Colorectal Surgery
- Year 3 - Elective
Research
The fellow has up to 12.2 to 13.8 months of dedicated research time. Nine months come from 3 dedicated months each year and the additional 3.2 to 4.8 months come from the 2/3 to 1 clinical research day during each of their 8 clinical months each year (2/3 x 1/5 x 8 x 3 = 3.2 and 1/5 x 8 x 3 = 4.8).
Research interests and ongoing projects include:
- NIH funded -Urinary Incontinence Treatment Network (UITN)
- NIH funded - Pelvic Floor Disorders Network
- Epidemiology of Pelvic Floor Disorders
- Robotic surgery education
- Novel urodynamic technology
- Comparative surgical trials of the anterior compartment
Beginning in July of the Year 1, it is expected that the fellow will attend a 2-year course that meets every Wednesday from 4-6 pm. This Clinical Research Enhancement through Supplemental Training (CREST) course is a Masters level comprehensive program that covers the following courses over 24 months:
- Patient Oriented Research I
- Basic Epidemiology
- Health Services Research
- Basic Biostatistics
- Advanced Biostatistics
- Data Management and Informatics
- Patient-Oriented Research II
- Advanced Epidemiology
Education
In addition to the CREST course, other educational activities include:
UCSD Research Meeting - every Friday AM
Kaiser Patient Case Conference - weekly, Wed AM
Research meeting - weekly with research mentor
Urogyn chapter review - twice monthly - Comprehensive review chapter by chapter of our specialty using the selected textbooks
Urogynecology Seminars - Monthly- Formal lecture every month for 24 months on 24 topics essential to the specialty.
Journal Club every month - 1st Tuesday Evening
Wednesday afternoons also include departmental grand rounds, research meetings, and Morbidity and Mortality conferences at both institutions. The fellow will be expected to attend and participate in all relevant UCSD/Kaiser educational conferences.
Clinical Experience/Volume
UCSD Medical Center is a tertiary medical center at two sites: Hillcrest and Thornton (La Jolla). The Department of Reproductive Medicine (Ob/Gyn) performs >2000 deliveries each year and approximately 45 major gynecologic surgeries each month. It has a long tradition of affiliation with Kaiser Permanente, San Diego and the 5-resident/year residency is an integrated program. The Ob/Gyn residents spend 25% of their training time at Kaiser. The UCSD Department of Reproductive Medicine also has fellowships in Maternal-Fetal Medicine and Reproductive Endocrinology and Infertility.
Kaiser Permanente, San Diego serves 500,000 members in San Diego. The Urogynecology Division manages nearly all female incontinence and this division manages 200 urogynecology referrals each month and performs 300 surgeries each year.
Urodynamic Facilities
At present, the multiple sites offer urodynamic studies with Laborie equipment.
Imaging
The UCSD Department of Radiology and Reproductive Medicine are one of the few centers with expertise in 3-dimensional ultrasound and research opportunities are possible in this area.
Administrative issues
The goals and objectives of our fellowship include compliance with the special requirements for Female Pelvic Medicine and Reconstructive Surgery approved by the American Board of Obstetrics and Gynecology and the American Board of Urology.
Fellows are expected to participate in the faculty on-call and coverage rotations at UCSD and Kaiser. Typical on-call responsibilities at UCSD average one call night each month.
Salary
Salary is commensurate with the University of California pay scale for a PG5. At present, this is approximately $48,000.00 per year.
Application
Any graduate from a US or Canadian accredited residency program may apply. We participate in the National Residency Matching Program and all applicants must enroll in this program. Applications are accepted from April 1 - July 15 in the year prior to matriculation. Selected applicants will be offered interviews in August or September. Match lists are submitted in October. For further application inquiries, please contact urogyn@ucsd.edu.
Director: Charles W. Nager, MD, Department of Reproductive Medicine, UCSD
Associate Director: Shawn Menefee, MD, Department of Ob/Gyn, Kaiser Permanente, San Diego
Address all administrative inquiries to Dr. Nager's Administrative Assistant:
Ms. Angela Ribant
9350 Campus Point Drive
UCSD Women's Pelvic Medicine Center
Perlman Ambulatory Care Center, Suite 2A
Mail Code 0974
La Jolla, CA 92037- 0974