MD Fellowship Programs: We have two programs Accredited by the American Board of Obstetrics and Gynecology for training MD fellows interested in pursuing Academic Careers after completing an approved Residency Program.

• Fellowship Training Program in Maternal - Fetal Medicine: Program Director is Dr. Thomas Moore. The Maternal-Fetal Medicine Fellowship Training Program focuses on providing State-of-the-Art care for High Risk pregnancy and has a strong emphasis on training in basic science and clinical research.
  
  The Maternal-Fetal Medicine Fellowship Program at University of California, San Diego, School of Medicine is approved for three fellows in any three-year cycle. This fellowship provides a broad base in the practice of Maternal-Fetal Medicine, incorporating both clinical and basic science elements, and is focused on preparing graduates for careers in academic medicine.
  
  Training of fellows is centered at UCSD Medical Center, with a delivery rate of approximately 260 per month, of which 50-60% are high-risk, encompassing a wide range of complex obstetrical problems. UCSD Medical Center has an outstanding Neonatal Intensive Care Unit adjacent to the delivery unit. Additional training sites include perinatal consultation at Mercy Hospital (approximately 260 deliveries per month) and Scripps Memorial Hospital (approximately 270 deliveries a month). All of the latter hospitals have level II+ nurseries with neonatologists and our Maternal-Fetal Medicine specialists on site.
  
  An especially strong aspect of our training program is the Center for Fetal Diagnosis and Treatment, a multidisciplinary center receiving referral patients from throughout San Diego County and the Pacific Rim, sited on our academic campus in La Jolla. This center is staffed with geneticists, our own Maternal-Fetal Medicine faculty, and dedicated fetal sonographers. Affiliated with the center are specialists in the disciplines of pediatric urology, neurosurgery, nephrology, teratology, and perinatal pathology. A number of active research protocols are being pursued in the center as well as on our clinical service, including regulation of human amniotic fluid volume, prevention of gestational diabetes, use of 3-D ultrasound, prenatal diagnosis, and ultrasound markers of fetal aneuploidy. Research efforts are directed by Drs. Thomas Moore, Thomas Kelly, Dolores Pretorius, Robert Resnik, Angela Scioscia, Andrew Hull, and David Schrimmer.
  
  Basic science research in our Fetal Physiology Laboratory is a major focus for those of our fellows interested in bench-or animal-based perinatal investigation. Under the leadership of Robert Brace, Ph.D., Cecilia Cheung, Ph.D., Lubjica Bogic, Ph.D., Dongbao Chen, Ph.D., and Douglas Woelkers, M.D., we are currently actively pursuing topics related to amniotic fluid dynamics, fetal blood volume and renal physiology, endocrine factors responsible for fetal cardiovascular homeostasis, and molecular mechanisms underlying premature membrane rupture and preeclampsia.
  
  The structure of research and clinical service activities of our fellows is flexibly determined according to the needs and desires of the individual fellow. Ordinarily, our fellows spend at least 50% of their time in protected clinical or basic science research and the remainder in diagnostic ultrasound, perinatal consultation, and intensive inpatient management of complicated pregnancy. Fellows function on our service at the Attending Physician level and thus are also responsible for an appropriate proportion of resident and medical student teaching. During fellowship, fellows typically publish 2-6 manuscripts and present regularly at Society for Maternal-Fetal Medicine and Society for Gynecologic Investigation meetings. A list of our recent fellows and the academic programs to which they have been recruited following completion of fellowship follows.
  
  If you think our fellowship program will assist you in your career goals, please send your curriculum vitae (attached photograph is optional) and personal statement, and arrange for three letters of recommendation, including one from the Chair of your department. All correspondence should be sent to:
  
  

  Thomas R. Moore, M.D.
  Maternal-Fetal Medicine Fellowship
  UCSD Medical Center
  200 W. Arbor Drive
  San Diego, CA 92103-8433

  The UCSD Maternal-Fetal Medicine Fellowship Training Program participates in the National Resident Matching Program. You must also call or write the NRMP for application. Your file should be complete with us by August 15 of the year preceding your fellowship. Interviews will be scheduled from March 1 through mid-September. If you would like to discuss the fellowship with Dr. Moore personally, please feel free to call him at (619) 543-7900.
  
  

  RECENT PROGRAM GRADUATES MATERNAL-FETAL MEDICINE
  Year	Fellow	Recruited to
  2002	Sean S. Daneshmand, M.D.	Private Practice, California
  2002	Matthew J. Kim, M.D.	Private Practice, Chicago
  2001	-------
  2000	Larry C. Matsumoto, M.D	Private Practice, Texas
  2000	Richard B. Wolf, D.O.	Returned to Naval Hospital, San Diego
  1998	Andy Hull, M.D.	University of California, San Diego
  1998	Bryan Sohl, M.D.	Private Practice, Oregon
  1997	Donald Roberts, M.D.	University of Nevada, Las Vegas
  1996	Elizabeth Tipton,	Naval Hospital, San Diego
  1996	Andrée Gruslin-Giroux, MD	University of Ottawa
  1995	Virgil L. Graham, M.D.	University of Wisconsin, Madison
  1994	Herman L. Hedriana, M.D.	University of California, Davis
  1993	Donna D. Johnson, M.D.	University of South Carolina
  1993	Laurence E. Shields, M.D.	University of Washington, Seattle
  1992	Martin P.R. Walker, M.D.	University of British Columbia
  1992	Thomas F. Kelly, M.D.	University of California, San Diego
  1991	Oliver W. Jones III, M.D.	University of Colorado, Denver
  1990	Robert L. Andres, M.D.	University of Texas, Houston
  1990	Kathleen M. Piacquadio, M.D.	Naval Hospital, San Diego

REPRODUCTIVE ENDOCRINOLOGY TRAINING PROGRAM

DIVISION OF REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY
DEPARTMENT OF REPRODUCTIVE MEDICINE
UNIVERSITY OF CALIFORNIA, SAN DIEGO

1. FACULTY

A. Full-Time Faculty

The clinical and research activities of the Division of Reproductive Endocrinology and Infertility are conducted by faculty members composed of basic scientists, clinicians, and clinical investigators. This cohesive group of faculty members provides a conducive academic environment to pursue high quality and contemporary training. The faculty preceptors and their expertise are listed below:

• R. JEFFREY CHANG, M.D. - Professor and Director of the Division of Reproductive Endocrinology and Infertility.
  Reproductive metabolic processes in ovarian disorders.

• GREGORY ERICKSON, Ph.D. - Professor of Reproductive Medicine.
  Role of the oocyte in ovary physiology and pathophysiology

• PAMELA MELLON, Ph.D. - Professor of Reproductive Medicine and Neurosciences, Director of the NICHD Center for the study of Reproductive Biology and Disease and the NIH Training Program in Reproductive Sciences.
  Molecular mechanisms in the neuroendocrine regulation of mammalian reproduction.

• SAMUEL S.C. YEN, M.D., D.Sc. - W.R. Persons Professor Emeritus in Reproductive Medicine.
  Neuroendocrine-metabolic regulation of the human menstrual cycle and its disorders.

• SHUNICHI SHIMASAHI, Ph.D. - Professor of Reproductive Medicine.
  Molecular mechanism of growth factor control in folliculogenesis.

• MARK LAWSON, Ph.D.

B. Clinical Faculty

   Reproductive Partners - UCSD Regional Fertility Center

• DAVID MEDLRUM, M.D. - Center for Advanced Reproductive Care

• GABRIEL GARZO, M.D. - Center for Advanced Reproductive Care

• LARRY LAUFER, M.D. - Naval Medical Center San Diego

• RONALD REINSCH, M.D.

• LI-SHEI LIN, M.D. - Kaiser Permanente San Diego
  

2. THE PROGRAM

This fellowship training program is designed to qualify individuals for the subspecialty board in reproductive endocrinology. The goal of this training program is to provide fellows with a balance of training between clinical and research activities and to prepare them for an academic career with a solid foundation for leadership in reproductive endocrinology. To meet the demands of the rapid advancement of molecular and cellular components of the reproductive system, the duration of your training program is extended from two to three years.

A. Clinical Training

• Fellows actively participate in the evaluation, management, and follow-up of patient care with special emphasis toward the comprehensive understanding of reproductive disorders and infertility processes. Acquisition of knowledge and techniques in Assisted Reproductive Technologies (ART, by rotation at noted institutions), endoscopy, and microsurgery are integrated segments of our training program. Although clinical activities are continued throughout our three year training program, fellows are involved in specific rotations during their first year. Diverse reproductive disorders are managed by the faculty with increasing responsibility by the fellows. Fellows are expected to be highly versed with policies and procedures of the Clinical Research Center in order to delineate the pathophysiology of complex clinical problems.

Clinics: Throughout the year fellows will participate in the evaluation and management of patients with reproductive disorders under the supervision of the full-time clinical faculty within the Division of Reproductive Endocrinology. During one three month interval they attend medical endocrine and pediatric endocrine clinics once a week. They will also receive training in andcology and male infertility once a week for four months. Fellows will have their own clinic, which will allow them to follow through the evaluation, treatment and the final outcome of their patients.

Surgery: Under the supervision of clinical faculty fellows are responsible for a variety of surgical procedures and related patient care activities. They will be involved in the surgical management of patients which are seen during the course of the year with full-time clinical faculty as well as those seen in their own clinic. During a six months interval fellows will attend and participate in the surgical management of patients seen at the Kaiser Reproductive Endocrinology and Infertility Clinics and at the Naval Medical Center San Diego.

Assisted Reproductive Technology: Fellows will receive training in the specialized field of ART at the Reproductive Partners- UCSD Regional Fertility Center for four months.  They will be supervised by clinical faculty in learning the principles of gamete physiology and acquiring the techniques of a variety of procedures including IVF, GIFT, and current micromanipulative methodologies.

B. Research Training

The research component of our training program offers a range of projects with faculty expertise represented in ovarian molecular and cellular biology, gene regulation and expression, endocrine-metabolic regulation, neuroendocrine control mechanisms and biostatistics. Ethics in research and attendance of School of Medicine courses is emphasized. Our research training program is integrated with the activities of the specialized Population Research Center funded by NICHD. Functioning in a coordinated fashion and with direct participation by the fellows, our training program offers diverse research opportunities; examples:

• Characterization and regulation of hormone gene expression

• Physiology, pharmacodynamics and clinical applications of hypothalamic peptide hormones including synthetic analogues.

• Interrelationship between GnRH, opioidergic and catecholominergic neurons and their modulation by sex steroids, inhibin, activin and follistatin as well as other growth factors.

• Cellular and molecular mechanisms in the regulation of follicular growth and differentiation.

• The role of neuropeptides, growth factors, and inhibin related peptides in intragonadal regulation.

• The use of transgenic mouse models to uncover molecular mechanisms in GnRH and gonadotropin subunit biosynthesis, expression and regulation.

• Neuroendocrine-metabolic control of the human menstrual cycle and its disorders.

• Delineation of pathophysiology of chronic anovulation.

• Ovarian physiology, senescence and menopause.

These research areas as well as others are targeted for an integrated analysis of hypothalamic-pituitary-gonadal-endometrial interactions during puberty, the menstrual cycle, and menopause in rodent models as well as in humans. Clinical disorders will be investigated to answer specific questions. The research component of this program includes classroom teaching, discussion groups, a journal club, seminars, laboratory training in both in vitro and in vivo techniques, molecular biology, and clinical investigation. Emphasis is placed on the fundamental design and execution of experiments, methodology, and analysis of data. Our aim is to prepare the physician-scientist with expertise in broad areas of basic and clinical reproductive processes and disorders.

• Grant Writing: all fellows are required to prepare a grant proposal at the end of 1st year, and to apply for one of the various fellowships for young investigators in reproductive sciences. This experience is crucial for their future development and to become independent investigators.

C. Course Work

Fellows have the opportunity to participate in undergraduate and/or graduate courses to remedy background deficiencies and to acquire skills important to their career goals. A variety of courses relevant to human reproduction are available at the UCSD School of Medicine as well as the General Campus. The required courses set forth by the American Board of Obstetrics and Gynecology in the subspecialty area of Reproductive Endocrinology must be fulfilled. Among them are Biostatistics, Molecular Biology, Molecular and Cellular Neurobiology, Molecular and Cellular Neuroendocrinology, Neuroscience, Pharmacology and Physiology.

D. Research Protocol Preparation

During the first six months of our program, each fellow is expected to develop hypothesis and to focus on a selective area of research under the guidance of the faculty. Fellows are required to prepare a full research protocol to include a critical review of pertinent literature, a statement of the problem and its significance, formulate hypothesis and the design of the experiment combined with a description of the various methodology and procedures to be employed.

3. OTHER ACTIVITIES

Fellows are encouraged to attend the Reproductive Medicine Departmental Grand Rounds scheduled on Wednesday afternoons as well as seminars and conferences provided by other departments and institutions (i.e. Department of Medicine, Neuroscience, Biology, Salk Institute). Also, night call rotation in obstetrics and gynecology and coverage as faculty for the residents in primary care clinic.

4. POSTDOCTORAL FELLOWSHIP APPLICATION REQUIREMENTS

Applicants who have completed their residency training in obstetrics and gynecology are eligible to apply. Prior approval by the American Board of Obstetrics and Gynecology, Subspecialty Division of Reproductive Endocrinology is required.

A. A letter from the candidate outlining his/her past academic and/or clinical experiences, a statement of his/her long term career goal(s) as well as current interests as related to the training he/she hopes to obtain.

B. A curriculum vitae, including a bibliography.

C. Two letters of recommendation to be sent directly to:

If you need further explanation contact Sandra Stanton, coordinator Fellowship Training Program at (858) 534-8930, Fax (858) 534,8856, or e-mail sstanton@ucsd.edu.