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Andrology Fellowship Program

Andrology Fellowship Program Description

   A. Program D emographics

  • Name of Host Institution:  Tulane University School of Medicine
  • Specialty/Subspecialty:  Urology/ Andrology
  • Address (Mailing):  1430 Tulane Avenue, #8642, New Orleans, LA 70112
  • Address (Physical location, if different from mailing):  n/a
  • Phone Number:  (504) 988-2794
  • Fax Number:  (504) 988-5059
  • Program Director:  Dr. Wayne J. G. Hellstrom
  • Program Coordinator:  Stefanie de Abreu
  • Program Email:  sdeabreu@tulane.edu

B.   Introduction

  • History:  The program has been in existence for over ten years.
  • Duration: The training program is a one-year duration with an additional month of patient care continuity transitional period.  There is an option to stay an additional year.  The second year is at the discretion of the Program Director and is based on the progression and aptitude of the fellow, which includes advanced andrology and sexual medicine training.
  • Prerequisite Training/Selection Criteria:

          a. Successful completion of Medical School.

          b. Successful completion of a Surgery Internship and Urology Residency.

          c. Demonstrated proof of United States citizenship or appropriate visa status.

             d. Ability to obtain medical licensure from the Louisiana State Board of Medical Examiners.

             e. Ability to conduct clinical and basic science research which results in a minimum of three major publications within

                the first year of fellowship training.

  • Goals and Objectives for Training:  The goals and objectives for the fellow includes extensive experience with penile prosthesis surgery, artificial urinary sphincters, sling procedures, and reconstructive surgeries. In addition, the fellow is expected to undertake both basic and clinical research with presentations and publications at the local, regional, national, and international level. In addition, the fellow is encouraged to become familiar with the clinical and research grant process, develop alliances with the medical industry, and serve on academic committees related to andrology and men’s sexual health. As per our record here at the Andrology section of Tulane University Medical Center, we have demonstrated excellent productivity, with the majority of previous fellows entering academic positions both in the United States and abroad.
  • Program Certifications: n/a

C. Resources

  • Teaching Staff:  Dr. Wayne J.G. Hellstrom
  • Facilities: Tulane University School of Medicine; Tulane Medical Center

D. Educational Program (Basic Curriculum)

Elements of the training program:

  • Clinical and research components: Case mix is 60% prosthetics, Peyronie's and reconstruction, 25% male infertility (microsurgery – vasovasostomy, vasoepididymostomy, MESA, TESE, varicocele and 15% urethral stricture disease & general urology TURP, Hydrocele, etc. During the week, the fellow spends about 70% clinical & 30% academic research.  The fellow is expected to do academic work (review papers, write & publish manuscripts, perform animal and basic science research (Two PhDs in our department), and work with residents, medical students, and other researchers in the medical school.

The fellow co-runs three clinics and operates with Dr. Wayne Hellstrom 2 ½ days per week.

Monday:  

OR:                              7 am - 1 pm

Clinic:                          1 pm- 6 pm          

 

Tuesday: 

Clinic:                          8 am - 2 pm

Academic:                    1 pm - 6 pm

Journal Club:                6 pm - 7 pm

 

Wednesday:  

Pre-Op:                         6:30 am - 8 am

Clinic:                          8 am - 2 pm

VA Clinic:                    1 pm -  5 pm

Imaging Conference:   6 pm - 7 pm

 

Thursday:

OR:                       7 am -  3 pm

Academic:                    3 pm -  6 pm

 

Friday: 

OR:                         8 am -  3 pm

Academic:                  3 pm -  6 pm

The fellow does 1 in 6 calls with faculty.  The fellow covers Tulane Medical Center, Tulane-Lakeside Hospital, University Medical Center New Orleans (Formerly Charity), & Southeast Louisiana Veterans Health Care System New Orleans.

  • Trainee’s supervisory and patient care responsibilities: The fellow participates in all resident (lower level trainee) teaching sessions.  In addition, the fellow will be responsible for patient care as a clinical fellow, including management of patients in the clinic and preoperatively under the supervision of the Program Director.
  • Clinical procedural requirements: The Tulane Urology Andrology Fellowship Program specializes in training and mentoring academic urologists in the diagnosis and treatment of sexual dysfunction including Peyronie's disease, surgical and vascular reconstruction, prosthetic surgery, male infertility (both surgical and medical therapies),  BPH, and urethral stricture disease.
  • Didactic sessions and teaching methods used to ensure program goals and objectives are met:  Patient care and the didactic related educational experience are the highlights.  The fellow is encouraged to participate actively in the resident/fellow didactic conference, urology teaching and research conference. These conferences are held weekly with required attendance by the fellow.
  • The progression in responsibilities by PGY level, if more than twelve months in duration: The Andrology Fellowship Program is designed to enhance expertise in medical and surgical management of male sexual, endocrine, and reproductive health acquired by a urology trainee, particularly in the nonsurgical disciplines. As a department,  we strive to train physicians who are not only superior clinical care providers but also active  strive to train physicians who are not only superior clinical care providers but also active researchers pursuing initiatives to help advance men’s health for the growing and aging male population.researchers pursuing initiatives to help advance men’s health for the growing and aging male population.  By program completion, the fellow will have the expertise needed to provide comprehensive, contemporary subspecialty care as well as organize a multidisciplinary approach to male sexual dysfunction, endocrine dysfunction, and male infertility care.  Our goal is to train physicians who will not only be leaders in the field of andrology but also more broadly in urology.

(PGY-VII)

The first twelve months focus on the development of clinical excellence in all aspects of male fertility management and basic science techniques in andrology.  The clinical fellow will spend the majority of his/her time in the clinic and in the operation room, evaluating and managing patients with infertility problems.  

The first twelve months of training will consist of basic diagnostic and therapeutic management of sexual disorders which include the following:

Percutaneous epididymal sperm aspiration (PESA), testicular biopsy, testicular sperm extraction (TESE), transrectal ultrasound (TRUS) of the prostate and seminal vesicle aspiration, vasectomy, duplex Doppler penile ultrasound, testosterone pellet insertion, intracavernosal injections, intralesional injections (collagenase and interferon), penile deformity assessment, dorsal slit; circumcision; excision of tumor/cyst; biopsy; partial amputation and complete penile amputation; insert non-inflatable, semi-rigid prosthesis; insertion of inflatable, three-piece prosthesis; insertion of inflatable, triple-unit prosthesis; excision of fibrotic corpora; chordelysis; repair injury; and all aspects of Peyronie's disease.

(13 months) is an additional month of patient care continuity transitional period.

(PGY-VIII)

Once the fellow has proven that he/she has attained cognitive and technical skills necessary to be competent for the independent practice of sexual medicine, a second year may be offered at the discretion of the Program Director.  A fellow completing this program will have the expertise needed to investigate and treat all aspects of male infertility and the ability to critically appraise research and literature related to this urologic surgery subspecialty.  

The second twelve months of training will consist of advanced diagnostic and therapeutic management of sexual disorders which include the following:  

Micro-TESE, microsurgical vasectomy reversal, vasectomy, microsurgical varicocelectomy, transurethral resection of the ejaculatory duct (TURED), orchiectomy, orchiopexy, hydrocelectomy, spermatocelectomy, penile fracture repair, plaque incision/excision and grafting, penile prosthesis insertion, penile plication, and priapism shunting comprise the core andrology cases.

In special circumstances involving a fellow who has achieved postresidency clinical and surgical proficiencies, a modified training program may be designed and customized at the discretion of the Program Director. 

E.   Supervision and Evaluation

  • In addition to participating in safe, effective, and compassionate patient care under supervision, the fellow is expected to develop a personal program of self-study and professional growth under the general supervision of appropriately credentialed attending teaching staff commensurate with the level of advancement and responsibility.  Supervision will be constant throughout the training program.
  • We have a semiannual evaluation process to provide feedback to the fellow in the following categories: Medical Knowledge, Patient Care, Practice-Based Learning & Improvement, Professionalism, and Systems-based Practice.  Additionally, evaluations are performed on an “as-needed” basis with prompt feedback.