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Fellowship Programme

Curriculum for fellowship programme Urology – Subspeciality

1. Name of the subject : Minimally Invasive advanced urology & Laser (MIUL)
2. Goal : The mission of MIUL fellowship training and certification of advanced clinical training is to facilitate the development of academic and clinical excellence in Advanced endourology, Laser and minimally Invasive Surgery(Laparoscopy) as a subspeciality training programme. in urology
3. Qualification : The applicant must have completed a nationally approved and accredited residency program in urology
4. Duration of the programme : 18 months
5. Objectives 

a. Fellowship training is focused on development of advanced knowledge, experience and technical skills in Advanced endourologic procedures , Laser applications in urology and laparoscopic surgery.

b. Fellows shall also receive training in translational or basic science, as an underlying goal is the training of future academicians and potential local , national and international leaders in the specialty.

c. Introduce fellows to the approach to evaluate and research data relavent to the urological disorders

d. To uptodate the technical advances undergoing in the field of urology inturn help the advanced patient care

e. Develop expertise in advanced technology and patient care and medical knowledge base required to manage the following technological aspects of urology

Laser applications: Fellow will be updated with the approved laser technology to tackle the complex case scenario
Advanced Endourology: fellows will be trainine in the advanced procedures of day to day endourologiacl procedure with special emphasis on image guided procedures including ultrasound both abdominal and transabdominal(TRUS).

Laparoscopic procedures; emphasizes the need for training in lapaproscopy in urology which has been the boon for urological conditions for their early recovery

6. Course contents: consists of subspecialty training in minimally invasive procedures of the following.

a. Focus is on both pediatric and adult diseases for the above training

b. Urooncology ( cancer diseases of the Genitourinary system)

c. Prostate diseases

d. Urolithiasis (stones )

e. Other reconstructive diseases

f. Female urology

7. Curriculum shall include

Part – A: Advanced training in endourology and LASER applications
Upper tract : PCNL , Micro PCNL , RIRS ,ureteroscopic procedures , Innovative applications
Lower tract : Bipolar TURP, Laser VIU, Laser lithotripsy , TURBT , HoLEP, Laser fulguration procedures ,Other lower tract applications
Basic LASER application training : include practice on models/ endotrainer . Laser physics , Laser usage training , precautions
Exposure to various approved (EBM) LASERs : Holmium high power , Holmium low power , KTP lasers
Part – B: Advanced Laparoscopic training in urology

Advanced laparoscopic procedure training in Endotrainer

Uppertract lapaproscopic procedures ; Radical nephrectomy , Partial nephrectomy ,Pyeloplasty, Donor nephrectomy , ureteral procedures etc Lower tract laparoscopic procedures: Radical cystectomy, partial cystectomy, seminal vesiculectomy, Radical prostatectomy, Ureteric reimplant, Sacrocalposuspension, Bursch calposuspension, Laparoscopic assisted other continence procedures

Lower tract laparoscopic procedures: Radical cystectomy, partial cystectomy, seminal vesiculectomy, Radical prostatectomy, Ureteric reimplant, Sacrocalposuspension, Bursch calposuspension, Laparoscopic assisted other continence procedures

Part – C: Fellow will be given the opportunity to undertake Research activities and to actively involve in scientific research paper Publications.

The fellow must be an author of at least 2 peer reviewed articles generated during the fellowship and first author of at least one of these

Part – D : Training in Imaging and labaroratory ;

Ultrasound imaging and interventional procedures of the kidney, Transrectal ultrasound and its diagnostic and therapeutic applications . Special training in MRI and CT scan , Doppler in associatin with radiologywill be planned . urodynamic lab applications are provided

Part – E : Teaching and learning activities

Teaching clinical bed side rounds

Out patient training with bedside ultrasound applications

Weekly journal clubs

Bimonthly seminars covering all the sub speciality areas

Bimonthly – Uro Pathology , Uro Radiology and Tumor board meetings

Supervised surgical training in advanced endourology, laser and laparoscopy

8. Log book :

Every fellowship candidate shall maintain a record of the various procedures done / assisted during the training programme. Fellows are encouraged to record the interesting cases encountered during the period of training. Log books of the trainees are certified prior to examination by the faculty.

9. Dissertation /project work : Topics selected from Endourology , laser and lapaproscopic work must be submitted prior to qualification for the fellowship
10. Graduating fellows must submit an academic portfolio of works produced during their 18 months of training including manuscripts, chapters, videos, lectures, poster presentations and abstracts (to national and international meetings) to the Office/ university.
11. Fellowship requirements :

Fellows must actively participate in at least the following number of operationsduring the 2 year course of training: 30 RIRS retrograde ureteroscopic – ureterorenoscopic cases, 20 percutaneous renal cases, 20 HoLEP procedures , 10 Laser VIU , 100 cases pertaining to laser applications. 20 Advanced laparoscopic procedures

Image-guided procedures, including percutaneous procedures and TRUS guided procedures are encouraged.

The fellow must participate in basic science/translational research for a minimum of 12 months or receive an advanced degree as previously described during the 18 month period of training. The 12-month research time can be non-consecutive but a 6 month minimal block is strongly encouraged.

Laser applications (basic science of and competence in performing treatment) must be part of the educational curriculum for endourology fellows.

The fellow must be an author of at least 2 peer reviewed articles generated during the fellowship and first author of at least one of these.

Graduating fellows must submit an academic portfolio of works produced during their 2 years of training including manuscripts, chapters, videos, lectures, poster presentations and abstracts (to national and international meetings) to the office of the fellowship director / University .

12. Evaluation :

Each program must be subjected to external peer review by the Fellowship Review Committee. This external review should occur every five years and will ensure that all of the essential elements of the fellowship are available and adhered to by the trainee, the trainer and the host institution

13. Match Process :

It is each respective program’s responsibility to determine whether a candidate has proper credentials to be a fellow at their respective institution. If they do not have proper credentials, the program should not list the candidate on their match list. If a candidate matches with a program, the program is obligated to provide training unless the candidate provided false information regarding their credentials. If the program refuses to train a matched applicant, they will lose their accreditation. They may re-apply for fellowship accreditation 3 years later. If the candidate does not accurately disclose credentials, the matching program is not obligated to provide fellowship training. In addition, the individual will be banned from participating in the Advanced endourology (MIUL) match process.

14. Remedial action s/ Probation:

A program may be placed on probation for 1(one) year if the minimum number of index cases is not performed, if the academic productivity (minimum number of publications and fellowship essay) is inadequate, if validated case logs are not submitted, if the program director is delinquent in the aforementioned responsibilities/qualifications, if deficiencies identified in the program on the evaluation forms are not corrected or if significant deficiencies are found at the time of the 5 year review of the program.

Final examination/ Fellowship qualifying crieteria

Completeion of the log book

1.Completeion of the project work/ dissertation /minimum 10 interesting cases work book

2. Peer Reviewed publications in the field considered for fellowship

3. The program director(s) must submit a letter of endorsement regarding the fellow’s progress and successful completion of their training program