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Andrology

McGill Infertility/Andrology Fellowship

  • Length: 2 years
    Number of positions: 1
    Fellowship Director: Dr. Armand Zini

GUIDELINES AND OBJECTIVES

The Andrology fellowship at the McGill University Health Centre (Division of Urology) is offered as two-year fellowship. The fellows will work under the direct supervision of fellowship-trained Andrology experts: Drs. Armand Zini, Peter Chan and Serge Carrier. The fellowship is designed to teach the urologist the necessary clinical and surgical skills to effectively manage male infertility.

The Andrology fellowship is not designed to train the urologist in sexual medicine. The fellows may also spend up to three months working with female infertility specialists to gain some understanding of the clinical evaluation of the infertile woman and the techniques of assisted reproduction.

 The fellows will need to meet specific learning and research objectives and will be given clinical responsibilities.

LEARNING OBJECTIVES:
To meet these objectives, fellows will attend all andrology clinics, participate in regular andrology rounds (with presentation of clinical and basic science topics in andrology) and will be given a list of suggested reading material. Specific areas to be covered will include:

 1) Biology of reproduction. Fellows are expected to learn the basic aspects of:
 Spermatogenesis Hormonal control of germ cell development and steroidogenesis.  Sperm biology Basic female reproductive biology and fertilization.

 2) Clinical evaluation and management of male infertility
Fellows are expected to learn how to appropriately evaluate and manage infertile couples. Anunderstanding of the treatment algorithm (including the application of assisted reproduction) is during the fellowship.

 3) Surgical aspects of andrology
Fellows are expected to develop the basic surgical skills (with emphasis on microsurgical skills) to perform microsurgical varicocelectomy, microsurgical vasectomy reversal (including vaso-epididymostomy) and various techniques of sperm retrieval (including percutaneous sperm retrieval and microdissection testicular sperm extraction).

RESEARCH and ACADEMIC OBJECTIVES:
Fellows are responsible for undertaking a minimum of two research (clinical and/or basic) projects under the supervision of Drs. Zini, Chan and/or Carrier. These projects will be submitted for presentation and publication. Fellows will also be given the opportunity to write book chapters in selected topics in Andrology.

Clinical and basic research interests at McGill include varicoceles, vasectomy reversal, sperm

function evaluation (including sperm DNA integrity, semen oxidants) and genetics of infertility.

Fellows are required to attend weekly research rounds at the research laboratory of Dr. Armand Zini.

This will expose the fellows to the scientific thought process used in the development of basic and clinical research projects. 

CLINICAL AND TEACHING RESPONSIBILITIES:
Fellows are responsible for attending all male infertility clinics (with Drs. Zini, Chan and/or Carrier).  Fellows will also be responsible for assisting during male infertility-specific surgeries (this responsibility will be shared 50:50 with the rotating urology resident). It is expected that during a 3-month block, any given urology resident rotating with one of the Andrology fellowship supervisors will be assisting on 6 - 10 Andrology surgical cases (the fellow will be assisting on a similar number of cases [6-10] during the same period). Exceptionally, the fellow will given priority for some of the more complex cases (specifically, vaso-epididymostomy).

 For all other surgical procedures (i.e. non-andrology), the rotating resident(s) will be given priority.

 Fellows will also assist in the teaching of residents and students.

 Fellows will be asked to share the “on call” duties with the McGill Urology residents. The “on call” frequency will be in accordance with the FMRQ guidelines (www.fmrq.qc.ca).

ELIGIBILITY:
Candidates for the fellowship must be graduates of a recognized Medical School and must have completed their urology residency at a recognized University.  Candidates need to be fluent in English and/or French.

FUNDING:
Candidates should secure their own funding for the duration of the fellowship. Candidates are encouraged to apply (with the assistance of one or more of the co-supervisors) for external funding through an established agency (e.g. FRSQ, Kidney foundation, CIHR, AFUD).

Candidates enrolled in a 2-year research fellowship may also apply for funding through the Surgical Scientist Program at McGill University. For more information regarding the amount and acceptable sources of funding please visit the link at http://www.medicine.mcgill.ca/postgrad/admission_fellowships.htm

McGill Sexual Medicine/Genitourinary Reconstructive Urology Fellowship

  • Length: 1 year
    Number of positions: 1
    Fellowship Directors: Dr. Serge Carrier and Dr. Alex Brzezinski

 GUIDELINES AND OBJECTIVES

The Sexual Medicine/Genitourinary Reconstructive Urology (SMRU) fellowship at the Jewish General Hospital and McGill University Health Centre (Division of Urology) is a one year clinical fellowship. The fellows will work under the direct supervision of fellowship-trained experts: Drs Serge Carrier and Alex Brzezinski. The fellowship is designed to teach the urologist the necessary clinical and surgical skills to effectively manage sexual dysfunction (SD) and complex reconstructive genital, penile and urethral surgery.

The fellows will need to meet specific learning and research objectives and will be given clinical responsibilities.

Learning Objectives:
To meet these objectives, fellows will attend all (SMRU) clinics, participate in monthly andrology rounds (with presentation of clinical and basic science topics in andrology) and will be given a list of suggested reading material. Specific areas to be covered will include:

1) Genitourinary Reconstructive Urology

Biology of urethral healing and principle of urethral surgery
The fellow will obtain a clear view on the current role of surgery for the management of urethral stenosis affecting both the anterior and posterior urethra in contemporary clinical practice.

 At the end of the fellowship, the fellow should:

  • Be able to fully evaluate the patient with urethral stricture disease
  • Be familiar with most of the current surgical techniques for the repair of urethral stricture
  • Management of Urethral Stricture Disease including urethroplasty and substitution urethroplasty using grafts and flaps (both local flaps as well as extra-genital flaps)
  • Have reviewed the treatments available for urethral stricture disease
  • Have a clearer understanding of the role of anastomotic and substitution urethroplasty in the management of urethral stricture disease
  • Have understood the harvesting of tissues used for urethroplasty: oral mucosa, genital and extragenital skin
  • Be able to outline the principles of the surgical management of traumatic urethral strictures
  • Familiarize with protocols and guidelines for the postoperative period and follow-up

 2) Sexual Medicine & Prosthesis Surgery
The fellow will obtain a clear view on the current evaluation and medical as well as surgical management of Sexual Dysfunction in contemporary clinical practice.

Physiology of Erection and Sexual Function

Fellows are expected to learn the basic aspects of:

  • Neuro-anatomy of the penis
  • Pharmacology of erection
  • Physiology of the Pituitary-Gonadal axis
  • Physiology of the Sexual Function (Sensation, Ejaculation)

 Clinical Evaluation and Management of Male Sexual Dysfunction
Fellows are expected to learn how to appropriately evaluate and manage men with SD. This will include evaluation by penile Duplex ultrasound. An understanding of the basic and extended evaluation and of the treatment algorithm is expected. Fellows will give formal presentations on various clinical topics during the fellowship. 

Surgical Aspects of Sexual Medicine
The fellow will acquire the skills necessary for the surgical management of Erectile Dysfunction and Peyronie’s Disease as well as the use of prosthesis in GU surgery. Fellows will also become familiar with penile prosthetic surgery (including revisions) and surgical correction of penile curvatures. Types of surgery that the fellow will become familiar:

  • Inflatable penile prosthesis (with or without modeling)
  • Malleable penile prosthesis
  • Revision of Penile surgery and/or Prosthesis
  • Penile plication for Peyronie’s disease
  • Penile plaque excision and grafting for Peyronie’s disease
  • Reduction scrotoplasty
  • Glanuloplasty
  • Shunts for priapism
  • Testicular prosthesis
  • Urethroplasty
  • Complex penile/scrotal wound closure

Research Objectives:
Fellows are responsible for undertaking clinical projects under the supervision of Drs. Carrier and/or Brzezinski. These projects will be submitted for presentation and publication.

Clinical and Teaching Responsibilities:
Fellows are responsible for attending all SD and reconstructive clinics (with Drs. Brzezinski and Carrier). Fellows will also be responsible for assisting during specific surgeries. (these responsibilities will be shared 50:50 with the rotating urology resident).  For all surgical procedures, the rotating resident(s) will be given Priority for category 1 surgery according the Royal College of Canada. Fellows will also assist in the teaching of residents and students.

Eligibility:
Candidates for the fellowship must be graduates of a recognized Medical School and must have completed their urology residency at a recognized University. Candidates need to be fluent in English and/or French.

Funding:
Candidates should secure their own funding for the duration of the fellowship. Candidates are encouraged to apply (with the assistance of one or more of the co-supervisors) for external funding through an establish agency (e.g. FRSQ, Kidney Foundation, CIHR, AFUD).

Names of the Teaching Faculty:
Dr Serge Carrier is a fellow trained in Sexual Medicine and an expert in his field.

Dr Alex Brzezinski is a fellow trained in reconstructive urology and an expert in his field.