Female Pelvic Medicine and Reconstructive Surgery Fellowship

Program Director: Emily Lukacz, MD, MAS

Associate Director: Keisha Dyer, MD

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 both ob/gyn and urology residency graduates.

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

UCSD

  • Charles Nager, MD - 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).
  • Emily Lukacz, MD - completed the three-year fellowship at UCSD/Kaiser in June of 2003 and joined Drs. Nager and Albo at UCSD's Women's Pelvic Medicine Center at that time. She has extensive experience in clinical research and completed a Masters in Advanced Studies of Clinical Research at UCSD. Dr. Lukacz took on the role of director for the Female Pelvic Medicine & Reconstructive Surgery Fellowship Program in 2010 and is also the Division Chief.
  • Michael Albo, MD - 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 and serves as Vice Chief of the Department of Urology.
  • Marianna Alperin, MD, MS – completed a fellowship at University of Pittsburg, Magee-Women's Hospital. She joined the division in July 2017.
  • Yahir Santiago-Lastra, MD – is a UCSD urologist who completed a fellowship in FPMRS at University of Michigan. In August 2016, she joined UCSD Women's Pelvic Medical Center.
  • Linda Brubaker, MD, FACOGcompleted a fellowship at Rush University. In January 2017, she joined UCSD Women's Pelvic Medical Center.
  • Tatiana Catanzarite, MD, MAS – is our most recent graduate (June 2018) who will begin practice here at UCSD in January 2019.

Kaiser Permanente

  •  Karl Luber, MD - 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.
  • Shawn Menefee, MD - 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.
  • Keisha Dyer, MD, MPH – completed the three year fellowship at UCSD/Kaiser in June 2010 and joined Drs. Menefee and Luber at Kaiser Permanente, San Diego. She is the associate director of the Female Pelvic Medicine & Reconstructive Surgery Fellowship Program and Fellowship Site Director at Kaiser Permanente, San Diego.
  • Gouri Diwadkar, MD - completed a three year fellowship at Cleveland Clinic under the guidance of Dr. Matthew Barber. In 2010, she joined Drs. Karl Luber and Shawn Menefee at Kaiser Permanente, San Diego.
  • Jasmine Tan-Kim, MD - completed both her residency and fellowship training at UCSD/Kaiser in June 2011 andjoined Drs. Karl Luber and Shawn Menefee at Kaiser Permanente, San Diego
  • Kimberly L. Ferrante, MD – completed the three year fellowship at UCSD/Kaiser in June 2015. She practiced at NYU for two years and in January 2018 joined Kaiser Permanente, San Diego.

    Other faculty includes Drs. Maro Tomassi and Daniel Klarensfield.

Structure and Rotations

There is one fellow in each year of training. Each year of training is divided into three (3), 16 week blocks pluse one (1) four 4 week block (elective/colorectal). These rotations are:

  • UCSD (16 weeks) - a predominantly clinical rotation. On this rotation there will be 2-½ days spent in the office, 2 days in the OR and ½ day of Research/Education. Fellow leads a team of one urology resident, one ob/gyn resident, as well as medical students. The fellow will be working with Drs. Nager, Albo, Lukacz, Alperin, Santiago-Lastra, Brubaker, and Catanzarite.
  • Kaiser (16 weeks) - a predominantly clinical rotation. On this rotation there will be 2 days spent in the office, 2-½ days in the OR and ½ day of Education. The fellows will be working with Drs. Luber, Menefee, Dyer, Diwadkar, Tan-Kim, and Ferrante.
  • Research and off-service rotations - ( 16 weeks research + 4 weeks service/elective) The elective rotations will be:
    • Year 1 - Colorectal (Drs. Tomassi and Klaristenfeld)
    • Year 2 - None
    • Year 3 - Global Health Research

The fellows' schedule is subject to change. It is recognized that the development of a high quality educational experience requires a continuous quality improvement process and Program Director (with fellow input) will modify this as necessary. The 50/50 UCSD/Kaiser clinical experience and 50/50 ambulatory/OR clinical experience are guiding principles.

Clinical Experience

 

UCSD Medical Center is a tertiary medical center at two sites: Hillcrest and Thornton (La Jolla). The Department of Obstetrics, Gynecology and Reproductive Sciences (OB/GYN) performs >2000 deliveries each year and approximately 200 pelvic flor surgeries each year. It has a long tradition of affiliation with Kaiser Permanente, San Diego and the OB/GYN residency is an integrated program. The OB/GYN residents spend 25% of their training time at Kaiser. The UCSD Department of Obstetrics, Gynecology and Reproductive Sciences also has fellowships in Maternal-Fetal Medicine, Reproductive Endocrinology and Infertility, Gynecologic Oncology, and Family Planning.

Kaiser Permanente, San Diego serves 500,000 members in San Diego. The Female Pelvic Medicine and Reconstructive Surgery division manages nearly all female incontinence and this division manages 300 urogynecology referrals each month and performs over 300 pelvic floor surgeries each year.

Both institutions perform the full spectrum of pelvic floor surgeries. Click here to view the Institutional Data for AYS 2017-2018.

Urodynamic Facilities

At present, the multiple sites offer urodynamic studies with Laborie equipment with and without fluoroscopy..

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. MR defecography is also available.

Education

In addition to the CREST course, other educational activities include:

  • Research meeting – weekly as needed with primary mentor
    • Additionally, fellows present research ideas and projects the 5th Wednesday every quarter
  • Urogyn chapter review – 2x monthly
    • Comprehensive review chapter by chapter of our specialty using the selected textbooks
  • Urogynecology Seminars – 7 or 8 lectures yearly
    • Formal lecture for 36 months on 22 topics essential to the specialty.
  • Journal Club every month – 1st Tuesday evening a month
    • Includes UCSD Faculty, Kaiser Permanente faculty, and local FPMRS practitioners.
  • Colorectal conference
    • Semiannual multidisciplinary conference reviewing defecography, manometry, and ultrasound imaging studies.
  • 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 educational conferences.

Research

 

The fellow has up to 48 weeks of dedicated research time. Research interests and ongoing projects include:

  • Basic science in pelvic floor muscle physiology
  • NIH funded – Prevention of Lower Urinary Tract Symptoms (PLUS)
  • NIH funded - Pelvic Floor Disorders Network (PFDN)
  • Epidemiology of Pelvic Floor Disorders
  • Robotic surgery education and outcomes
  • Novel urodynamic technology
  • Comparative surgical trials
  • Laser therapy

Beginning in July of Year 1, it is expected that the fellow will attend a 2-year course that meets every Wednesday afternoon for 2-hours. This Clinical Research Enhancement through Supplemental Training (CREST) Program is a Masters level comprehensive program that covers the following courses over 24 months:

  • Basic Epidemiology
  • Advanced Epidemiology
  • Patient Oriented Research I
  • Patient-Oriented Research II
  • Basic Biostatistics
  • Advanced Biostatistics
  • Health Services Research
  • Data Management and Informatics
  • Scientific Communication Skills
  • Professional Development Module (elective of your choice)

These credits can be applied to a Master of Advanced Studies (MAS) Degree in Clinical Research and 50% of the course fees are covered by the Ellis Wyer Endowment (valued at $11,400.00)

Application Process

  • Application Deadline: March 1, 2019
  • Application Period: December 1, 2018 - March 1, 2019
  • Interview Date: May 18, 2019
  • Applicants must have graduated from a US or Canadian accredited residency program.
  • We participate in the National Resident Match Program (NRMP) and all candidates must enroll in the Electronic Residency Application Service (ERAS).  To register for the fellowship matching process, please go to nrmp.org.

Application to the University of California San Diego Medical Center Program, Female Pelvic Medicine & Reconstructive Surgery (OB/GYN) - Accreditation 2210522003 may be made through the ERAS. For more information on the ERAS application process, please visit aamc.org.

In addition to the ERAS application, please forward the following documents to ERAS:

  • Photo (optional)
  • Curriculum Vitae
  • Personal Statement
  • At least two Letters of Recommendation. One of these must come from the
  • Residency Program Director or Department Chairperson.
  • USMLE Transcripts, Step 1, 2 and 3
  • CREOG Scores
  • Current email address

For further inquiries, please contact the Fellowship Program Manager:

Eunice Tingzon
9500 Gilman Drive
Mail Code 0633
La Jolla, CA 92037
urogyn@ucsd.edu

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.

The program is also compliant with ACGME 80 hour work week restrictions and duty hour requirements. Click here to be taken to UCSD House Officer Policy and Procedure Document (See pages 12 & 13 for detailed information).

Salary

Salary is commensurate with the University of California pay scale for a PG5. At present, this is approximately $68,554.28 per year.

Effective July 1, 2018 – June 30, 2021 a labor contact between UCSDH and San Diego House Staff Association has been negotiated. Click here to view MOU. More information will be forthcoming and posted on the UCSD Office of Graduate Medical Education website.