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Female Pelvic Medicine & Reconstructive Surgery Fellowship

Program Director: Emily Lukacz, M.D., MAS

Associate Director: Keisha Dyer, M.D.

About the Fellowship

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 (UCSD) 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 is welcome to participate in ongoing research, but he/she/they will be also be encouraged to develop his/her/their own ideas and to plan, execute, analyze, and report on these subjects. Presentations are expected at the American Urogynecologic Society (AUGS) meeting. The fellowship is accredited by the American Board of Obstetrics and Gynecology (ABOG) and the American Board of Urology. As such, the fellowship program length is three 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 approache.

Faculty

UC San Diego

  • Charles Nager, M.D. – completed his residency in Ob/Gyn at UCSD in 1986; 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. .
  • Michael Albo, M.D. – is a UCSD urologist who completed a Female Urology fellowship with Dr. Shlomo Raz at UCLA in 1994. He serves as Vice Chief of the Department of Urology.
  • Emily Lukacz, M.D. – completed her fellowship at UCSD/Kaiser in June of 2003 and joined Drs. Charles Nager and Michael 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 and Reconstructive Surgery Fellowship Program in 2010 and is also the Division Chief.
  • Marianna Alperin, M.D., M.S. – completed her fellowship at University of Pittsburg, Magee-Women's Hospital. She joined the division in July 2017 and accepted the role of Fellowship Research Director in April 2019..
  • Yahir Santiago-Lastra, M.D. – is a UCSD urologist who completed a FPMRS fellowship at the University of Michigan. In August 2016, she joined UCSD Women's Pelvic Medical Center.
  • Linda Brubaker, M.D., FACOG – completed her fellowship at Rush University. In January 2017, she joined UCSD Women's Pelvic Medical Center. Dr Brubaker took on the role of Interim Department chair in July 2020.

Kaiser Permanente

  • Shawn Menefee, M.D. – 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, M.D., M.P.H. – completed her fellowship at UCSD/Kaiser in June 2010 and joined Drs. Menefee and Luber at Kaiser Permanente, San Diego. She is the Co-Director of the Female Pelvic Medicine and Reconstructive Surgery Fellowship Program and Fellowship Site Director at Kaiser Permanente, San Diego.
  • Gouri Diwadkar, M.D. – completed her 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, M.D. – completed both her residency and fellowship training at UCSD/Kaiser in June 2011 and joined Drs. Karl Luber and Shawn Menefee at Kaiser Permanente, San Diego
  • Kimberly L. Ferrante, M.D. – completed her fellowship at UCSD/Kaiser in June 2015. She practiced at NYU for two years and in January 2018 joined Kaiser Permanente, San Diego in January 2018.
  • Tatiana Catanzarite, M.D., MAS – is our 2018 graduate who joined as faculty in February 2019. She accepted the role of Fellowship Simulation and Skills Director in April 2019.

Other faculty includes Drs. Marco Tomassi and Daniel Klarensfield for the colorectal rotation.

Structure and Rotations

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

  • UC San Diego (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. The fellow leads a team of one urology resident, one ob/gyn resident and medical students. The fellow will be working with Drs. Albo, Alperin, Brubaker, Lukacz, Nager and Santiago-Lastra.
  • 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. Diwadkar, Dyer, Catanzarite, Ferrante, Menefee and Tan-Kim.
  • Research and off-service rotations (16 weeks research + 4 weeks service/elective) – The elective rotations will be:
    • Year 1: None
    • Year 2: Colorectal (Drs. Tomassi and Klaristenfeld)
    • 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 that the Program Director (with fellow input) will modify as necessary. The 50/50 UCSD/Kaiser clinical experience and 50/50 ambulatory/OR clinical experience are guiding principles.

Clinical Experience

UC San Diego 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 floor 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 Complex 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. Institutional Data for AY 2019-2020 (PDF)

Urodynamic Facilities

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

Imaging

The UC San Diego 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 Clinical Research Enhancement through Supplemental Training (CREST) Program, other educational activities include:

  • Research meeting: weekly and/or as needed with primary mentor
    • Additionally, fellows present research ideas and projects the 5th Wednesday quarterly.
  • Urogynecology Chapter Review: 1–2 times, monthly
    • Comprehensive review chapter by chapter of our specialty using the selected textbooks.
  • Urogynecology Seminars: 7–8 lectures, yearly
    • Formal lecture for 36 months on 22 topics essential to the specialty.
  • Journal Club: 4th Tuesday evening, monthly
    • Includes UCSD Faculty, Kaiser Permanente faculty, and local FPMRS practitioners.
  • Colorectal Conference: semi-annual
    • Semi-annual multidisciplinary conference reviewing defecography, manometry, and ultrasound imaging studies.
  • Wednesday afternoons also include department grand rounds, research meetings, and patient case 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/NIDDK funded - Prevention of Lower Urinary Tract Symptoms (PLUS)
  • NICHD 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 complete, at minimum, the six core CREST courses outlined below. These will occure every Wednesday evening from 4-6 pm. 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

A Masters in Advanced Studies in Clinical Research can be obtained with 12 additional courses after completing the full CREST program and is funded 50% through the Ellis Wyer Endowment (valued at $11,400). Additional funds are available to support a 4-week global health elective.

See our UCSD-Kaiser 2010–2020 graduated fellows' publications (PDF)

Application Process

Note: For the 2021–2022 application season, we will not offer first round interviews.

Application Dates

  • Application Deadline: March 1, 2022
  • Application Period: November 17, 2021 – March 1, 2022
  • Notification Date: March 14, 2022
  • Interview Date: April 23, 2022. By consensus of UC SOM Deans, we will offer remote/virtual interviews only.

For additional reading on the virtual process, linked here is a publication on the "Do's and Don'ts of the Virtual Interview: Perspectives From Residency and Fellowship Applicants (Bounpane C, et al, 2020)
Applicants must have graduated from a U.S 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, 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, visit aamc.org.

Required Documents

In addition to the ERAS application, upload the following documents to ERAS:

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

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. UCSD House Officer Policy and Procedure Document (PDF) See pages 12 & 13 for detailed information.

Salary

Salary is commensurate with the University of California pay scale for a PGY 5–7. See updated pay scale (PDF).

Effective July 1, 2018 – June 30, 2021 a labor contact between UCSDH and San Diego House Staff Association has been negotiated. View MOU (PDF). More information available on UC San Diego Office of Graduate Medical Education.

Questions

For further inquiries, contact urogyn@ucsd.edu