Urologic Oncology Fellowship Program
To Apply for a Fellowship
Please apply as per the Society of Urologic Oncology (SUO) instructions on the SUO Website. We are part of the SUO matching system. We only accept fellows through the SUO match. We have one fellowship position open for July 2021.
The Division of Urology at the Schulich School of Medicine & Dentistry, Western University offers post-residency fellowship training in Urologic Oncology. The fellowship is a two-year program with approximately one year spent on clinical training and one year spent conducting basic research. This program has trained fellows from across Canada and worldwide, many who have become prominent urologic oncologists in their communities and countries. The fellowship program is accredited by The Society of Urologic Oncology (SUO), an American Urological Association affiliate. The fellowship is organized in an integrated, multi-disciplinary fashion offering rotations in urologic oncology, medical oncology, radiation oncology, gynecologic oncology, diagnostic genitourinary pathology, and experimental oncology. Each area is supervised by experts in the field, providing fellows with the best training experience.
The mission of the Urologic Oncology Fellowship program at the Schulich School of Medicine & Dentistry, Western University is to train urologic oncologists so that they are well-equipped to play a prominent leadership role in the field of urologic oncology nationally and internationally. The fellowship adheres to a philosophy of a multi-disciplinary approach so that those who complete a fellowship at this centre will have received extensive clinical training as well as basic and/or clinical research experience, which should be very advantageous in pursuing a career in urologic oncology. Fellows who have completed this program should be able to assume responsibilities of academia and conduct a clinical practice in urologic oncology.
- To enhance the clinical experience in various treatment options of urologic oncology, including assessment and consultation of new patients, follow-up of patients in the ambulatory care setting and operative experience (including radical urologic oncologic surgery and reconstruction)
- To become competent in the surgical management of all complex tertiary & quaternary urologic oncology referral cases
- To enhance clinical experience in other ancillary diagnostic and therapeutic disciplines
- To gain experience in clinical trials involving urologic oncology patients, in all urologic organ sites, including experimental therapeutic trials
- To gain experience by participating in the development of new and investigational and emerging treatment modalities
- To gain experience by participating in the research activities relating to all areas listed above as well as to initiate and conduct other urologic oncologic research projects that are compatible with and complementary to all current ongoing clinical programs
- To gain experience in translational research by participating in and being a liaison with clinical applications for the on-going basic research studies (e.g. new markers for prostate cancer) and conducting studies on clinical correlation
- To produce several high-quality peer-reviewed publications from the fellowship period based on the candidate's research work
- To enrich the academic experience by participating in teaching of junior trainees and students, through academic rounds and discussions, attendance and active participation in international, national and regional meetings, active involvement in writing peer-reviewed grants, and in preparation of manuscripts for publication
This is a two-year fellowship comprised of one clinical year and one research year. The clinical year will consist of the following rotations:
- 10 months in Urologic Oncology
- 1 month in Medical Oncology
- 1 month in Radiation Oncology
In addition to the mandatory rotations listed above, fellows have the option of completing an additional one-month elective in one of the areas listed below. If one of these electives is chosen, it may be done as part of the “Research Year” or as part of the “Urologic Oncology” clinic time.
- 1 month in Gynecological Oncology
- 1 month in Diagnostic G. U. pathology
The Fellow, while on Clinical Rotations, will take an active role in clinical trials involving hormone therapy, chemotherapy and alternative therapies, in addition to surgically and radiation-related therapies and epidemiologic studies. In the Research year, the Fellow will receive training in clinical trials in the role of primary investigator in whichever aspects of prostate cancer research he/she prefers. The Fellow can participate in on-going laboratory studies in molecular genetics, experimental therapeutics (including gene therapy), tumour marker studies and image-guided innovative therapies and various other translational research projects.
What to Expect With Each Rotation
Urologic Oncology Rotation
Throughout the time spent in Urologic Oncology, fellows gain exposure to specialized areas including; laparoscopic renal procedures, reconstructive and andrology, and pediatric uro-oncology. Activities during this time include; all Urologic Oncology lists (including robotics, HIFU, brachytherap), ambulatory care clinics (with some clinical trials patients incorporated into these clinics), post-op. follow-up in-patient care, weekly GU disease site group conference at cancer clinic, evening on-call 1-2, evening(s) per month, no weekend on-call, teaching of residents and occasional seminars for medical students to develop teaching and leadership skills.
Medical Oncology Rotation
Activities during the Medical Oncology rotation include; all medical oncology GU cancer new referral and follow-up clinics (3 times per week), in-patient medical oncology GU consults, advanced renal cancer multidisciplinary clinic (every 2-3 weeks), advanced bladder and miscellaneous GU cancer multidisciplinary clinic (every 2-3 weeks), GU disease site group conference (weekly), familiarization with various treatment protocols and activities in the systemic therapy suite for both ambulatory and in-patients.
Radiation Oncology Rotation
This rotation exposes the fellows to all radiation oncology GU cancer new referral and follow-up clinics (4 times per week), in-patient radiation oncology GU consults, advanced bladder and miscellaneous GU cancer multidisciplinary clinic (every 2-3 weeks), advanced renal cancer multidisciplinary clinic (every 2-3 weeks), disease site group conference (weekly), and familiarization with radiation physics, various treatment protocols and activities in the radiotherapy suite including dosimetry and treatment planning.
Gynecologic Oncology Rotation
This is an optional rotation that includes all gynecologic oncology cancer new referral and follow up clinics (includes systemic chemotherapy), in-patient gynecologic oncology consults, and special emphasis cases requiring exenteration and urinary diversion.
Diagnostic G.U. Pathology Rotation
The diagnostic G.U. Pathology rotation is also optional and allows fellows to be involved with diagnostics on all GU cancer surgical specimens, conduct consults / “second opinions” by pathologists, and allows for familiarization with routine technical specimen processing and advanced diagnostic techniques.
Didatic Sessions and Conferences
Urologic Oncology Fellows are expected to attend and participate in:
- Uro-Oncology Seminar Program (topics specific to the needs of Fellows and vary, seminar leaders coincide with topics).
- Weekly Inter-hospital Grand Rounds attended by all consultants with full range of topics with the majority being oncology-related.
- Annual Uro-Oncology Fall Review Weekend: In-depth multi- review of current uro-oncology management for practicing urologists, including update on available clinical trials for “problem cases”.
- Monthly Multidisciplinary TeleMedicine Uro-Oncology Rounds: difficult cases as submitted by regional urologists with management discussion led by our Uro-oncologists, Radiation Oncologists and Medical Oncologists.
- Weekly G.U. Disease Site Team Multi-disciplinary Rounds: at London Regional Cancer Center, discussion of in-house cases, presented by residents and fellows, attended by Uro-oncologists, Medical Oncologists, Radiation Oncolgists, (and Pathologists and Radiologists when appropriate).
- Monthly Division of Urology Journal Club.
- Annual Western University Division of Urology Research Day: Work presented by residents and fellows and appraised and critiqued by the Guest Professor.
- Annual London Regional Cancer Center Research Day: Uro-oncology. Fellows have a chance to present their research work to a multi-disciplinary audience.
- Annual Western University Department of Surgery Research Day.
- Annual Prostate Cancer Imaging and Guided Therapy Workshop: Focused on recent advance and development in imaging and therapy research with updates from our own investigators research group and collaborators and co-investigators at other centers.
- Annual Cancer Program GU Disease Site Retreat: In-depth discussion of coordination of clinical care with practitioners in the region (our referral base), including patient-centered issues such as “navigation of care”, “survivorship”, “psycho-so social concerns” etc.
Additional / Ancillary Training
- Canadian Surgical Technologies and Advanced Robotics “CSTAR” Surgical Skills Lab: complete training module with a da Vinci robot devoted part of each week to surgical training
- LAP mentor simulator, virtual laparoscopic procedures (e.g. cholecystectomy)
Specific New Technologies
- Basic da Vinci Robotics training course (Intuitive Surgical, Sunnyvale CA)
- LDR Brachytherapy training course (Seattle WA)
- HIFU introductory course (Ablatherm, Toronto ON)
- Prostate and Renal Cryotherapy training course (Cryocare, Pittsburgh)
Research Year; Research Rotation and Opportunities
- Concurrent basic laboratory projects and translational research
- Robert Hardie Urologic Oncology Research Laboratory
- Bench Research: Bio-Markers/Molecular Biology
- Opportunities to learn about and/or perform actual bio-assays (IHC, TMA, etc.) and be involved in the actual study design, data acquisition and analysis as well as taking a primary role in the translational aspects of the research
- Ghrelin: receptor agonist as a novel PET marker for Ca P
- PTEN ktP: potential prognostic marker for Ca P and Ca B
- CD151: prognostic indicator for Ca B and Ca P
- Advanced Prostate Imaging Laboratory and Minimally Invasive Therapy Research
- Lab Advisors/Supervisors: Aaron Fenster, PhD; C. Romagnoli, MD; Terry Peters, PhD; R. Bartha, PhD
- Clinical Supervisors: J. Chin, MD; G. Bauman, M.D.; J. Izawa, MD; S.E. Pautler, MD
- Biophysics and Engineering Lab
- Opportunities to participate in clinical assessment of new imaging modalities and techniques
- CIHR (Canadian Institutes of Health Research) Programmatic Grant in advanced prostate imaging and image-guided therapies including focal therapy research
- 3-D Ultrasound guidance system for biopsy
- Functional imaging with M.R.I., M.R.S., P.E.T., C.T.
- Multi-modality fusion techniques
- Image-guided therapies: HIFU, Cryosurgery, PDT (e.g. TOOKAD, Brachytherapy, HDR, and LDR)
Clinical Outcomes Research
Supervisors: J.I. Izawa, MD; S.E. Pautler, MD; J.L. Chin, MD; G. Rodrigues, MD, V. Venkatesan, MD, G.B. Bauman, MD; E. Winquist, MD
Opportunities for participating in various on-going quality assurance programs and other clinical projects, utilizing current data bases for various procedures
- CUSUMS (Cumulative Summation) Analysis of Radical Cystectomy, Robotic Prostatectomy and other laparosocopic and open surgical procedures
- Cost Analysis Studies
- Wait Times Analysis for radical nephrectomy, prostatectomy and cystectomy
- Quality of Life Studies for various malignancies post-treatment, with large databases starting from 1990’s
Clinical Trials Research: LHSC Urologic Oncology Clinical Trials Unit
Supervisors: J.L. Chin, MD; C. Hildebrand, PhD, E.Winquist, MD
Opportunities to draft formal clinical trial grant proposals and be involved in all aspects from conception of hypothesis, study design, ethics submission, sample size/statistical calculations to actual execution and data collection. Also opportunities to be sub-investigator for various randomized clinical trials (both peer-reviewed, multi-center non-industry government trials agency-sponsored as well as industry-sponsored studies), to be familiarized with all aspects of clinical trial conduct and conventions, including attendance at investigators’ meetings
- Our Clinical Trials Unit has organized studies according to organ site and stage of disease ranging from Prevention, Screening, ASAP, Early Disease, Salvage, Locally Advanced, Early Metastatic, Castrate Resistant Non-metastatic, Castrate Resistant Metastatic, Bone Health, IND Phase I/II studies as well as Phase III. Fellows participate in all aspects of studies
- Highest accruing center in numerous NCI (Canada), SWOG, RTOG, NCI, MRC, CALGB, ACOSOG, Inter-Group studies e.g. START trial, SELECT (completed), SPIRIT (closed), RTOG 0126, RTOG 0415, RADICALS (on-going), Abiraterone
- Also loco-regional and in-house trials, e.g. Primary Cryoablation vs EBRT for cT3, in-house salvage HIFU, salvage cryoablation, Phase II/III PDT
- Highest accrual center in many pharmaceutical/industry-sponsored studies e.g Taxotere (3501, 3503), Atrasantan (M366, M244, M211), Denosumab (103, 138, 147, 560), Bisphosponates, Provenge, OGX
- Bladder Cancer Trials (NCIC BL11, Mycobactrium Cell Complex, NCIC BL8, Zarnestra Phase II –closed, PHL 036)
- Also Renal Cell Ca Trials: PHL 039, RAD 001, ASSURE (completed accrual), GSK VEG113387, PHL077, Longitudinal Small Renal Mass Study
Other Clinical Research Opportunities
Supervisors: J.L. Chin, MD; J.I. Izawa, MD; S.Pautler, MD, N.Power, MD
Opportunities to utilize databases for updates and new projects, for example:
- Various organ sites (e.g. bladder: cystectomy, testis: RPLDN, prostate: RRP, robotics)
- Specific procedures (e.g. cryoablation prostate and kidney, salvage HIFU prostate, partial nephrectomy, Brachytherapy, EBRT)
- Specific clinical trial cohorts (e.g. small renal mass follow-up, active surveillance for CaP, Screened cohort through SELECT study, ASAP pts, Cryo versus Radiation, High risk neoadjuvant chemo/hormone study)
Nicholas Power, MD, FRCSC
Associate Professor of Surgery & Oncology
Divisions of Urology & Surgical Oncology
Program Director, SUO Fellowship
Schulich School of Medicine & Dentistry
Western University, Canada