UBC FELLOWSHIP IN MALE REPRODUCTION, SEXUAL MEDICINE & MICROSURGERY
Duration: One or two year positions
This fellowship has been designed to prepare recently graduated Urologists with the clinical, surgical and research skill set to embark on an academic career.
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Dr. Ryan Flannigan will serve as the fellowship director for this program. After completing a 2-year fellowship at Weill Cornell Medicine (Mentors: Dr. Peter Schlegel, Dr. Marc Goldstein) and Memorial Sloan Kettering (Mentor: Dr. John Mulhall), Dr. Flannigan joined the Department of Urologic Sciences at the University of British Columbia as an Assistant Professor. Dr. Flannigan is the Director of the Male Reproductive and Sexual Medicine Research program (UBC), and serves as the clinical lead for the Prostate Cancer Supportive Care Program Sexual Medicine Module in British Columbia. Dr. Flannigan also hold an Adjunct Assistant Professor Position at Weill Cornell Medicine to facilitate international research collaborations. Dr. Flannigan’s clinical and surgical practice is largely focused on male sexual and reproductive medicine, with large volumes of Erectile Dysfunction, Peyronie’s Disease, and Infertility.
CLINICAL & SURGICAL EXPERIENCE
Clinical Schedule: The fellow will attend 1-2 clinic days per week and 1-2 surgical days per week. This will typically leave 2 research days per week.
Peyronie's Disease. Fellows will become proficient with evaluation and treatment of men with Peyronies disease. They will learn and perform: in-office curvature assessments, duplex ultrasound, verapamil injections, Xiaflex injections, penile traction, penile plication, plaque incision grafting, penile implants.
Erectile Dysfunction. Fellows will become proficient with evaluation and treatment of men with erectile dysfunction. This includes a full arrange of medical, and surgical treatment (i.e. PDE5i’s, ICI, VED, malleable, 2-piece and 3-piece penile implants). Opportunities will be present to attend group cognitive behavioral sessions for psychogenic or situational erectile dysfunction. Opportunities will be available to participate in sexual and reproductive needs for men with neurologic diagnoses.
Infertility patient evaluation and treatment. Fellows will evaluate and treatmet infertile couples via medical hormonal manipulation, microsurgical varicocele repairs, VE’s, VV’s, microTESE’s, PESA’s, TESE’s, oncoTESEs and TUREDs. Opportunities will also be available for PVS and EEJ for sperm retrieval in spinal cord injured men through the Vancouver Sperm Retrieval Clinic.
Low Testosterone. Fellows will evaluate and manage men with low testosterone through a variety of therapies such as T injections, natesto, gel-based therapy, hCG and clomiphene.
Vasectomies. Fellows will perform no scalpel vasectomies are frequently performed in the clinical setting.
Chronic scrotal pain. Fellows will perform spermatic cord injections, and microsurgical denervations.
Sexual Rehabilitation in cancer survivors. Fellows will participate in a multi-modal prostate cancer survivorship program. This program is centered with the Prostate Cancer Supportive Care Program and involves a biopsychosocial approach to treating pelvic cancer survivors and their partners for sexual dysfunction. This program over sees 3 clinical sites across the province.
Fellows will be provided a primary translational research project prior to starting their fellowship. It is the goal of our research program to provide broad exposure to different projects with a predominant focus on a primary project. Fellows will be involved with experiments, data collection, analysis, and manuscript writing. Our team works in a very collaborative environment; many opportunities will be available for learning new techniques or collaborating with groups that have the ability to assist with analyses or experiments (eg. bioinformatic support). Fellows will be encouraged to apply for research opportunities such as the SMSNA (Sexual Medicine Society of North America) Fellowship Grant, and the American Urological Association Scholar Award. Opportunities for presentation of abstracts at local, national, and international meetings will exist. A focus will be to prepare the fellow to transition to an independent investigator. As such, fellows will be encouraged to attend grant writing workshops such as the American Urological Association Early Career Investigator Workshop, in addition to exploring career development funding opportunities within the last year of fellowship to help facilitate career transition to an independent investigator.
Specific areas for research include the following foci:
Male Infertility. Numerous studies are investigating the mechanisms contributing to non-obstructive azoospermia. Techniques revolve around single cell investigations and multi-OMICs techniques. In vitro and regenerative techniques are being developed and utilized to further investigate and potentially treat male infertility such as tissue organoids, and 3-D bioprinting. Other avenues of research are utilizing technological applications such as machine learning.
Peyronie’s research. Several studies are investigating the cellular dysfunction of Peyronie’s fibroblasts, and potential genetic and immunologic mechanisms of dysfunction. Technological approaches to optimizing Peyronie’s treatments are also being investigated.
Erectile Dysfunction. Engineering app roaches to novel penile implant technologies, and drug discovery are being investigated.
Sexual Rehabilitation in Cancer survivors. Prospective data collection, expansion of existing programs are being investigated.
Men’s Health. Opportunities for population-based men’s health exist and working with the Canadian Men’s Health foundation, and collaborators in psychosocial elements of Men’s Health and sexual medicine.