Urology Fellowship Training
The Division of Pediatric Urology at Children’s Hospital of Philadelphia (CHOP) values diversity and seeks talented fellowship applicants from varied backgrounds. The Division of Urology does not discriminate on the basis of race, color, ethnicity, sexual orientation or gender identity, religion, or disability.
About CHOP’s Pediatric Urology Fellowship Program
In 1976, Dr. John Duckett introduced the first fellowship in pediatric urology as he established the program for the Division of Urology. Since the beginning, the CHOP fellowship in pediatric urology consistently graduated future stars in pediatric urologic care and academia.
A few reasons why we attract the best candidates:
- Our fellow’s surgical volume is well over 1,000 cases each year, with unsurpassed complexity.
- There are four standard research track options available to our fellows after they complete their clinical year: an extensive basic science laboratory experience (one lab research year), clinical research including the Certificate Program in Clinical Epidemiology (one research year), a Master of Science in Clinical Epidemiology (MSCE) (two research years), or a Master in Translational Research (two research years).
- You make the choice about which research track you prefer. We will make it happen!
Until 1987, all fellowships in pediatric urology were one-year programs. Beginning in 1989, our Division has offered two- and three- year fellowship programs, with Dr. Stephen Zderic serving as CHOP’s first two-year fellow. Currently, the program is divided into a clinical year and a research year (with additional research years if desired).
Here are a few characteristics shared by CHOP fellows:
Fellowship program leaders
- Thomas Kolon, MD – Fellowship Program Director
- Stephen Zderic, MD – Basic Science Research Director
- Natalie Plachter, MHA, MSN, CRNP, CPNP – Director of Clinical Care
Additional faculty fellows will work alongside and learn from:
The pediatric urology fellow is representative of the CHOP Urology mission: “To be the world leader in the advancement of Urologic healthcare for children by integrating excellent patient care, innovative research and quality professional education into all of our programs”
The key goals of the Pediatric Urology Fellowship Program are to:
Develop collaborative clinical care expertise
- To lead the comprehensive care of children with urologic diseases, including but not limited to: reconstruction, andrology, uro-oncology, stone disease, chronic kidney disease, hypospadias, bladder exstrophy-epispadias complex, neuropathic bladder, and hydronephrosis, to pioneer new surgical techniques including minimally-invasive surgery and robotic surgery.
- To incorporate the role of medical and allied healthcare professionals in patient care with an interdisciplinary approach.
- To understand the role of community resources in the care of children with urologic diseases.
Foster independent basic science, translational and clinical investigation
- To offer formal post-doctoral course work in basic science, translational, and clinical research, in which each fellow can choose a path most in line with their interests and strengths.
- To provide mentoring to develop and complete innovative and feasible research projects.
- To ensure academic achievement by rigorously supervising academic progress.
- To provide an opportunity to present discoveries in presentations and publish those results.
Invest in the future of pediatric urology
- Bridge the gap between pediatric and adult care through our transitional urology program with the Hospital of the University of Pennsylvania, and CHOP attendings, including adult congenital urologist Dr. R. Caleb Kovell.
- To promote management skills for independent direction of a urology team, including formal participation in divisional quality and patient safety initiatives.
- To solidify research skills to further independent research careers.
- To foster mentoring skills to educate subsequent trainees.
- To cultivate leadership skills to advance the field of pediatric urology and patient care practices.
The pediatric urology fellow will be able to demonstrate competence in the various domains of Pediatric Urology, including proficiency in the following:
- Open surgery: Experience in all aspects of open surgery in the child with a urological problem. This includes major reconstructive, renal, ureteral, bladder, and urethral surgery in the boy and in the girl. Genital surgery in both sexes as well as intersex surgery. Management of the fetus with a pediatric urological problem is also emphasized.
- Endoscopic surgery: Experience in endoscopic, including laparoscopic surgery. This should include diagnostic as well as therapeutic intervention and should include vaginal, urethral, vesical and ureteral surgery as well as laparoscopic diagnostics and therapeutics.
- Outpatient pediatric urology: Experience in all aspects of outpatient care with graded responsibility.
- Spinal defects and neurourology: This includes the knowledge of the physiology and pharmacology of voiding dysfunction. This latter term includes obstructive and irritative phenomena, urinary incontinence and dysfunctional voiding. In addition, it includes knowledge of urodynamics, broadly defined as the data that relate to bladder and outlet parameters during the filling and emptying phases of micturition. It also includes the antenatal, newborn and subsequent care of children born with spinal defects.
- Pediatric andrology and differences of sex development (intersex): The long term care of children born with cryptorchidism or ambiguous genitalia or who develop a varicocele and the long term treatment to maximize fertility and minimize carcinoma formation for these children when they become adults.
- Stone disease: This includes endourology and lithotripsy. This includes the knowledge of the pathogenesis of urinary stone disease and the evaluation and management. Endourology and lithotripsy refer broadly to the specialized techniques used to treat some varieties of stone disease. Endourology further includes the use of special endoscopic techniques to diagnose and manage disorders of the upper urinary tract other than stone disease.
- Urologic trauma: This includes the evaluation and management of trauma to all parts of the genitourinary system in the male and female.
- Infectious disease: This includes a working knowledge of those factors involved in the pathogenesis of urinary infection, both lower and upper tract, of the bacteria, fungi, viral and other organisms involved, and of the various techniques used to diagnose and to treat infection. Expertise in the indications for specific use of antimicrobials and side effects of treatments are stressed.
- Reconstructive urology: This includes the use of innovative techniques for reconstruction of renal, ureteral, vesical, urethral, penile and vaginal congenital and acquired anomalies. This includes indications for and techniques for construction of continent urinary reservoirs.
- Renal transplantation: This includes a working knowledge of the urologic factors involved in renal transplantation and their application. Also included is knowledge of the reconstruction required in the recipient born with bladder or ureteral congenital anomalies to provide for successful long-term function of the transplanted kidney.
- Urologic imaging: This broadly refers to all of those entities involved in the radiologic study of urologic disease including urography, retrograde upper tract studies, urethrography and cystography including imaging of the perineal anatomy in children born with intersex anomalies, urologic ultrasound, computerized tomography, magnetic resonance imaging, angiography, and the various types of interventional uroradiology.
The fellow will be able to work effectively in the aforementioned areas in a multidisciplinary setting.
A day in the life: Yearly routines
Weekly routine: Year 1
Each day begins with morning rounds at 6:30 a.m. and concludes with rounds in the evening. Fellows may have a case in the OR as early as 7:30 a.m. We emphasize the operating room experience in the first year. In subsequent years, fellows may have a light clinical schedule that will include an outpatient schedule and selected surgical cases to perform to increase independence both in and out of the operating room.
Each week there are several conferences and meetings for fellows to participate in, including:
- WEDNESDAY mornings: rotating Research Conference; Campbell’s Club; Faculty meeting
- WEDNESDAY evenings: Collaborative Urology/Radiology/Nephrology conference; dry (pre-op) rounds
- THURSDAY mornings: PENN Urology grand rounds
Sample Surgical Case List
Each year, CHOP Urology fellows consistently outperform the national averages and required surgical caseloads compared to other pediatric urologic fellowship programs across the nation. Below is a table showcasing the large number of procedures, including robotic cases, through which CHOP fellows will have the opportunity to learn and perform.
|CHOP Fellow Total OR Cases||CHOP Fellow Total Index OR Cases||National Median Total Index OR Cases|
|For all years Required Total Index OR Cases was 300.|
|CHOP Fellow Robotic OR Cases||National Median Total Robotic OR Cases|
|For all years Required Total Robotic OR Cases was 0.|
Weekly routine: Year 2
The research year(s) for fellows offer a more flexible, less structured schedule. Fellows still participate in:
- Lab hours, Basic science/clinical research (if applicable)
- Travel for meetings
- Classes (if applicable)
- Clinical instruction in clinic/OR
- Wednesday conferences
- PENN Urology grand rounds/conferences
- Fellow call (split with the first year fellow)
Additional benefits and resources for fellows
Our team at CHOP has routinely supplied the fellows with:
- Custom fitted 4.5 x Loupes
- Appropriate software and hardware
- Office space in both the laboratory and in the clinical office
- Adequate financial and tuition support in the clinic and the laboratory
- Travel expenses to meetings, including the annual US-India Bladder Exstrophy Collaborative Workshop
- Each Wednesday evening, fellows and faculty from the Divisions of Urology, Radiology, and Nephrology convene for a case-based conference to review complex cases. With guidance from attending physicians, fellows will help plan an interdisciplinary approach for patient care. Fellows will learn invaluable management and critical thinking skills.
- Each Wednesday evening, the Division hosts a pre-operative planning meeting for upcoming cases (“Dry Rounds”). The clinical fellow helps to assign surgical cases for the upcoming week.
- On the first Wednesday morning of each month, fellows attend the Division Faculty meeting. Here we discuss safety, administrative, teaching, clinical and research strategy/organization and financials. This gives the fellows a valuable introduction to the process of running a division of pediatric urology
- On the 2nd and 3rd Wednesday mornings of each month, fellows attend the Division research meeting. In these meetings, members of the faculty discuss their current research projects and receive feedback from the other faculty members. At least twice a year the fellow will formally present their research at these meetings. This gives the fellows the opportunity to receive feedback from all of the faculty.
- Fellows with attendings teach a monthly Campbell’s Urology Textbook conference meeting to review specific pediatric urology research chapters.
- Every Thursday morning, fellows and faculty attend Urology Grand Rounds at the Hospital of the University of Pennsylvania with selected topics and lectures by esteemed medical professionals.
- The fellow is expected to attend the AUA and AAP meetings each year during fellowship. The fellow makes one or more presentations at the AUA meeting in the spring of the first and second year. Additionally, the fellow makes at least one presentation at the Society for Pediatric Urology (SPU) meeting in the fall of the second year of fellowship. Additional meetings are also possible depending on the fellows interest.
- Our faculty evaluates each fellow’s progress and competence at the end of 6 months, 12 months, 18 months, and 24 months of training, and as needed. Every 6 months during training, the fellow meets with the Division Chief and Program Director to review the evaluations. Fellows also provide feedback about their experience at each evaluation assessment.
- The fellow keeps a running log with academic projects assigned or undertaken, including research-focused projects (i.e. chapter, abstract, manuscript, lecture). Each month, logs will be reviewed to track progress.
- Fellows have the support of a clinical research coordinator and research team to meet their goals and facilitate data collection and analysis.
Duties and responsibilities of the pediatric urology fellow at CHOP
- Enforce the 80-hour work week regulations
- Oversee all aspects of the pediatric urology inpatient/consult service
- Scrub on all index cases, and any other cases as needed/desired
- Prepare and present at the Management Case Conference
- Ensure proper OR fellow/resident coverage
- Provide back-up call coverage for the residents
- Take primary call as needed
- Prepare and represent CHOP at annual meetings (ie. AUA, Pediatric Urology Fall Congress)
- Prepare monthly Campbell’s Urology Textbook conference
- Attend weekly Urology Research Meetings
- Attend weekly HUP Urology Grand Rounds
- Scrub with residents on more common cases (i.e. hernia, orchiopexy, circumcision, endoscopy)
- Participate in Outpatient Clinic as scheduled by the Nurse Manager and Program Director
- Attend Faculty meeting monthly
- Review the Wednesday Dry Rounds (preoperative) schedule
- Review the Wednesday Case Conference schedule
- Prepare and complete clinical (and/or basic science) research
- Competence in the area of service organization and management
- Competence in the area of practice based learning and improvement
- Teaching status in the attainment of interpersonal and communication skills
- Teaching status in the area of professionalism
- Teaching status in the area of systems based practice
- Teaching status in the area of the usage of knowledge and analytical thinking to address clinical questions
- Teaching status with respect to the management of in-house and emergency room consultants (with attending staff)
Testimonials from former fellows
“I was a fellow here 20 years ago. Looking back at the fellowship's growth, the experience offered, case diversity, volume, etc., I am just astounded. I can't imagine that there is a training program that provides a more well-rounded experience. The opportunity to train with urologists of such skill and towering reputations was hard to pass up. Being a CHOP fellow immediately connected me with a network of alumni that have mentored and guided me along the path and opened doors and opportunities for global work, prestigious committees and societies, and research collaborations that I've leveraged throughout my career.” - Aseem Shukla, MD (CHOP Urology Fellow 2001-2004)
“After I finished [my fellowship] in 2014, I looked around at a number of programs and ultimately came back to CHOP. It provided the perfect environment and culture. It provided the resources to treat the most complex children and to develop a research program that is transformative for care in the future. The commitment to discovery permeates through every aspect of the Division of Urology. I am convinced the program we built and centers we developed can’t be done elsewhere. We have a remarkable infrastructure that allows us to bring what was once an idea to become operational and grow in the future. You will be pushed and will be able to meet your personal goals, and you will contribute to the legacy of the Division of Urology." - Gregory Tasian, MD, MSC, MSCe (CHOP Urology Fellow 2011-2014)
“The ability to learn how each attending operates and does a procedure was a great advantage to this program. We have a breadth of age ranges among our faculty, so you can see into the nuances of each generation and have a melting pot of techniques as you develop your own. CHOP also has a phenomenal basic science program led by Dr. Zderic. He’s one of the most outstanding people I’ve ever met in medicine. And a great thing about being associated with University of Pennsylvania is you can take classes and be supported by CHOP for extra years of learning. At CHOP you have a genuine quality of people and leaders...they’re good human beings and care about other people. That’s something I remember.” - Jason Van Batavia, MD (CHOP Urology Fellow 2015-2017)