Urology Fellowships

• Achieve level 4 competency in endourology procedures including PCNL (including siting own tracks trained by interventional radiology), flexible ureterorenoscopy, and endourological management in patients with reconstructed urinary tracts and urinary stricture disease.
• The above in a complex cohort of patients including those with neuropathic issues.
• Training in bladder outflow procedures and laparoscopic nephrectomy to level 3 depending on fellows learning agreement. It is possible to achieve level 4 in HOLEP and urolift if the trainee has the commitment to achieve.
• Acute management of urinary tract stone disease sequelae e.g. ureteric colic, pyonephrosis, including management on critical care/ITU.
• Managing patients in an outpatient stone clinic setting, both acute and chronic. Involvement with nephrology colleagues in managing patients with metabolic problems causing kidney stones.
• Performing and advising on ESWL.
• Performing audit, research and quality improvement/service development activity with subsequent presentation of work at regional/national and international meetings. 
• At least one peer-reviewed publication within the 12-month fellowship.
• Development of leadership skills within the theatre and ward environment and also outside clinical practice e.g. running the new Northeast Stone Forum (due 29 April 2022).
• Develop teaching skills by provision of undergraduate and post-graduate teaching sessions in clinical and non-clinical environments.
• Non-clinical administrative skills and management e.g. admin work, theatre list planning, patient complaints etc. 

• Level 4 flexible and semi-rigid ureterorenoscopy.
• Level 4 laser lithotripsy of renal tract stones.
• Level 4 PCNL (with Interventional radiology assistance), Level 3 PCNL if solo.
• Level 4 endoluminal treatment of ureteric stricture disease.
• Level 3 HOLEP (possibly level 4 depending on starting experience).
• Level 4 in ESWL provision.

• Independence in managing new patients with kidney stone problems.
• Part of the stone team proving MDT input to complex cases.
• Competency in endourology techniques demonstrated by running courses for theatre nurses and organising Northeast Stone Forum.  

• Able to manage acute urological emergencies, with particular emphasis on endourological problems, independently.
• Help in the management of acute stone patients on theatre waiting lists e.g. involvement in ureteroscopy allocation meetings, redeveloping patient pathways, and increasing liaison with A+E.

• PCNL: 50–70 per year
• Ureteroscopy: 120–150 per year
• HOLEP: 20–40 per year
• Other endourology procedures: 70–100 per year
• ESWL: 100–120 per year

Based at: Newcastle-upon-Tyne Hospitals NHS Foundation Trust

Surgical Specialty Association approving: BAUS

Approval period: Initially approved July 2016 / Reapproved December 2019 - October 2024 / Reapproved December 2024 - November 2027

Supervisor / Lead Consultant: Mr Christopher Harding, Consultant Urological Surgeon, with Miss Victoria Lavin, Consultant Urological Surgeon

Fellowship duration: 6-12 months

Stated learning outcomes:

• Outpatient management of complex tertiary referrals.
• Independently perform botulinum toxin injections into the bladder.
• Independently perform female stress incontinence surgery.
• Independently perform sacral neuromodulation.
• Wide exposure to surgery for male stress urinary incontinence.
• Independently perform ileal conduit urinary diversion.
• Complete robotic simulation training, commence console training and independently perform certain steps of cystectomy and other robotic reconstructive procedures.
• Perform and interpret video cystometry.
• Complete an audit.
• Submission of publication to a peer-reviewed journal.
• Participation in departmental and national research.

Clinical competencies to be achieved:

• Independent operator for female stress incontinence surgery.
• Independent operator for ileal conduit urinary diversion.
• Independent operator for sacral neuromodulation procedures.
• Independent operator for male incontinence surgery.
• Lead operator for advanced reconstructive urological surgery.
• Intermediate competency in robotic surgery.

Number of main operations the fellow could expect to be involved in:

(Estimates are for a fellowship with duration of 12 months)

• Video/ Simple Urodynamics – more than 25 cases
• Cystoscopy and Botulinum Toxin – more than 25 cases
• Sacral Nerve Stimulation Procedures – more than 25 cases
• Artificial Urinary Sphincter Insertion – 6-10 cases
• Urethroplasty – 6-10 cases
• Periurethral Bulking Injection – 4-6 cases
• Ileal Conduit Urinary Diversion – 10-12 cases
• Cystectomy – 10-15 cases
• Bladder Augmentation – 1-2 cases
• Orthotopic Bladder Reconstruction – 1-2 cases
• Penile prosthesis insertion – 2-4 cases
• Colposuspension – 4-6 cases
• Mesh removal cases – 3-5 cases
• Urethral Diverticulum excision – 2-4 cases
• Urogenital Fistula Surgery – 1-3 cases
• Autologous Fascial Sling – 1-3 cases
• Penile Reconstruction (Nesbitts procedure) 2-4 cases

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Andrew Harris (Aug 16 - Sep 17)
• Frances Burge (Oct 18 - Mar 19)
• Omar Naser (Jul 19 - Mar 20)
• Bianca Menke Barea (Mar 20 - Nov 20)
• Arjun Nambiar (Dec 20 - Oct 21)
• Niyukta Thakare (Oct 21 - Oct 22)

• To develop advanced skills in the surgical management of patients and reconstruction of genitalia in patients with gender incongruence/dysphoria.
• Outpatient management of complex tertiary referrals in Gender Affirming Surgery and its complications.
• Wide exposure to surgery for Gender Affirming feminising surgery and its complications.

Feminising surgery:

• Independently perform vaginoplasty using penile skin lining, with creation of neoclitoris and labia.
• Perform with supervision surgery using penile skin.
• Perform with supervision or assist with revisional surgery including revision meatoplasty.
• Complete an audit and Quality Improvement Project.
• Submission of a publication to a peer-reviewed journal.
• Participation in Departmental and National Research

• Independent operator for feminising genital surgery using penile skin inversion technique.
• Independent operator for some common complications in feminising gender affirming surgery.
• Participation in feminising genital surgery using other skin or non-skin techniques.

• Vaginoplasty/Vulvoplasty – involved in 156 primary cases over 2 years.
• Bilateral orchidectomy as a sole procedure – independent operator for a minimum of 10 cases.
• Formation of a neovaginal cavity – independent operator for 20 cases.
• Using skin to form a neovaginal lining – independent operator in 50 cases.
• Creation of a neoclitoris, labia minora and majora - independent operator in 50 cases.
• Treating complications of genital reconstruction in transgender women and men – involved in 30 cases.

Based at: Hertfordshire and South Bedfordshire Urological Cancer Centre

Surgical Specialty Association approving: BAUS

Approval period: Initially approved November 2012; reapproved April 2016; reapproved June 2019 - August 2022; reapproved June 2023 - May 2026

Supervisor / Lead Consultant: Mr J.M. Adshead, Consultant Urological and Robotic Surgeon, with Mr Nikhil Vasdev, Consultant Urological and Robotic Surgeon, and Mr Tim Lane, Consultant Urological and Robotic Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• Safe understanding of the equipment.
• Safe and independent Robotic surgeon ready for independent consultant practice.
• To be ready to become a national proctor.
• Ready for consultant Robotic urology posts.
• Understood and carried out robotic audit research and hopefully peer reviewed presentation and publication.

Clinical competencies to be achieved:

• Independent surgeon in RALP.
• Experience in Radical Robotic Cystectomy.
• Independent surgeon in Pyeloplasty.
• Independent surgeon in Robotic Nephrectomy.
• Experience in Robotic Partial Nephrectomy.

Number of main operations the fellow could expect to be involved in:

Ralps: 169 total

• Primary operator: 39
• Secondary: 95 with console time
• Assisting approx 40 (some crossover with secondary)

Partials

• 1 x primary (for off clamp AML)
• 11 x console/secondary
• 4 x assist 

Nephrectomy

• 1 x  primary 
• 2 x assist

Pyeloplasty

• 3 cases primary
• 1 cases secondary but with console time
• 3 cases secondary

Open and robotic cystectomy

• 25 over half of the fellowship
• Approximately 10 as secondary (open rather than robotic)

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Ranjan Arianayagam (Mar 18 - Apr 19)
• Ashwin Tamhankar (Jun 19 - May 20)
• Jonathan Noel (Nov 19 - Sep 20)
• Arvind Nayak (Jul 20 - Jul 22)
• Yogit Wagh (May 20 - Jan 23)
• Andrew Brodie (Oct 22 - Sep23)
• Ned Kinnear (Mar 23 - Mar 24)

Based at: Newcastle-upon-Tyne Hospitals NHS Foundation Trust

Surgical Specialty Association approving: BAUS

Approval period: October 2021 - September 2024

Supervisor / Lead Consultant: Mr Bhavan Rai, Consultant Urological Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• An understanding of the intuitive Robotic System
• Independent in Robotic Surgeon in Radical Prostatectomy (NHS standard)
• Experience in Robotic Assisted Radical Cystectomy, Robotic Assisted Partial Nephrectomy, Robotic Assisted Pyeloplasty, Robotic Assisted Nephro-ureterectomy
• Academia related to Robotic Surgery or uro-oncology

Clinical competencies to be achieved:

• Complete All Modules of Robotic Assisted Radical Prostatectomy
• Independent in Robotic Assisted Radical Prostatectomy
• Experience in Robotic Assisted Radical Cystectomy, Robotic Assisted Partial Nephrectomy, Robotic Assisted Pyeloplasty, Robotic Assisted Nephro-ureterectomy

Number of main operations the fellow could expect to be involved in:

• Robotic Assisted Radical Prostatectomy-110
• Independent in Robotic Assisted Radical Prostatectomy-20
• Robotic Assisted Radical Cystectomy-15-20
• Robotic Assisted Partial Nephrectomy-15-20
• Robotic Assisted Pyeloplasty-15-20
• Robotic Assisted Nephro-ureterectomy-15-20

Overall Robotic Cases ~ 180. This will be a combination of bedside assisting, observation and console cases. We will discuss with the fellow their individual needs with bedside assisting. We have a dedicated bedside assistant team with an established rota who will engage with fellow for any bedside assisting training needs. We anticipate this to be less than 10% of the time needed.

Over Console Cases ~ 110. This is the total number of cases that we anticipate the fellow will spend on the console

Primary Surgeon ~ 40. This is the number of cases we anticipate the fellow to be the first surgeon has done over 80% of the operation

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Arun George (Nov 21 - Nov 22)
• Nnaemeka Eli (Nov 22 - Oct 23)

Based at: St George’s University Hospitals NHS Foundation Trust, London

Surgical Specialty Association approving: BAUS

Approval period: January 2019 - March 2022; reaccredited September 2023 - August 2026

Supervisor / Lead Consultant: Mr Christopher J Anderson, Director of Robotic Urology and Fellowship Training

Fellowship duration: 12 months

Stated learning outcomes:

• Pre-operative, Peri-operative and Post Operative care of Urological Robotic Cancer Cases.
• Competency by Modular training for Robotic Urology Surgery.
• Patient and Cancer outcomes during SURF by AUDIT.
• Trainee opinion on training and trainers to improve quality and trainee satisfaction of training.

Clinical competencies to be achieved:

• Competency in planning Urological Robotic Surgery, including the use of Radiology and Pathology.
• Competency in operative steps as defined by the Urological Robotic Surgery modular steps.

Number of main operations the fellow could expect to be involved in:

Caseload for the fellow in 1 year (46 weeks):

• Prostatectomy (n=50 supervised; 15 independent); Nephrectomy (n=30 supervised; 15 independent).
• Gaining experience in Partial Nephrectomy (n=40), Radical Cystectomy (n=40) and Pyeloplasty (n=15).
• All these competencies will be measured and certified by using validated assessments agreed by the training agreement. 

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Alarick Picardo (April 20 - April 21)
• Dharmender Aggarwal  (Apr 21 - Oct 22)
• Luis Euceda Cerna (Apr 23 - Mar 24)

Based at: Addenbrooke’s Hospital, Cambridge University Hospitals NHS Trust

Surgical Specialty Association approving: BAUS

Approval period: January 2018 - March 2021; reapproved October 2021 - September 2024

Supervisor / Lead Consultant: Mr Nimish Shah, Consultant Urologist, with Mr Benjamin Lamb, Consultant Urologist

Fellowship duration: 12 months

Clinical competencies to be achieved:

• Independent surgeon in robotic radical prostatectomy.
• Safe and effective preoperative management of patients undergoing robotic radical prostatectomy.
• Appropriate case selection of patients for robotic radical prostatectomy.
• Safe and effective follow-up of patients who have undergone robotic radical prostatectomy including management of complications.

Stated learning outcomes:

• Safe understanding of the equipment.
• Safe and independent robotic prostatectomy surgeon ready for independent consultant practice.
• Active involvement in robotic prostatectomy audit and research, hopefully resulting in peer-reviewed presentation and publication.

Number of main operations the fellow could expect to be involved in:

Supervisor (2017): 'The fellow will attend theatre for 3 days and be involved with 6 robotic prostatectomy cases per week. Over the course of the year, they will be involved with >200 cases.'

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Mohamed Abd Alazeez (Apr 18 - Apr 19)
• Saiful Miah (Apr 19 - Apr 20)
• Keval Patel (Apr 20 - Dec 20)
• Li June Tay (May 21 - Mar 22)
• Neil Maitra (Apr 22 - May 23)
• Ahmed Ibrahim (May 23 - Oct 23)

Based at: Frimley Health NHS Foundation Trust

Surgical Specialty Association approving: BAUS

Approval period: January 2019 - March 2022; reapproved December 2022 - November 2025

Supervisor / Lead Consultant: Mr Neil Barber, Consultant Urologist, Director, Frimley Renal Cancer Centre, with Mr Muddassar Hussain, Consultant Urological and Robotic Surgeon, and Mr Manar Malki, Consultant Urological & Robotic Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• To formulate appropriate management plans for patients with complex upper tract conditions.
• To independently perform advanced minimally invasive renal surgery.
• To lead and support a multidisciplinary team managing renal cancer.
• To teach junior team members the basics of renal surgery.

Clinical competencies to be achieved:

See operation numbers

Number of main operations the fellow could expect to be involved in:

• To independently perform robotic partial nephrectomy (total: 22-25).
• To independently perform laparoscopic nephrectomy and nephroureterectomy (total: 30).
• To perform robotic pyeloplasty and nephroureterectomy under minimal supervision (total: 10).

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Manar Malki (Feb 18 - May 19)
• Matthew Crockett (Oct 19 - Oct 20)
• Denosshan Sri (Oct 20 - Oct 21)
• Sarah O'Neill (Oct 21 - Oct 22)
• Mohammed Aldiwani (Oct 22 - Sep 23)

Based at: Guy's & St Thomas' NHS Foundation Trust

Surgical Specialty Association approving: BAUS

Approval period: Initially approved August 2015; reapproved March 2019 - May 2022; reapproved December 2022 - November 2025

Supervisor / Lead Consultant: Mr Ramesh Thurairaja, Consultant Urological Surgeon, with Mr Rajesh Nair, Consultant Urological Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• Comprehensive knowledge of management principles and rational decision making.
• Safe and independent dual accredited Open and Robotic surgeon ready for independent consultant practice.
• To be ready to become a national proctor.
• Ready for consultant bladder cancer urology posts.
• Understood and carried out open/robotic audit research and hopefully peer reviewed presentations and publications.

Clinical competencies to be achieved:

• Independent surgeon in open cystectomy.
• Independent surgeon in robotic cystectomy.
• Independent surgeon in the urinary diversion.
• Experience in the robotic urinary diversion.

Number of main operations the fellow could expect to be involved in:

Supervisor (2018): The fellow will certainly have exposure to approximately 80 cystectomy cases over a 12 month period with 60-70% of these cases being performed robotically (due to involvement with iROC trial reduction in percentage to 50-60%). In addition, there will also be opportunities to be involved with approximately 30 renal

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Rajesh Nair (Oct 15 - Jul 16)
• Brian Parsons (Sep 16 - Aug 17)
• Teck-Wei Tan (Oct 17 - Oct 18)
• Diarmaid Moran (Aug 18 - Aug 19)
• Ella Doerge (Jan 19 - Jan 20)
• Sonpreet Rai (Oct 20 - Oct 21)
• Marc Furrer (Jan 22 - Dec 22)

Based at: HealthCare Global Cancer Centre, Bangalore

Surgical Specialty Association approving: BAUS

Approval period: Initially approved June 2023 – June 2026

Supervisor / Lead Consultant: Dr Raghunath Sarakanur Krishnappa, Uro-Oncologist, Program Director – Co-Supervisor Dr Tejus Chiranjeevi, Consultant, Uro-Oncology & Robotic Surgery.

Fellowship duration: 18 months

Stated learning outcomes:

The objective of this course is to enable the student,

• To be competent on the evaluation and diagnosis of urological cancer patients.
• To be competent on the standard surgical procedures (Open, laparoscopic and Robotic) for the treatment of urological cancers.

At the end of the training period the candidates are expected to have in-depth knowledge, skills and attitude to take up academic career in urological oncology and leadership positions in the field.

Clinical competencies to be achieved:

• To participate in all major open, laparoscopic, robotic surgery & endo-urology cases done for urological malignancies.
• To carry out the surgery steps in a progressive manner under guidance of the faculty.

Number of main operations the fellow could expect to be involved in:

• Diagnostic and therapeutic endourologic procedures: 120
• Open oncologic and its related surgeries [radical nephrectomy, radical cystectomy, radical prostatectomy, RPLND, Partial Penectomy, Inguinal lymphadenectomy]: 40
• Laparoscopic surgeries [Radical nephrectomy]: 20
• Robotic surgeries as console surgeon (some steps of each surgery) [Radical nephrectomy, Partial Nephrectomy, Radical cystectomy, Urinary diversion, Radical prostatectomy, RPLND, rVEIL]: 110
• USG guided diagnostic and therapeutic procedure [Prostate biopsy and Percutaneous nephrostomy]: 70
• Intravesical BCG, Mitomycin C and Gemcitabine: 100

Based at: Leeds Teaching Hospitals NHS Trust

Surgical Specialty Association approving: BAUS

Approval period: Initially approved September 2014 / Reapproved March 2019 - May 2022 / Reapproved December 2024 - November 2027

Supervisor / Lead Consultant: Mr Sanjeev Kotwal, Consultant Urological Surgeon - Co-Supervisor: Mr William Cross, Consultant Urologist.

Fellowship duration: 12 months

Stated learning outcomes:

• Fellows should be able to perform Robotic-assisted Radical Prostatectomy (RARP) independently (Level - 4 competence) and Intracorporeal Robotic-assisted Radical Cystectomy (iRARC) under supervision (level 3).
• Fellows should be able to provide comprehensive care to uro-oncology patients in a multi-disciplinary setting.

Clinical competencies to be achieved:

See stated learning outcomes.

Number of main operations the fellow could expect to be involved in:

Able to perform/assist in :

• Minimum of 50 robotic radical prostatectomy.
• 25 robotic / open cystectomy.
• 10 nephro-ureterectomy.
• 5 retroperitoneal node dissection cases.

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Deligiannis Dimitrios (Jun 17 - Jun 18)
• Marcelino Yazbek Hanna (Aug 19 - Jan 21)
• Avinash Odugoudar (Jan 21 - Jan 22)

Based at: Royal Free London NHS Foundation Trust

Surgical Specialty Association approving: BAUS

Approval period: First approved July 2018 / Reapproved August 2021 - July 2024 / Reapproved December 2024 - November 2027

Supervisor / Lead Consultant: Mr Faiz Mumtaz, Consultant Urological Surgeon, with Prof Axel Bex, Consultant Urological Surgeon, and Clinical Lead, specialist centre for kidney cancer, Royal Free Hospital

Fellowship duration: 12 months

Stated learning outcomes:

• In depth knowledge of relevant aspects of upper urinary tract cancers including epidemiology, risk factors, presentation, diagnosis and management.
• Comprehensive knowledge of management principles and rational decision making in renal cancer.
• Safe and independent dual accredited Open and Robotic/laparoscopic surgeon ready for independent consultant practice.
• Able to manage all aspects of both benign and malignant disease spectrum relating to the upper urinary tract.
• Able to manage acute renal oncological emergencies.
• Understood and carried out an audit of open/robotic surgery.
• Recognise future directions of research relating to renal cancer.
• Ready for consultant upper urinary tract urology posts.
• To be ready to become a national proctor.

Clinical competencies to be achieved:

• To develop competencies in decision making about individualised treatment, preoperative assessment for surgery, appropriate patient selection and surgical procedure for all aspects of renal cancer surgery.
• Manage patients postoperatively, diagnose and treat complications with minimal supervision.
• See operation numbers
  

Number of main operations the fellow could expect to be involved in:

• Competent surgeon in open (25), laparoscopic (25) and robotic nephrectomy (25)
• Competent surgeon in robotic partial nephrectomy (30)
• Competent surgeon in robotic nephroureterectomy (20)
• Competent surgeon in robotic pyeloplasty (15)
• Exposure to various aspects of very complex upper tract surgery

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Aziz Gulamhusein (Sep 18 - Sep 19)
• Nicholas Campain (Oct 20 - Oct 21)
• Saeed Dabestani (Oct 21 - Sep 22)
• Shane Considine (Oct 22 - Dec 23)

Based at: Cardiff and Vale University Health Board, University Hospital of Wales NHS Foundation Trust

Surgical Specialty Association approving: BAUS

Approval period: Initially approved January 2024 – December 2026

Supervisor / Lead Consultant: Mr Krishna Narahari, Consultant Urological Surgeon - Additional Supervisors: Jon Featherstone, Gokul Kandaswamy, Matthew Jefferies all of whom are Consultant Urological Surgeons in Wales

Fellowship duration: 12 months

Stated learning outcomes:

• Comprehensive knowledge, skills and experience of managing a tertiary oncology practice.
• Ready to be a Day 1 Consultant Urological Surgeon with Subspecialist interest in Uro-Oncology.
• Level 4 (independent) competency in Robotic Radical Prostatectomy & Partial Nephrectomy.
• Presentations at national and/or international meetings and peer-reviewed publications.

Clinical competencies to be achieved:

• Level 4 (independent) competency in Robotic Pelvic Oncology (RALP, Steps of Cystectomy) & RPN (Partial Nephrectomy) based on fellows interest.
• Comprehensive knowledge, skills and experience of managing a tertiary oncology practice.

Number of main operations the fellow could expect to be involved in:

• Robot Assisted Radical Prostatectomy (Performed: 25)
• Robotic Nephrectomy/Partial Nephrectomy (Performed: 15)
• Radical Cystectomy (Performed: 10)

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Sarah Prattley (Aug 23 - Aug 24)