The three-year Reproductive Endocrinology and Infertility Fellowship at Mayo Clinic enables you to assume full clinical responsibility as a reproductive endocrinologist, perform advanced research and become an independent investigator in the field of reproductive physiology.
The first year of the fellowship involves intense clinical training in reproductive endocrinology, andrology, and reproductive surgery, with ample opportunity to prepare for research in the subsequent two years.
The second year is devoted to research and didactic instruction in basic science, while the third year continues to emphasize research and also provides focused clinical training in reproductive, medical and pediatric endocrinology, as well as genetics.
The first year of the Reproductive Endocrinology and Infertility Fellowship provides general clinical experiences in reproductive endocrinology. You spend 90 percent of your time in the Division of Reproductive Endocrinology and Infertility.
As you manage patients under close supervision by consultant staff, you develop clinical and surgical skills related to:
- Abnormal uterine bleeding
- Neuroendocrine dysfunction
- Reproductive tract abnormalities (acquired and developmental)
- Androgen disorders
- Recurrent abortion
You also participate in the multidisciplinary Mayo Clinic Assisted Reproductive Technology (MCART) Program, which offers in vitro fertilization (IVF), gamete micromanipulation, assisted hatching and embryo-cumulus cell coculture techniques, embryo cryopreservation, and oocyte donation.
The MCART Program experience prepares you for a clinical practice in reproductive endocrinology through extensive experience in sonography, sonohysterography, controlled ovarian hyperstimulation, transvaginal ultrasound-directed oocyte retrieval, and ultrasound-guided embryo transfer.
Through the MCART Program, you also learn medical and surgical treatments of male infertility, including epididymal aspiration, testicular biopsy, and electroejaculation in collaboration with the Department of Urology.
All infertility care is supervised by a reproductive endocrinologist, who works closely with a urologist and a medical andrologist.
During the MCART Program experience, you fulfill specific learning objectives pertaining to IVF laboratory and andrology laboratory procedures. You study:
- Quality control testing of culture media
- Surgical items and labware
- Culture media and sperm preparation for IVF
- Egg retrieval and insemination
- Fertilization evaluation
- Embryo culture and transfer and assisted hatching
- Cumulus cell coculture techniques
- Blastomere biopsy
- Preparation for preimplantation genetic diagnosis and embryo cryopreservation
- Semen analysis, anti-sperm antibodies, cryopreservation and thawing of semen, and sperm washing
The remaining 20 percent of your first year (one day each week) is spent participating in didactic activities and preparing a research proposal. Initially, you visit the laboratories of research investigators to develop a specific research interest with an individual mentor. Then, you prepare a grant proposal according to National Institutes of Health guidelines. Your proposal is reviewed by members of the Mayo Clinic scientific community no later than the end of the first program year.
In the second year, you spend 80 percent of your time in research-related activities, where you gain a further understanding of the latest scientific techniques.
You continue to attend mandatory graduate school courses, which prepare academicians and independent investigators. Your continued participation in the MCART Program a half day each week provides ongoing training in assisted reproductive technology.
To provide a continuous 18-month research experience throughout the second and third years, you continue to spend 60 percent of your time in research-related activities. You have one three-month elective in research or clinical medicine (depending on your individual needs and interests) as well as three separate one-month rotations in medical endocrinology, pediatric endocrinology and medical genetics (if these have not been completed earlier).
Throughout the third year, you spend 40 percent of your time as a junior faculty member in the Reproductive Endocrinology and Infertility Clinic, where you get complete up-to-date training in assisted reproductive technology and teach junior colleagues to develop those skills.
The following provides an overview of the rotations you will do during your third year of the Reproductive Endocrinology and Infertility Fellowship.
Division of Endocrinology, Diabetes, Metabolism, & Nutrition
In this division, you manage adult disorders pertaining to endocrinology, metabolism, and diabetes through these outpatient clinics:
- Metabolism Clinic (diabetes mellitus and lipid disorders)
- Nutrition Clinic
- Intensive Diabetes Management
- Thyroid Clinic
- Metabolic Bone Disease Clinic (hypercalcemia and other metabolic bone diseases)
- Osteoporosis Clinic
- Pituitary, Gonad, and Adrenal (PGA) Clinic
You present patient cases at the endocrinology, metabolism, and diabetes resident-staff conferences held twice weekly, and discuss salient issues among all residents, fellows, and staff.
Division of Pediatric Endocrinology and Metabolism
During your rotation in the Division of Pediatric Endocrinology and Metabolism, you manage complicated childhood disorders related to endocrinology, metabolism, and diabetes. Along with specialists in pediatric and adult endocrinology, you also provide ambulatory care at Mayo Clinic and inpatient care at Mayo Clinic Hospital, Saint Marys Campus. Your patient care experience is augmented by regularly scheduled didactic courses, seminars, and case conferences.
Department of Medical Genetics
In the Department of Medical Genetics, you gain extensive clinical experience with genetic diseases, including single gene, chromosomal, mitochondrial, multifactorial, and teratogenic disorders. You participate in the genetic screening of oocyte donors from the Anonymous Oocyte Donation Program. You also attend journal clubs and seminars pertaining to genetics.
Your call schedule is different for each rotation. Mayo Clinic follows the recommendations of the Accreditation Council for Graduate Medical Education (ACGME).
You may moonlight with program director approval. Moonlighting should not interfere with the required learning and must not violate the work-hour rules of the Accreditation Council for Graduate Medical Education (ACGME) or visa regulations.
The didactic courses that fulfill your fellowship requirements include:
Biostatistics and epidemiology. In this class, basic statistical terms and concepts are presented, with an emphasis on:
- The conceptual framework for sampling, inference, and P values
- Mean, median, percentiles, range, standard deviation, proportions, and graphic displays of different data types
- Paired and unpaired t-testing
- Linear regression and their generalizations
- Sensitivity, specificity, prevalence, and positive and negative predictive values
- Sample size, power, and Type I and Type II errors
Depending on your individual needs, additional training in statistical analysis is available.
Molecular genetics. During this course, genetic topics relevant to biomedical research are discussed, while emphasizing the molecular basis of disease.
Genome biology. The organization and function of the genome are explored in this class, along with the regulation of gene expression in mammalian systems. Topics examined include genome packaging, replication, and transcription as well as RNA processing, translation, and protein processing.
Research at Mayo Clinic is characterized by collaboration among research groups and shared resources. To support researchers and students, Mayo Clinic has dozens of research core facilities with modern instrumentation.
During the second year of the Reproductive Endocrinology and Infertility Fellowship, you spend about 80 percent of your time in clinical research. These activities continue into the first six months of the third year of your training, for a total of at least 18 continuous months of research.
All research facilities at Mayo Clinic's campus in Rochester, Minnesota, provide resources to those training in this fellowship.
Additional research possibilities related to reproductive endocrinology include:
Andrology laboratory. The Mayo Clinic andrology laboratory is a two-room facility that performs regular and post-vasectomy semen analysis in accordance with World Health Organization (WHO) guidelines, WHO and strict criteria sperm morphology assessment, indirect and direct sperm antibody testing by the immunobead technique, sperm preparation for intrauterine insemination and therapeutic donor insemination, and semen cryopreservation.
Approximately 6,500 tests are performed annually for Mayo Clinic physicians and for physicians outside Mayo Clinic through Mayo Clinic Laboratories.
A reproductive endocrinology scientific laboratory is fully equipped to provide you with an excellent environment to learn in vitro cell culture techniques and participate in molecular biological research.
Clinical Research and Trials Unit. The Clinical Research and Trials Unit at Mayo Clinic provides specialized resources and training to investigators conducting human studies that translate high-quality research into improved patient care. It consists of an integrated inpatient-outpatient unit and a separate outpatient facility. Both units provide highly specialized clinical research facilities and trained staff, including research nurses, dietitians, and technicians devoted to carrying out studies in human physiology and disease.
The unit includes computer and biostatistical support as well as a comprehensive research education and training program for new investigators and trainees.
Proteomics Core. The Proteomics Core is designed to provide investigators throughout Mayo Clinic with the tools needed for proteomic analyses, including differential and global cell protein expression, protein quantification, protein sequencing, protein-protein interactions, and protein structure, and function. The core is equipped with mass spectrometers and additional state-of-the-art instruments needed for medium-throughput and high-sensitivity proteomic analyses.
You have opportunities to teach Mayo Clinic Alix School of Medicine students, obstetrics and gynecology residents, and visiting students from other medical schools through bedside instruction and formal didactic lectures.
To ensure that you acquire adequate knowledge and develop the appropriate technical skills to meet program expectations, your performance is monitored carefully during the Reproductive Endocrinology and Infertility Fellowship. You are formally evaluated by supervising faculty members on a regular basis and meet with the program director to review these evaluations. In addition, you regularly evaluate the faculty to confirm that your educational needs are being met.