The three-year Mayo Clinic Reproductive Endocrinology and Infertility Fellowship 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.
The third year continues to emphasize research and also provides focused clinical training in reproductive, medical and pediatric endocrinology, as well as genetics.
The following description of Mayo Clinic's Reproductive Endocrinology and Infertility Fellowship provides an overview of each program year.
First Postgraduate Year
The first year of the fellowship provides a general clinical experience in reproductive endocrinology. You will spend 90 percent of your time in the Division of Reproductive Endocrinology and Infertility (REI). You will manage patients under close supervision by consultant staff, thereby developing clinical and surgical skills related to:
- Abnormal uterine bleeding
- Neuroendocrine dysfunction
- Reproductive tract abnormalities (acquired and developmental)
- Androgen disorders
- Recurrent abortion
During the first postgraduate year, you will 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 will also learn medical and surgical treatments of male infertility, including epididymal aspiration, testicular biopsy and electroejaculation in collaboration with 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 will fulfill specific learning objectives pertaining to IVF laboratory and andrology laboratory procedures. You will 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, antisperm antibodies, cryopreservation and thawing of semen, and sperm washing
The remaining 20 percent of your first postgraduate year (one day weekly) will be spent participating in didactic activities and preparing a research proposal. Initially, you will visit the laboratories of research investigators to develop a specific research interest with an individual mentor. Then, you prepare a grant proposal according to NIH guidelines. Your proposal will be reviewed by members of the Mayo Clinic scientific community no later than the end of the first program year.
Second Postgraduate Year
In the second year postgraduate, you will spend 80 percent of your time in research-related activities, during which time you will gain a further understanding of the latest scientific techniques.
You will continue to attend mandatory graduate school courses, which prepare academicians and independent investigators. Your continued participation in the MCART Program one-half day weekly provides ongoing training in assisted reproductive technology.
Third Postgraduate Year
To provide a continuous 18-month research experience throughout the second and third years, you will continue to spend 60 percent of your time in research-related activities . You will have one three-month elective in research and/or clinical medicine, depending upon your individual needs and interests, and three separate one-month rotations in medical endocrinology, pediatric endocrinology and medical genetics (if these have not been completed earlier).
Throughout the third postgraduate year, you will spend 40 percent of your time (one-half day weekly) as a junior faculty member in the REI clinic, gaining complete up-to-date training in assisted reproductive technology and teaching 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
In the Division of Endocrinology, you will manage adult disorders pertaining to endocrinology, metabolism and diabetes through the following 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
- PGA Clinic (pituitary, gonad and adrenal disease)
You will 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
During your rotation in the Division of Pediatric Endocrinology, you will manage complicated childhood disorders pertaining to endocrinology, metabolism and diabetes. With specialists in pediatric and adult endocrinology, you will also provide ambulatory care at Mayo Clinic and inpatient care at Saint Marys Hospital. Your patient care experience will be augmented by regularly scheduled didactic courses, seminars and case conferences.
Department of Medical Genetics
In the Department of Medical Genetics, you will gain extensive clinical experience with genetic diseases, including single gene, chromosomal, mitochondrial, multifactorial and teratogenic disorders. You will participate in the genetic screening of oocyte donors from the Anonymous Oocyte Donation (AOD) Program. You will also attend journal clubs and seminars pertaining to genetics.
The didactic courses which would fulfill your fellowship requirements would 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, graphical displays of different data types; paired and unpaired t-testing, linear regression and their generalizations; sensitivity, specificity, prevalence, positive and negative predictive values; sample size, power and Type I as well as Type II errors.
Depending on your individual needs, additional training in statistical analysis is available.
During this course, genetic topics relevant to biomedical research are discussed, while emphasizing the molecular basis of disease.
The organization and function of the genome are explored in this class, along with the regulation of gene expression in mammalian systems. Topics that are examined include genome packaging, replication and transcription; RNA processing; translation; and protein processing.
Molecular Biology Training Course
If you do not have laboratory experience in molecular biology, the molecular biology core facility offers a six-week hands-on course that teaches the basic techniques of molecular biology, including DNA/RNA preparation, polymerase chain reaction, in situ hybridization and protein electrophoresis.
Research at Mayo Clinic is characterized by collaboration among research groups and shared resources. To support researchers and students, Mayo Clinic has 11 research core facilities with modern instrumentation:
- Analytical nuclear magnetic resonance (NMR)
- Biomedical imaging
- Confocal microscopy
- Electron microscopy
- Flow cytometry/optical morphology
- Mass spectrometry
- Molecular biology
- Protein sequencing/peptide synthesis
- Research computing
- Transgenic mouse facility and gene targeting
During the second year of the Reproductive Endocrinology Fellowship at Mayo Clinic in Rochester, you will spend nearly 90 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 in Rochester provide resources to those training in this fellowship program. Additional research possibilities related to reproductive endocrinology include:
The Mayo Clinic Andrology Laboratory is a two-room facility which performs regular and post-vasectomy semen analysis (in accordance with the 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 (IUI) 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 Medical Laboratories (MML).
A Reproductive Endocrinology scientific laboratory is fully equipped to provide you an excellent environment to learn in vitro cell culture techniques and participate in molecular biological research.
Endocrinology Research Laboratories
The Mayo Clinical Research Unit (CRU) 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 center includes computer and biostatistical support, and a comprehensive research education and training program for new investigators and trainees at both sites.
Mayo Proteomics Research Center
The Mayo Proteomics Research Center (MPRC) 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 MPRC is equipped with nine mass spectrometers and additional state-of-the -art instruments needed for medium throughput and high sensitivity proteomic analyses. Additional facilities are currently under construction in collaboration with the University of Minnesota.
Your call schedule will vary by individual rotation. Mayo Clinic follows the recommendations of the Accreditation Council for Graduate Medical Education.
To ensure that you acquire adequate knowledge and develop your technical skills, your performance will be monitored carefully during the course of your fellowship. You will be evaluated formally by your supervising faculty member at appropriate intervals. In addition, you will regularly evaluate the faculty to ensure that your educational needs are being met.
You will have opportunities to teach Mayo Medical School students, OB/GYN residents, and visiting students from other medical schools through bedside instruction and formal didactic lectures.