San Diego Sexual Medicine Fellowship Program
Our Sexual medicine fellowship training involves management of women and men with sexual dysfunction: diagnosis, determination of etiology of the disease state, treatment options, and an opportunity to perform clinical research.
Offering a one year combined clinical training & research opportunity
San Diego Sexual Medicine is a 6000 sq ft facility dedicated to sexual medicine patient care and research. We boast 6 exam rooms, front and back waiting rooms, private offices for providers, a conference room for teaching, and dedicated space for a fellow. We have state-of-the-art equipment available for our patient management which the fellow will learn to use.
Dr. Goldstein has trained fellows in sexual medicine since 1984. Past fellows include many names that are well known and well respected such as John Mulhall, Hossein Sadeghi, Martin Bastuba and Larry Hakim, current thought leaders in the field, past and present SMSNA board members, academicians and private practitioners. Recent trainees are future leaders of the field, including Sherita King, Director of Prosthetic Urology at Augusta University, and Rachel Rubin, incoming Education Chair for the International Society for the Study of Women's Sexual Health. Of the 35 physicians who completed fellowships under Dr. Goldstein, all but two went from this fellowship to a position involving sexual medicine.
The sexual medicine fellowship is open to North American medical school graduates as well as foreign students who are US citizens or resident aliens who have completed a residency in urology. You must be eligible to obtain a medical license in California to apply for this fellowship. Please note that San Diego Sexual Medicine cannot provide documentation for visas for non-US residents.
To begin the process of application, please make your interest known by emailing Sue Goldstein, the program coordinator at firstname.lastname@example.org. Serious applicants are asked to come to San Diego to experience SDSM for at least a day, to submit a personal statement of why you want to practice sexual medicine, and where you see yourself after completion of your fellowhip. In addtion, please provide two letters of recommendation from your residency program including the following areas rated using the NIH nomenclature of “exceptional, outstanding, excellent, very good, good. fair and poor”: depth of your interaction with individual; potential as a sexual medicine fellow; performance on service as a resident; urologic knowledge base: appropriate as a fourth year resident; performance relative to other residents; and manual dexterity. Formal interviews are conducted at the AUA, with decisions made shortly afterward.
Train alongside the best
Experience a one-on-one mentorship with training in the medical & surgical management of men and women with sexual dysfunction
Fellowship experience opportunities
Sexual medicine involves medical, surgical and psychological assessment. Fellows in this sexual medicine will be trained in the medical and surgical management of men and women with sexual dysfunction. Psychologic evaluations are performed by our staff sex therapist, Dr. Harzell, and physical therapy evaluations by providers on staff with Comprehensive Therapy Services at their SDSM branch. The trainee will have an opportunity to interface with these experts as well as all staff at San Diego Sexual Medicine.
The most common surgical procedures performed at SDSM are penile implants, vestibulectomies and Bartholin's gland marsupialization, but unique to our facilitiy is microsurgical revascularization. Dr. Goldstein has more experience performing revascularization surgery than any other surgeon, and has trained those fellows interested in this procedure. This fellowship includes assisting in the OR for all procedures and learning to perform surgeries. As a tertiary care center SDSM provides an opportunity for the young urologist to learn not only how to insert a prosthesis, but how to minimize infection rates and how to perform the difficult implant placement. Other procedures include the Nesbitt procedure, correction of penile curvature, and dorsal slit..
Participation in this fellowship includes:
care of patients at San Diego Sexual Medicine, including both men and
women with sexual dysfunction from the local community and around the
at Alvarado Hospital, a private hospital across the street from SDSM
with state of the art equipment, and a friendly, knowledgeable nursing
- Surgery at Scripps Green Hospital under the tutelage of Dr. Jordan Siegel for additional surgery opportunities
- Exposure to Male Infertility under the tutelage of Dr. Martin Bastuba
- Clincial research at San Diego Sexual Medicine
- Sexual Medicine rounds at Alvarado Hospital monthly
- Journal club, San Diego Urological Association
- Attendance at Sexual Medicine Society of North America, International Society for the Study of Women's Sexual Health, AUA
Upon completion of this fellowship, you will have an understanding of the rationale behind the step-care approach to sexual medicine and the ability to perform the following:
- Sexual history taking and physical examination of men and women with sexual dysfunction, including vulvoscopy in women.
- Laboratory tests and in office diagnostic procedures including duplex Doppler, dynamic infusion cavernosometry, quantitative sensory testing and nerve blocks. This includes learning how to perform these tests as well as interpret the results.
- Modification of reversible causes including medication changes, lifestyle changes for sexual complaints in men and women.
- First line therapies including PDE5s and hormone therapy, buproprion/dostinex therapy in men and women with sexual dysfunction. This includes learning how to interpret blood hormone values, when it is safe to treat post cancer patients, how to titrate medications, and when to move to second line therapies.
- Intracavernosal injection therapy with more than 15 mixtures, intraurethral injection, vacuum therapy, steroid blocks including how to determine which second line therapy is best for which patient.
- Surgical intervention as listed above, including assisting and performing surgical procedures.
Experience an opportunity to train alongside a leader in the field of sexual medicine, Dr. Irwin Goldstein