Clinical Specialist in Male Reproductive Medicine
submitted by Mary K. Samplaski, MD
Being a clinician in Male Reproductive Medicine, Sexual Medicine, Microsurgery and Andrology, has a wide variety of possible career hybrids. Many aspects of men’s health often fall under “andrology”. The conditions treated and procedures performed by these clinicians may include:
The distinction between Andrology and Male Reproductive Medicine can be subtle and there is substantial overlap between the two specialties. Most clinicians do some of both, but Andrologists tend to do more testosterone supplementation and erectile dysfunction, whereas Male Reproductive Medicine (or Male Infertility) specialists tend to focus more on optimizing sperm production and live births for their patients. As such your practice will include aspects of:
The pathway to achieving this career goal is drawn out, as it is a highly specialized field. After medical school the physician will complete a residency in Urology, a surgical subspecialty. During residency, physicians will be exposed to the various components of Urology, including Male Reproductive Medicine and Andrology. This distinction is important in choosing a fellowship, as most tend to be skewed more toward one or the other, as well as in deciding on a permanent faculty position.
Once the physician has decided to pursue a career in Male Reproductive Medicine or Andrology, they may choose to apply for a fellowship. In an effort to centralize information on these fellowships, the Society for Male Reproduction and Urology has a list of some of these on their website at: http://www.smru.org/detail.aspx?id=926. There is information about each of the fellowships, including the length (1 or 2 years), approximate research to clinical ratio, and contact information. While many of the available fellowships are listed there, it is not a comprehensive list and the applicant should also inquire with any specialists in Male Reproductive Medicine that they know on a personal level. If potential applicants would like assistance with mentoring, the Andrology Society of American is in the process of developing a mentoring program, and interested trainees should contact them for pairing. At present, most Male Reproductive Medicine and Andrology fellowships have joined a match program, although there still are a few programs that take applicants outside of the match. Of note, for the academically-oriented trainee, there are numerous awards and distinctions available during the fellowship training years.
After fellowship, the now highly trained physician will determine if they wish to pursue a career in academic medicine or private practice. Additional factors that may play into the type of career that they wish to develop include personal clinical and research interests (clinical or basic science), geographic location, personality, and ambition. In general most physicians gravitate toward either Male Reproductive Medicine or Andrology. Interaction with a reproductive endocrinology and infertility gynecological group and a strong specialized andrology lab is recommended. Close interaction with endocrinologists and local urologists and gynecologists is advantageous. This usually suggests a larger metropolitan environment, but not always. While there is no formalized job-posting website, at this point in their careers most physicians have done enough networking to learn where positions are available. In addition, some positions (private practice or academic) may be posted on the American Urological Association Careers In Urology or JobFinder website at http://www.auanet.org/about/careers-in-urology.cfm.
While the training period to becoming an academic clinician is long (undergraduate: 4 years, medical school: 4 years, residency: 5-6 years, fellowship: 1-2 years), the opportunity to care for patients sexual and reproductive needs is incredibly rewarding.
Mary K. Samplaski, MD, Director of Male Infertility, University of Southern California
Ajay Nangia, MD, Director of Male Infertility, University of Kansas Medical Center
Kirk Lo, MD, Co-Director of Male Infertility, University of Toronto