Primary Institution



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Please send completed form to info@smsna.org with SMS FELLOWSHIP LISTING in the subject line.


Primary Institution





Fellowship Director





Fellowship Administrator





Candidate Citizenship Requirement


☐ US only

☐ US & Canadian

☐ All Nationalities _______________________________________________


Fellowship Duration


☐ 12 months

☐ 24 months

☐ Other _________ months


Type of Fellowship


☐ Sexual Medicine

☐ Sexual & Reproductive Medicine




Research Available


☐ Mandatory ☐ Optional

☐ Clinical research ☐ Laboratory research ☐ Both




Fellowship Overview (300 words)





Research Focus (300 words)





Surgical Procedures Performed


☐ Crural ligation

☐ Penile fracture repair

☐ Plaque incision/excision and grafting

☐ Penile implant

☐ Penile revascularization

☐ Penile plication

Priapism shunting

☐ Vulvar surgery

☐ Percutaneous sperm extraction

☐ TESE


☐ Varicocele ligation

☐ Electroejaculation

Vasectomy

☐ Vasovasostomy

☐ Vasoepididymostomy
☐ Other _________________________________________________________________


Office Procedures Performed


☐ Cavernosometry/cavernosography

Duplex Doppler Ultrasound

☐ Intracavernosal injections

☐ Intralesional injections

☐ Penile deformity assessment

Testosterone pellet insertion


☐ Other _________________________________________________________________


Conference Schedule





Fellowship Application (PDF/Link)





Interview schedule (Free text)





Fellowship Website (Link)





Housing Options (Free Text)




Prior Fellows & Contact Information (Free text)







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