About the Program

The Head and Neck Oncologic and Reconstructive Surgery Fellowship is a one-year program. The department matches with two fellows each year. The fellowship includes broad experience in ablative surgery, endocrine surgery, microvascular surgery and endoscopic skull base surgery. The fellowship year will be characterized by a balance of mentorship and autonomy. Clinical faculty in head and neck surgery, surgical oncology, radiation oncology, medical oncology and surgical pathology will mentor the fellow during the training program. Early on, close supervision will be provided. As the clinical year progresses, the fellow will function more as a junior faculty member, leading residents through surgical procedures and determining treatment plans more independently. All fellows participate in clinical research projects. Fellows interested in additional basic research training may complete an additional two-year NIH funded research training program.

On completion of this program, the fellow will be fully prepared to assume a faculty position in academic head and neck oncology. The successful fellow will demonstrate outstanding surgical skills, sound judgment in diagnosis and decision-making, excellence as a clinical investigator and as an invested educator. The goal will be reached through a combination of required and optional clinical rotations, weekly protected research time, didactic and interactive conferences, and an outlined curriculum of study. Progress during training will be regularly evaluated with both written and verbal feedback.

Training

Fellows train in multiple UAB affiliated hospitals and The Kirklin clinic all within several blocks of each other. This arrangement gives our fellows the advantage of training in several different medical environments with the convenience of one central location. University Hospital is a 1,157 bed state-of-the-art facility that serves as the tertiary referral center for the state of Alabama and beyond. As the third largest public hospital in the nation, University Hospital encompasses 11 city blocks and is the centerpiece of the UAB Medical Center.

UAB Medical Center is the major referral center for head and neck cancer patients from a service area including Alabama, northern Florida, western Georgia, and eastern Mississippi. University Hospital has more than 5,600 cancer admissions each year. Most patients are seen in response to referrals from community physicians. Most have a cancer diagnosis at the time of referral and the great majority has stage III or IV disease. The otolaryngology service functions as gatekeeper for 90-95% of head and neck cancer patient referrals. Radiation oncology and medical oncology do receive a small number of direct referrals from colleagues in the service area and those are subsequently referred to otolaryngology for comprehensive multidisciplinary evaluation.

The fellow has primary responsibility for 24 new patients and will operate on between 300-500 patients as primary surgeon or first assistant to a resident. The fellow will also serve as primary surgeon or first assistant for 400-550 major head and neck operations.

Supervision, Teaching, and Call Schedule

The goal of the fellowship is preparation of a head and neck surgeon capable of functioning as a junior level attending surgeon. This high level of competence will require careful observation by the participating faculty and open communication with the trainee as the program progresses. The limited time length of the training period mandates real-time feedback to the trainee. Faculty members will be encouraged to commend progress and to intervene early-on as deficiencies are detected. The fellow’s progress will be evaluated with reference to others working at the same level of sub-specialty training and 360 evaluations.

In addition to ongoing informal feedback, there will be a periodic, formal written evaluation of the fellow’s progress, and based on close observation of the trainee, faculty members fill out an evaluation form that specifically addresses the following characteristics: clinical judgment, medical knowledge, clinical skills, surgical skills, humanistic qualities, professional attitudes and behavior, and commitment to scholarship. Faculty members are encouraged to discuss their evaluations with the fellow and to provide them with timely feedback on their performance.

The Program Director will also collect a verbal “360 degree” evaluation of the fellow’s progress at the conclusion of each rotation. The 360 degree evaluators may include resident physicians assigned to the same service, OR nursing staff, clinic nursing staff, and the administrative secretary in the Otolaryngology office.

Each fellow will maintain a surgical log of all cases performed. The Program Director will review the log with the fellow every 3 months. The fellow will select two representative surgical cases to include in the Surgical Case Portfolio each month. The portfolio will include documentation of a patient’s initial workup, operative planning, intra-operative notes, discharge summary and brief synopsis of follow-up care. The Program Director will review the portfolio cases with the fellow every 3 months.

Clinical Procedural Requirements

The head and neck service is functionally divided into two sub-services based on OR and clinic days.The fellow will attend the outpatient clinic of the assigned head and neck oncology faculty member one half to one day per week. The fellow will evaluate new and return patients initially, formulate an assessment and treatment plan, and then finalize the plans with the faculty physician.Time in other departments will include two-week rotations in radiation oncology and medical oncology.) Additional arrangements have been made for elective time in dermatology, facial plastic surgery, and surgical pathology. These electives will be individualized according to the fellow’s interest. 

Fellow 1

 
Fellow 2

Research

During the year, the fellow will participate in clinical or basic research. The fellow will choose a topic of investigation and the Otolaryngology Research Committee will monitor progress. A research mentor will be chosen from the faculty. The fellow will attend monthly research meetings where the committee will review progress and recommend changes as needed. The fellow will present the completed project at the annual “Research Day” held in May each year. Prior to presentation, the project must be written in manuscript form suitable for submission for publication. Each head and neck faculty member has active research interests. These include clinical trials, outcome studies, health services research, population/community based studies and applied laboratory research. UAB has a rich basic science research community with ample opportunity for a broad range of cancer related investigation. During the clinical year, one day each week will be set aside to pursue research activities. Trainees interested in additional research training will be eligible to participate in a two-year, NIH sponsored T-32 training grant for basic science research.

Eligibility

AHNS guidelines 

How to Apply

Interested applicants should register and complete an application on the American Head and Neck Society (AHNS) website. Applicants who completed their medical education outside of the US or Canada, should register with the AHNS and apply separately here. 

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