PROGRAM DESCRIPTION

Overview: The Head and Neck Oncologic and Reconstructive Surgery Fellowship at the University of Iowa has a long and rich tradition. A number of distinguished head and neck oncologists have completed this fellowship. The Department of Otolaryngology-Head and Neck Surgery at the University of Iowa, which is highly ranked nationally, is a very strong department within the University of Iowa Carver College of Medicine. The University of Iowa Hospitals and Clinics serve as a major tertiary care center in the Midwest. Approximately 25% of the 35,000 yearly outpatient visits to the Department of Otolaryngology-Head and Neck Surgery are cancer related. Approximately 500 patients are referred to the University of Iowa every year for management of a head and neck tumor.  Approximately 300 of these patients are treated surgically. Patients are housed in the Clinical Cancer Center, which was opened in 1994. The University of Iowa Hospitals and Clinics surgical facility consists of 30 operating suites, including dedicated robotic surgical suites.

Objectives: The fellowship is carried out at the University of Iowa Hospitals and Clinics, including the Holden Clinical Cancer Center and the associated Iowa City Veteran’s Administration Medical Center. The objectives of the program include mastering the evaluation and management of patients with benign and malignant neoplasms involving the head and neck, including the upper aerodigestive tract, sinuses, orbits, soft tissues, and skin. The fellow will learn the most contemporary, effective, and efficient means of diagnosis and treatment for particular neoplasms. The fellow will participate in an interdisciplinary Head and Neck Cancer Tumor Board, and become proficient in the multidisciplinary management of complex head and neck cancer cases. The fellow will learn appropriate reconstruction and rehabilitation techniques used in the management of these patients, including free tissue transfer.  During the fellowship, a clinical and/or basic science research project relating to the field of head and neck oncology is completed by the fellow.

Strengths: One of the greatest strengths of the fellowship training at the University of Iowa is the extensive collaboration that the otolaryngology-Head and Neck Surgery Service has with the other surgical subspecialties. Routine collaboration with the Cardiothoracic Surgery, Neurosurgery, Oculoplastics Surgery, Oral and Maxillofacial Surgery, Dermatology and General Surgery Services are undertaken. The fellow gains a tremendous depth of understanding for all aspects of management of head and neck cancer patients through these rich collaborative relationships.

Additionally, the fellow functions as a junior faculty member, and is responsible for coordinating the management of the head and neck inpatients with the residents. This experience serves as an excellent preparation for transition into independent practice. The majority of the last ten head and neck oncologic and reconstructive surgery fellows are currently in academic positions.  A number of previous head and neck fellows from the University of Iowa have gone on to assume positions of national and international leadership within the field of head and neck oncology.

Eligibility: Fellowship candidates must either be board certified or board eligible in Otolaryngology-Head and Neck Surgery, General Surgery, or General Plastic Surgery. The fellowship candidate must be able to obtain a license to practice medicine in the State of Iowa. Documented experience and ability in the management of head and neck cancer patients, through letters of reference and the applicant’s personal statement, are required. The fellowship participates in the AHNS Fellowship Match.

Fellows’ Duties/Responsibilities: The clinical work will be performed primarily under the supervision of the fellowship director and the head and neck oncologic faculty within the department. The fellow will evaluate new and recurrent head and neck cancer patients under the direction of the faculty. The surgical responsibilities of the fellow will increase with his/her demonstrated abilities, and the fellow will perform and/or assist with procedures under the direction of the attending faculty. The fellow is expected to participate in the multidisciplinary Head and neck Cancer Tumor Board.  He/she is also required to attend regular departmental meetings, including Grand Rounds, Morbidity and Mortality Conferences, and Head and Neck Oncology Rounds, as well as other selected conferences available to the fellow throughout the year. The fellow also participates in the annual Iowa Head and Neck Cancer Course, a week-long didactic and cadaver dissection course. The fellow is expected to actively participate in the education of residents and medical students in the operating room, on the wards, and in the clinics. The fellowship experience at the University of Iowa consists of a very large clinical experience, encompassing all aspects of contemporary head and neck oncologic surgery.  Fellows will have the opportunity to participate in a broad range of advanced ablative procedures, including skull base resections, advanced techniques in laryngeal rehabilitation, and transoral robotic surgery, as well as endocrine surgery, and multidisciplinary cases involved the Neurosurgery, Oculoplastics, Oral and Maxillofacial, Dermatology and Cardiothoracic Services. In addition, the head and neck oncologic and reconstructive fellow routinely performs between 60 to 70 free tissue transfer procedures during one year of clinical training.

Research Opportunities:  A variety of research opportunities is available in the field of outcome evaluation and quality of life assessment for head and neck cancer patients.  In addition, the fellow has a variety of basic science laboratories available within which the fellow may coordinate research projects under the mentorship of the distinguished researchers at the University of Iowa.