University of North Carolina Dept of Otolaryngology/Head & Neck Surgery Houpt Building, G108 170 Manning Drive, CB 7070 Chapel Hill, NC 27599-7070 (919) 966-8927 Trevor Hackman, MD – Fellowship Director Jeffrey Blumberg, MD – Fellowship Co-Director Dawn Wilson – Program Coordinator Program Website

Number of Fellowships: 1 Duration (in years): 1 year advanced head and neck training including: Traditional ablative surgery, TORS, TLM, Reconstructive Surgery (Microvascular and Rotational), Open Skull base surgery, facial reanimation, Endocrine Surgery, Salivary Gland Surgery/ 1 year clinical Faculty:  Jeffrey Blumberg – Associate Fellowship Director UNC Department of Otolaryngology Trevor Hackman – Professor and Fellowship Director UNC Department of Otolaryngology Catherine Lumley – Assistant Professor UNC Department of Otolaryngology Travis Schrank – Assistant Professor UNC Department of Otolaryngology Wendell Yarbrough – Professor and Chair UNC Department of Otolaryngology Colette Shen, MD – Radiation Oncology Siddharth Sheth MD – Medical Oncology Shetal Patel MD – Medical Oncology Jared Weiss, MD – Medical Oncology

PROGRAM DESCRIPTION

Overview:

Fellow will have a 1 year clinical experience with advanced head and neck surgery.

Training will include: operative experience with surgical faculty, clinic experience with the core head and neck faculty, half day fellow clinic, and independent surgery. The fellow will rotate with the core head and neck surgical faculty throughout the year and get in depth exposure to each of the following:

• Traditional Ablative Surgery: Composite Resection, Laryngectomy, etc. (It is expected the fellow will be at an independent level with these surgeries)
• Transoral Surgery: Fellow will train in TORS and TLM – roughly 60 case/yr
• Reconstructive Surgery: Fellow will have an in depth reconstructive experience (120-150 flaps/year at the institution)–but the fellow is not expected to cover the complete volume of flaps – average fellow finishes with 60-80 flaps/year
  • Microvascular (RFFF, lateral arm, ALT, scapula tip, gracilis, medial fermoral condyle, serratus latissimus, Fibula, Rectus);
  • Rotational (Submental Island, Pectoralis, Latissimus, Temporalis, Supraclavicular, Nasoseptal, BAMM, FAMM, TPF)
• Skull base Surgery: Open Skull base surgery with Drs. Zanation and Thorp
• Endocrine Surgery: Thyroid surgery, Parathyroidectomy
• Salivary Gland Surgery: Parotidectomy, Sialendoscopy (clinic and OR)
• Facial Reanimation – static and dynamic reconstruction including cross face grafting, free tissue transfer, jump grafting, etc.
• Skin cancer, including sentinel node mapping

Fellow will be assigned research projects and have mentorship throughout the year by Dr. Hackman with the expectation of 2 high index publications.

The fellow will also spend time with medical oncology and radiation oncology to learn about treatment planning, radiation simulation, chemotherapy consultation and recommendations, clinical trial development.  Fellow will also rotate with surgical oncology for a focused experience in skin cancer, including sentinel node mapping.

The fellow will attend tumor board weekly and run a half day independent fellow clinic.

Objectives:

1. Enhance head and neck training and knowledge with:
   • Exposure to patients in clinic
   • Exposure to high volume ablative and reconstructive surgery
   • Weekly journal clubs review of AHNS curriculum
2. Foster teaching/mentor role – fellow will be placed in the role of instructor during training to help transition to becoming an attending
3. Enhance knowledge of clinical trials and research
4. Fellow expected to produce at least 2 high index publications
5. Develop a better understanding of the nuances of radiation therapy planning and treatment
6. Develop a better understanding of chemotherapy/immunotherapy options for patients and how choices for a therapy are made

Strengths:

• High volume Cancer center – over 1,000 new cases/year
• High Volume Transoral Surgery
• High Volume Reconstructive Surgery with an excellent variety of flaps utilized
• High Volume Endocrine and Sialendoscopy Practices
• High Volume open and endoscopic skull base surgery practice
• Facial Reanimation
• Balance of mentorship and independence

Eligibility: Applicant must be eligible for certification by the Canadian or the American Board Otolaryngology, the American Board of Surgery, or the American Board of Plastic Surgery (or equivalent). If you are trained outside of the U.S. or Canada, please contact the appropriate American Board to determine your eligibility status.

Fellows’ Duties/Responsibilities:

• 1/2 day Fellow clinic
• Fellow will act as an advisor to the head and neck team and will be present during morning signout to attendings
• Attendance at tumor board and weekly lab meeting
• Minimum of 2 research projects
• 1 Weekend call per month (call will be backed up by attending)

Research Opportunities:

Mentorship by Fellowship Faculty and Dr. Hackman
Basic Science Research

1. Dr. Yarbrough’s lab
2. In collaboration with medical oncology

Outcomes Research

1. Collaboration with UNC school of Public Health
2. Reconstructive Projects
3. Tumor ablative Projects

Simulation Research
Clinical Trials
Quality Improvement Research

1. ERAS
2. Opioid Reduction
3. Patient PreCare optimization
4. Readmission and Return to OR

Database Research

1. SEER / Cancer Database Reasearch

Translation Research

1. Genomics projects (HPV, SCCA, thyroid, salivary, etc)
2. Microbiomes

Supervision, Teaching and Call:
1 Weekend Call per month (backed up by attending)
1 Holiday Call ( backed up by attending)
1/2 day fellow clinic – fellow may schedule cases out of their clinic
Both team and one on one mentorship training model for clinic and OR with attending
Educational conferences twice weekly

Past Fellows:
Andrew Coniglio – current fellow
Blair Barton  (2019-2020)  Skull base fellow at Jefferson
Catherine Lumley (2018-2019) Faculty at UNC-Chapel Hill
Travis Schrank (2017-2019)*** Faculty at UNC-Chapel Hill
Eugenie Du (2016-2018)** – Faculty at Boston University
Brittany Howard (2015-2017)* – Faculty at Mayo Scottsdale, AZ
Jeremiah Tracy (2014-2015) – Currently at the University of Massachusetts
David Ludlow (2013-2014) – Currently at Metrohealth (Affiliate Case Western Reserve)
Travis Newberry (2012-2013) – Currently Program Director at San Antonio Uniformed Services Health Education Consortium
*did second year facial plastics fellowship
**did second year to obtain MPH
***did second year of basic science head and neck research at Lineberger Cancer Center