The Department of Otolaryngology-Head & Neck Surgery

Fellowship Programs

The Department consists of a several balanced fellowship programs. Listed below are the selected fellowships. Select the specific fellowship you are interested in to view further information.

The Fellowships consist of:

Facial Plastics and Reconstructive Surgery
Head and Neck Oncology
Neurolaryngology
Pediatric Otolaryngology

Faculty Fellowship in Facial Plastics and Reconstructive Surgery

The goal of this fellowship is to provide a comprehensive experience in the practice and techniques of facial plastic and reconstructive surgery. The fellow will work closely with faculty members in the department of Otolaryngology- Head & Neck Surgery with input from the divisions of Dermatologic Surgery and Maxillofacial Surgery in the treatment of both reconstructive and cosmetic problems involving the face, head and neck region.

At the end of one year the fellow will be experienced in a wide range of facial plastics and reconstructive problems. Facial trauma will also be emphasized with respect to both acute and late management of injuries. Facial plastic and reconstructive surgery is an intergral part of Otolaryngology- Head & Neck Surgery. Fully 25% of the certifying examination given by the American Board of Otolaryngology represents this area of the specialty.

Ideal Curriculum

The fellow will be primarily based on the campus of the Johns Hopkins Medical Institutions.

Further experience will be obtained by assisting in the care of private practice patients at the Facial Plastics Surgicenter in Owings Mills with Dr. Papel. This center has beeen previously certified as a training site by the Joint Committee on House Staff and Postdoctoral Programs. Extensive experience in facial skin malignancies will also be obtained in cooperation with the fermatalogic surgeons at Johns Hopkins (Dr. Renuka Diwan) and in the office of Dr. John Skouge in Lutherville.

Trauma experience will flow from not only the Johns Hopkins Hospital, but also from our affiliated hospitals (Sinai, GBMC, FSKMC) where agreements with our departmental chairman have already been discussed. Approximately 60% of the Fellow's clinical time will be spent at Johns Hopkins, with the remainder at the sites listed above. Interaction with the residents staff will occur at all locations.

Requirement for satisfactory training Certificate Experience

The American Academy of Facial Plastic and Reconstructive Surgery has reviewed this fellowship plan and found that it meets the requirements of the Education and Research Foundation of the Academy. In order to receive this endorsement the fellowship must be strictly modeled after AAFPRS and ACGME guidelines. Specific didactic and surgical experience guidelines must be followed and documented. Each fellow who completes a one or two year program must sit for a written and oral examination at the conclusion of the fellowship.

No certificate is offered by the AAFPRS Fellowship Program unless a satisfactory score and preceptor recommendation are obtained. These examinations are also used to track the performance of the individual fellowships. The progress of each fellow will be closely monitored by the coordinating faculty, with responsibilities and surgical experience gradually increasing. A certificate from Johns Hopkins would only be issued at the satisfactory completion of all the requirements listed above.

Research Goals

In Addition to the clinical experience listed above the fellow will participate in the academic and research activities of the faculty. He/She will be encouraged to identify and pursue research interest in facial plastics and reconstructive surgery under the direction of the faculty. Appropriate time will be provided for research and study activities. Our goal will be to direct each fellow to an area of interest early in the year, and also involve the fellow in active clinical and basic science research projects already in progress.

Service vs. Training

The Division of Facial Plastics and Reconstructive Surgery within the Department of Otolaryngology- Head & Neck Surgery has been functional since 1987. The fellow will participate in the clinical activities of the divison and will staff a clinic concentration of facial plastic surgery at Johns Hopkins. He/she will work under the direction of senior faculty, and also with a senior level resident in Otolaryngology- Head & Neck Surgery.
This will stimulate clinical analysis and planning among fellow, faculty and house staff. The fellow will be appointed as an Instuctor level faculty member, and with this appointment is expected to participate in the teaching programs of the department.

He/she will share in the preparation of didactic lectures concerning facial plastics surgery, and these will be shared with the faculty and house staff in the educational programs already in place within the department. The role of the fellow will be dual in that a service is being provided for patient care, and clinical training is ongoing.

Impact of Otolaryngology- Head & Neck Surgery & Plastic Surgery

We anticipate that the fellowship program will have a positive impact on the entire residency program in Otolaryngology- Head & Neck Surgery. the emphasis on facial plastic surgery generated by the participaton of the fellow will result in increased resident exposure and experience at all levels. There are presently twelve university based programs in facial plastics surgery in major academic medical centers; and the universal experience has been positive for the residency training programs. We do not anticipate any impact of the Division of Plactics Surgery or its training program. As the referral patterns for our patients are different than the plastic surgeons, we do not believe that any significant impact on clinical training would occur. Both specialties have been performing facial plastic procedures for many years, and this will continue whether a fellowship exists or not.

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Faculty Fellowship in Head and Neck Oncology

Program Director:

Joseph Califano, M.D.

Address: 601 N. Caroline Street, Baltimore, MD, 21287
Phone Number: (410) 955-6420
Fax Number: (410) 955-8510
E:mail: jcalifa@jhmi.edu

Chairman of the Department:

Lloyd B. Minor, MD

Faculty involved with the Head and Neck Surgical Oncology Fellowship:

Wayne M. Koch, M.D.
Christine Gourin, M.D.
David Sidransky, M.D.
Joseph Califano, M.D.
John Saunders, M.D.
Patrick Byrne, M.D.
Kofi Boahene, M.D.
Ralph Tufano, M.D.
Sara Pai, M.D.
Patrick Ha, M.D.

Total number of positions available per year:

One or two (two year) positions, one year clinical positions may be available.

Director of Research:

David Sidransky, M.D.

Other parallel fellowships:

Pediatrics, Otology/Neurootology

Objectives:

The objectives of the Head and Neck Surgical Oncology Fellowship at Johns Hopkins
is to promote and develop leaders in the field of Academic Head and Neck Oncology.
Emphasis is on broad clinical training includes all aspects of head and neck surgical oncology. Fellows will have a faculty appointment as Instructor that includes a mentored experience focused on a transition to independence. In particular fellows are developed in terms of skills in clinical teaching within the context of our residency program. Research focus includes a rich environment of translational research bridging surgical oncology and molecular biology pertaining to Head and Neck cancer. Fellows completing the program will have finely honed skills in surgical diagnosis and treatment of tumors of the head and neck and will have been introduced to basic laboratory research leading to publication of novel translational findings.

Fellows will be comfortable in a teaching role and ready to assume these responsibilities in an academic setting. The research training may serve as the basis to seek grant funding in order to facilitate the initiation of an academic career.

History:

The Head and Neck Oncology Fellowships at Johns Hopkins began in 1986. It received approval of the American Head and Neck Society in 1993. Dr. David Sidransky joined the program that year.

Past fellows include:

Glen Peters, M.D.,
Wayne Koch, M.D.,
Richard Scher, M.D.,
Joseph Brennan, M.D.,
Shelly McQuone, M.D.,
Michael Spafford, M.D.,
David Goldenberg, M.D.
Tony Chuang, M.D.
Patrick Ha, M.D.

Requirements:

Board eligibility in Otolaryngology, General Surgery or Plastic Surgery

Description of Medical Center:

The Johns Hopkins Medical Institutions are world renowned for leadership in clinical medicine, public health and basic biomedical research. Johns Hopkins is a busy regional referral medical center encompassing the full range of clinical medicine with training programs for medical students, residents, and fellows in all major fields. The Head and Neck Oncology Service performs more than half of all major head and neck resections in the state of Maryland as well as drawing from four state regions. Over 250 new cases of HNSCC are managed each year.

The fellowship also support Johns Hopkins Head and Neck Surgery at GBMC, a regional medical center with a well developed head and neck center that sees approximately 200 cases of head and neck cancer for all sites annually.

Outline of the program:

The first year - is dedicated to research in molecular biology of Head and Neck cancer, or to training in clinical trials methodology. Training in free tissue transfer may be arranged for selected applicants.

The second year - is focused on clinical advanced specialty training pertaining to medical, and surgical treatment of Head and Neck tumors, both benign and malignant. Exposure to reconstruction including free tissue transfer, medical and radiation oncology are included. Fellows will have a clinical role at both Johns Hopkins east Baltimore campus and at GBMC with attending faculty clinical practices, as well as a mentored individual clinic at Johns Hopkins east Baltimore campus.

Strengths

The tumor biology research program of the Johns Hopkins Department of Otolaryngology is world renowned as a leader in clinical translational research pertaining to HNSCC. Trainees have been highly successful in launching clinical translational academic careers. Dedicated clinical faculty provide mentorship to help develop skills and knowledge needed for an academic career. The academic milieu includes one of the finest Otolaryngology residency programs in the country, with excellence in every aspect of the field.

Careers of Former Fellows:

Glen Peters, M.D. - Chief of Otolaryngology, University of Alabama
Wayne M. Koch, M.D. - Professor of Otolaryngology, Johns Hopkins
Richard Scher, M.D. - Faculty, Duke University
Joseph Brennan, M.D. - Air Force
Shelly McQuone, M.D. - Faculty, University of Pittsburgh
Michael Spafford, M.D. - Faculty, University of New Mexico
David Goldenberg, M.D. – Faculty, Penn State Hershey Medical Center
Patrick Ha, M.D. – Faculty, Johns Hopkins

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Faculty Fellowship in Neurolaryngology

Neurolaryngology is a subspecialty of Otolaryngology-Head & Neck Surgery that has developed in response to the rapid advances in technology for diagnosis and treatment of laryngeal disorders. Diagnostic procedures include video technologic advances that have expanded the armamentarium for treatment of benign and malignant disease and now include percutaneous approaches to the larynx for vocal fold medialization and botulinum toxin injections, thyroplasty techniques for altering position or tension of the vocal folds, and microscopic and laser procedure for managing laryngotrachael stenosis and laryngeal malignancies.

The goals of this training program are:

1) to provide the fellow with advance experience in diagnosis and treatment of laryngeal disorders
2) to provide time for basic research training with a specific focus on neurolaryngology, and
3) to create an environment that will stimulate the participant to pursue a career in academic Otolaryngology- Head and Neck Surgery

Curriculum

The curriculum will provide for clinical experience, basic research in neurolaryngology, and didactic teaching including departmental and national conferences. The fellow will acquire experience in diagnosis of neurolaryngeal disorders and gain experience in a variety of surgical procedures including use of botulinum toxin for laryngeal and craniocervical dystonias; thyroplasty techniques for the management of unilateral and bilateral laryngeal paralysis; and microscopic, laser, and open techniques for management of benign and malignant diseases of the larynx.

The fellow will attend weekly conferences including Head and Neck Tumor Board, Otolaryngology- Head & Neck Surgery Grand Rounds, and coordinate the weekly combined Laryngeal Disorders/Difficult Airway Conference.

The fellowship will include four months of basic research which will be divided into eight 2-week sessions. During these 2-week sessions, the fellow will not have clinical responsibilities. Clinical research projects may be undertaken during the clinical training period.

Requirements of Satisfactory Training Certificate Experience

The fellow must:
1) demostrate expertise in diagnosis and management of neurolaryngeal disorders
2 ) complete a basic research project and submit this work for publication
3) participate in 50 major laryngeal procedures
4) satisfactorily particpate in department and divison teaching conferences
5) the fellow will be required to attend two national meetings with focus on neurolaryngeal disorders This includes:

The American Laryngologic Association/Triologic Society Meeting,
and the American Academy of Otolaryngology- Head and Neck Surgery Annual Meeting.

Monday AM	Clinic
Monday PM	Otolaryngology- Head and Neck Surgery Grand Rounds
Tuesday	Surgical Experience
Wednesday AM	Laryngeal and Voice Disorders Clinic (Flint/Cummings)
Wednesday PM	Surgical experience
Thursday	Laryngeal and Voice Disorders Clinic
Friday	Surgical experience

Service vs. Training

The laryngeal fellow will have privileges to perform general Otolaryngology- Head & Neck Surgery procedures and will be supervised during laryngeal procedures. The fellow will be expected to participate in major laryngeal procedures as well as oversee residents in general Otolaryngology-Head & Neck Surgery procedures. The fellow will not be used as coverage for general Otolaryngology- Head & Neck Surgery unless specific laryngeal problems are identified. the chief resident on the service will be responsible for the Otolaryngology-Head & Neck service.

Didactics

The fellow will participate in weekly Grand Rounds held by the Department of Otolaryngology-Head & Neck Surgery. The Fellow will also organize and direct the Laryngeal and Voice Disorders Conference alternating weekly with the combined Anesthesia/Otolaryngology- Head & Neck Surgery Difficult Airway Conference. Moreover, the fellow will be expected to participate in General Surgery Grand Rounds as well as present at one national meeting. Resident and medical students teaching will also be expected on a routine basis.

Impact of Training on Other Residents in Otolaryngology-Head & Neck Surgery Associated Specialties

The neurolaryngology fellow will not negatively impact on residents in Otolaryngology-Head & Neck Surgery. The fellow will be expected to evaluate patients with laryngeal and voice disorders and generate cases from this clinic as well as participate in other major laryngeal cases. The fellow will augment the training of the Otolaryngology-Head & Neck Surgery residents since increased volume of neurolaryngeal cases will be anticipated. This will result in an overall increase in exposure of residents to neurolaryngeal disorders.

Number of Trainees, Method of Trainee Selction, Duration of Training Program

One fellow will be selected each year for training in neurolaryngology. S/he will be selected after being interviewed by Drs. Cummings, and Flint. The duration of the program is one year.
Source of Funding and Salary Level

The neurolaryngeal fellow will be paid by the Department of Otolaryngology-Head & Neck Surgery. The salary will be $35,000 per year. Clinical revenue generated by the fellow will be applied to departmental expenses associated with the fellowship. Applicants will be encouraged to seek external support through basic science research grants. Selection of the neurolaryngology fellow will not, however, be dependent on external funding.

Anticipated Research Goals

During the training period, the fellow will be required to participate in ongoing or new basic science research for a minimun of four months. The basic science research will focus on neurolaryngology and may include studies on development anatomy, neuroanatomy, peripheral or central responses to denervation of the larynx, chronic degenerative diseases of the larynx, or neurolaryngeal physiology, specifically the laryngeal reflex. This research will be performed under the direction of Dr. Paul Flint in the Laryngeal and Voice Disorders Lab, located in Ross 813.

As a requirement of basic science research in the Department of Otolaryngology-Head & Neck Surgery, the fellow will present updates on his/her research at the monthly Research Meetings. The fellow is expected to complete the basic science research project and submit to a national meeting for presentation and publication. Clinical projects may also be undertaken but will not detract from the basic science program.

Faculty Advisors

The faculty advisors include Dr. Charles Cummings, and Dr. Paul Flint.

Clinical research will be directed by Drs. Charles Cummings. Basic science research will be directed by Dr. Paul Flint.

Percent of Faculty Advisor's Time Spent with Direct Fellow Interaction, Degree of Faculty Supervision

The neurolaryngeal fellow's clinical time will be divided equally between the three faculty advisors. Thirty percent of the fellow's time will be dedicated to basic science research.

Current Status of Potential Granting Board Process

There is currently no board certification in neurolaryngology. Otolaryngology-Head & Neck Surgery has no subspecialty board certification mechanism. There is no anticipated future Board recognition for this advanced training in academic Otolaryngology.

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Faculty Fellowship in Pediatric Otolaryngology

Application Process

Contact Helen Goeller, Program Coordinator,
at (410) 955-1559 to obtain a fellowship application.

Selected applicants will be invited Johns Hopkins for an interview and further discussion of professional goals.

Application Deadline - January 15

Start Date - July1

Duration of Fellowship Program - 1 year

University Affiliation - The Johns Hopkins University School of Medicine

Accreditation -

Licensing Requirements - Maryland licensure required

Number of Fellows per Year - one

Appointment Level - Faculty/InstructorOperation Privileges - Full operating privileges as an attending

Operative Experience - Extensive, full range of pediatric otolaryngology cases, with emphasis on tertiary pediatric surgical care.

Clinical Responsibilities - Will run independent clinic 1 day per week; work with attending staff in clinic as time permits up to 1/2 day per week.

Research - Research opportunities are available for clinical and laboratory projects, Dedicated time and training can be arranged based on the needs of each fellow.

Case Load - Extensive and varied, will perform and /or assist in 300-500 pediatric otolaryngology cases, mostly "tertiary" type cases.

Call Responsibility - Faculty call for pediatric emergencies, with full resident support at multiple levels.

Resident Responsibilities - The fellow will supervise residents in the clinic, the operating room, and on the consultation service. There is usually one junior level resident on pediatric otolaryngology service at a given time.

Salary Range - Commensurate with PGY level.

Benefits - Medical insurance, Dental insurance, Life insurance.

Additional Information - The primary focus of the fellowship is development of clinical skills. The fellow will be responsible for clinical decision-making, with staff back-up as needed. The fellow will participate in the craniofacial team. There are multiple opportunities for extended and collaborative research within the department and the institution.