University of Arkansas for Medical Sciences

University of Arkansas for Medical Sciences Department of Otolaryngology-Head & Neck Surgery 4301 W Markham St OTO Dept Slot 543 Little Rock, AR 7220   Emre A. Vural MD, FACS – Fellowship Director Richard Harper – Fellowship Coordinator    PROGRAM WEBSITE

Number of Fellowships: 1 Duration (in years) : 1 year Department Chair John L. Dornhoffer MD, FACS Faculty  Mauricio Moreno, MD – Professor Jumin Sunde, MD – Assistant Professor

PROGRAM DESCRIPTION

Overview: The Division of Head and Neck Surgery/Oncology at UAMS has an average of 2,100 new patient referrals, 7,800 return patient visits and a surgical caseload of over 1,300 inpatient or outpatient procedures annually. Head and neck team performs close to 200 free flaps and 30 to 40 TORS cases a year.

Fellows are 100% clinical and have a structured daily schedule to provide adequate exposure in the operating room and clinics. We carefully design schedules based on the widest possible exposure for training; however, minor changes are possible on a day-to-day basis, such as the variety of cases in the operating room available to the fellow in training or absence of certain faculty members, made at the fellow’s discretion.

Fellows have a responsibility of overseeing resident rounds on Head and Neck Service inpatients, and interact with APRNs on Head and Neck Service to facilitate inpatient care. Fellows facilitate inpatient consultations as an independent provider, see patients in the clinics, help in the management of immediate needs of the service such as tracheotomies and perform procedures under minimal or no supervision.

Our program has an average of 2,600 clinical duty hours for the 12-month period.

Objectives: This is a superb opportunity to build a strong and successful academic career and make significant contributions to the discipline of head and neck surgery. Graduates of this program are expected to become particularly adept at the management of benign and malignant tumors of the head and neck, including but not limited to:

• Benign and malignant upper aerodigestive neoplasms, namely oral cavity, oropharynx, hypopharynx, larynx and parapharyngeal space
• Benign and malignant tumors and disorders of major and minor salivary glands
• Benign and malignant cutaneous lesions of the head and neck region.
• Management of benign and malignant thyroid and parathyroid disease.
• Ample exposure to transoral robotic surgery
• Management of various head and neck defects necessitating local and regional flaps as well as microvascular free tissue transfer.
• Ample exposure to skull base and parapharyngeal space tumors. Basic proficiency in head and neck ultrasound (and guided needle biopsies,
  radiology and pathology)

Strengths:

• Robust high acuity / complex case load due to being the only academic center in the State of Arkansas.
• Strong clinical research within the Head and Neck Division resulting presentations and publications on a regular basis.
• Dedicated teams constantly supporting head and neck division such as speech-language pathologists, advanced practice nurses, head and neck radiologists-radiation oncologist-medical oncologist-pathologists and cytopathologists and social workers.
• Daily presence and support of a highly experienced endocrinologist/ultrasonographist in Head and Neck Clinic purely focused on thyroid/parathyroid disorders.
• Ample opportunity of working with other specialties such as medical oncology, radiation oncology, neurosurgery, thoracic surgery, vascular surgery, orthopedics, ophthalmology, general surgery and dermatology in the management of patients necessitating multi-disciplinary care.
• Opportunity of attending to a Head and Neck Meeting of choice during fellowship.
• Full exposure to the widest variety of microvascular reconstructive techniques available.
• Availability of two DaVinci XI and one DaVinci X systems which provide easier access to surgical robot.
• Friendly faculty, staff and residents.

Eligibility: Applicants must be either:

• Graduate of a medical school in the US or Canada accredited by the LCME, or
• Graduate of an osteopathic medicine school in the US accredited by AOA, or
• Graduate of a medical school outside the US or Canada who has a currently valid certificate from the ECFMG.

In addition, applicants:

• Must be either enrolled in or have graduated from an ACGME accredited or its international equivalent residency program in Otolaryngology. Prospective fellows who have graduated from residency must provide a letter from their residency training program director verifying successful completion of training. Applicants currently enrolled in a training program must have verification of successful completion provided prior to starting the fellowship.
• Must be legally able to maintain training/employment in the U.S. for the duration of the fellowship program. Visa status will be reviewed on an individual basis.
• Must be eligible for an Arkansas medical license, an Arkansas Controlled Substance license, and a Drug Enforcement Agency (DEA) license.
• Must pass a criminal background check. Must successfully complete the University of Arkansas for Medical Sciences and Central Arkansas VA credentialing process and receive approval for clinical duty. Must pass an employee physical exam, including a urine drug screen.

Fellows’ Duties/Responsibilities:
1. Scrub with attendings and/or chief residents in the service to provide surgical care either in the surgeon or first assist capacity for head and neck patients undergoing surgery.
2. See all new, return and postop patients during dedicated clinic days for treatment planning, postoperative management or follow-up services and provide documentation related to these visits.
3. Perform minor surgical procedures in the clinic
4. Oversee residents in the clinics, O.R. or on the floor during rounds for providing seamless patient care
5. Intervene as a surgeon in cases where immediate surgical management is necessary in primary surgeon capacity, especially in acute airway cases, as the primary surgeon or as the first assist.
6. Facilitate timely management of inpatient consultations.
7. Be responsible of keeping a surgery log.
8. Attend to tumor boards, M&M conferences, grand rounds, basic science and journal clubs as a presenter and/or commenter.
9. Act as the primary liaison between our service and the services necessitating Head and Neck Service assistance, or between our service necessitating other services’ assistance in patient care.
10. Provide education on patient care to medical students, nurses, staff and residents when and where appropriate.
11. Seeing his/her own postop, follow-up or new patients in Head and Neck clinic.

Research Opportunities:  Fellows have an academic and research requirement, including outcomes research, presentation(s) at national meetings, and submission of manuscript(s) for publication. Funds may be available to cover most, if not all, of the cost incurred during travel to meetings and/or educational conferences.

Supervision, Teaching & Call: The fellow will act as the primary liaison between our department and the other surgical and non-surgical services in requests of our head and service involvement. The fellow will have a certain level of independence in taking care of daily inquiries and will have his/her own OR time on an as needed basis (there is no currently available OR block allocation for the fellows in our institution). The fellow will run any patient who exceed his/her comfort level in terms of management by any available head and neck service attending for definitive management. The fellow rounds daily with the residents on head and neck inpatients in our service or inpatients in other services requiring head and neck service involvement. In addition, the fellow will act as the primary liaison for the assistance requested from other surgical and/or non-surgical specialties.
The fellow oversees the management of head and neck patients. The fellow sees inpatient consultations necessitating services from our Head and Neck Section with the residents. The fellow also provides one-on-one teaching in the operating room to the residents and medical students, where he operates at the attending capacity.
The fellow takes one-week-at-a-time attending calls, which is equally distributed among departmental faculty.

Past Fellows: 

Quinn A. Dunlap, MD
Del R. Sloneker, MD
Matthew T. Solverson, MD