Fellowship At The SPSC
Fellowship Program: Weekly Timetable
Monday
0700:
Rounds at ENT Clinic St. Paul’s Hospital. Every third week is dedicated to rhinology rounds
0800:
Rhinology Clinic at St. Paul’s Sinus Centre
Tuesday
0800:
Surgery, False Creek Surgical Centre
Wednesday
0700:
ENT city wide rounds at Vancouver General Hospital/WP4
0800:
Clinic at St. Paul’s Sinus Centre (occasionally a surgery day)
Thursday
0730:
Surgery, St. Paul’s Hospital OR’s (occasionally a clinic day)
Friday
0800:
Surgery/Clinic at St. Paul’s Hospital
-This day will eventually turn into a fellow clinic day in the latter half of the year
Summary of Fellowship
A fellow at the St. Paul’s Sinus Centre will be under the direct supervision of Dr. Amin R. Javer with potential participation from other sinonasal / Head and Neck surgeons in the division. The St. Paul’s Sinus Centre is a very busy tertiary and quaternary care sinus centre dedicated as the referral centre for British Columbia and western Canada. The sinus and skull base fellow is expected to attain the following basic requirements during his/her fellowship:
Objectives:
1.Complete at least one advanced (bench or clinical) research project and present it at a major national or international Rhinology / Skull base meeting.
2.Help in organizing and participate in the biannual advanced sinus course offered by the St. Paul’s Sinus Centre.
3.Help in organizing and participate in the annual national resident sinus course.
4.Carry out biweekly cadaver dissection teaching rounds for all residents.
5.Attain an exceptional degree of expertise in endoscopic sinus and skull base procedures.
6.Carry out at least one weekly fellow clinic during the second half of the fellowship year.
7.Help in organizing and teaching the sinus component of the resident course.
8.Attain an exceptional degree of expertise in clinical endoscopic skills and procedures in the outpatient setting.
9.Attain a high degree of knowledge and familiarity with the current research and literature in the field of medical rhinology, sinus and endoscopic skull base surgery.
Operative Experience Expected:
The operative experience will gradually increase from initial cadaver dissection and observation in the operating room to carrying out ethmoidectomies in primary cases to eventually carrying out tertiary procedures including participating in CSF leak repairs and tumour resections during the last six months. At the end of the fellowship it is expected that the fellow will feel comfortable dealing with tertiary rhinology cases including revision FESS, endoscopic management of sinus and skull base tumours, endoscopic medial maxillectomies, endoscopic CSF leak repairs, endoscopic DCR’s, and endoscopic drainage of orbital and anterior cranial fossa / skull base abscesses, and transnasal endoscopic pituitary hypophysectomies. The average time spent in the operating room varies between two and three days per week. At least half of this time is spent in operating rooms with no resident participation which allows the fellow ample surgical experience. During surgery in the teaching institutions, residents are expected to participate during the initial stages of the operation (often with the fellow acting as the primary teacher) with the fellow taking over for the more difficult stages of the operation e.g. frontal sinus surgery, actual repair of the CSF leak, tumour resections, etc.
Clinic Experience Expected:
The fellow is expected to participate and intimately become integrated into the two very busy clinic days per week at the sinus centre. Using a graduated approach, the fellow will eventually be expected to carry out the initial assessment and examination of all new patients seen in the clinic. During the final six months of the fellowship the fellow will be expected to have progressed significantly to competently run a “rhinology fellow” clinic between two and four times a month under minimal supervision.
Research Experience Expected:
The sinus centre is very active in clinical and basic research projects with eight to ten research projects running simultaneously at any one time. The fellow is expected to carry out at least one major research project during his/her year at the sinus centre. It is expected that the fellow will present his/her research at a national or international rhinology meeting at the conclusion of his/her fellowship. There is no dedicated time during the working hours of the week set aside for research. The fellow is expected to integrate his research into the workweek and use off hours/weekends to continue his/her projects. Because the sinus centre is highly integrated with the residency training program, it is hoped and expected that resident participation and affiliation with research projects will occur naturally.
Description of relevant clinical and research infrastructure at host institution:
The St. Paul’s Sinus Centre has had a fellowship program since 2002. Over the past two to three years, a very good infrastructure has been achieved for a successful fellowship program. Over a five day workweek, two and a half days are dedicated to clinic time. About 90% of patients seen in the clinic are rhinology and sinus referrals from otolaryngologists, pulmonologists, neurosurgeons and other specialists around the province. The rest are tertiary sinus referrals from out of province. Two and a half days of the work week are dedicated to operating time. All surgeries are carried out in highly advanced endoscopic sinus operating rooms with computer guidance systems. Dedicated office space with a desktop computer is provided for the fellow. E-mail communication with patients, clinic staff and residents is encouraged. A biweekly cadaver dissection session is available and encouraged. The fellow is expected to take residents to the morgue for dissection teaching whenever a consented body becomes available.
Other relevant information:
The integration of the rhinology fellowship program into the UBC division of Otolaryngology residency training program with all of its academic activities has resulted in the creation of a rich academic milieu for the fellow. Ongoing academic rounds in the division and at the sinus centre allow the fellow to present research as well as interesting cases on an ongoing basis throughout his/her year. Financial support of such a fellowship is imperative if rhinologic training and research within the Canadian setting is expected to advance.
Applying for a Fellowship at the SPSC
The following documentation is required to make an application for fellowship:
1.CV : please email to sinussurgeon@drjaver.com
2.Reference letters: A total of three reference letters should be sent via email to the attention of Dr. Javer at sinussurgeon@drjaver.com
All candidates selected for an interview will be expected to visit the centre for a week long observer-ship and interview process.