Kaiser Permanente Orange County Rhinology Fellowship

Institution & address
Kaiser Permanente Orange County Rhinology Fellowship
6670 Alton Parkway
Irvine, CA 92618
(949) 932-5035
(949) 932-5188 (Fax)

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fellowship director
David Keschner, MD, JD

Fellowship co-directors
Terry Shibuya, MD
Eugene Chu, MD
Rohit Garg, MD

departmental mission statement
The mission of the Department of Head and Neck Surgery is to provide excellence in service and quality in the care of our membership, using evidence-based medicine in an environment of high integrity, trust, and collegiality.

overview of fellowship
The Kaiser Permanente Orange County Rhinology Fellowship was developed to provide an education platform for graduates of an accredited Otolaryngology/Head and Neck Surgery Residency who desire a greater level of training in rhinology. The intent is to provide a broad-based exposure to both clinical rhinologic practice and basic and advanced rhinologic surgery. The Fellow will be primarily focused on Rhinology but the Fellow will also be given the opportunity to gain experience with clinicians in affiliated specialties, such as Skull base surgery, Allergy, Neurosurgery, Ophthalmology and Rheumatology.

At the completion of the program, the Fellow will be expected to have competency in the medical and surgical care of basic and advanced nasal and sinus conditions, and should have the tools to develop more advanced skills after the Fellowship. Finally, the Fellow should have an appreciation for a patient-oriented practice that focuses on service and evidence-based medicine.

fellowship description
Clinical Rotations: The Fellow will actively participate in the operating room and in the office. In the operating room, the Fellow will be exposed to the full range of endoscopic surgeries, including primary and revision surgeries for inflammatory disease, endoscopic removal of benign sinonasal tumors, image guided surgery, balloon dilation surgery and others. The Fellow will also participate in complex skull base cases with our skull base team. The Fellow will be given the opportunity to spend time with Dr. Chu at a nearby hospital and selected other local rhinologists to provide the greatest breadth of surgical experience and technique. Finally, the Fellow will be exposed to related orbital surgery through a collaborative relationship with our oculoplastic surgeon – including endoscopic DCR (approximately 20/year) and orbital decompressions. Endoscopic skull base surgery is done in cooperation with our Neurosurgery colleagues and as part of the skull base team. The Fellow will also be given supervised but independent OR time within which to schedule and perform sinus surgery. Conservatively, we expect the Fellow to be primary surgeon on 450-500 cases/year.

In the office, the Fellow will initially shadow Drs Keschner and Garg but will shortly be provided with independent but supervised clinic time, in which the Fellow will be expected to work up and manage those patients. This includes managing the patient non-operatively as well as scheduling appropriate cases in the Faculty’s OR time or in the Fellow’s own OR time. Over the course of the year, the Fellow will be given the opportunity to learn how to manage patients end-to-end, both routine basic and complex patients. This experience should prove invaluable to helping the Fellow appreciate the course of these chronically disease patients, many of whom are only partially improved with surgery and do require additional medical support. The Fellow will also rotate with our Clinical Allergy partners to gain exposure to that aspect of care. In addition, the Fellow will participate in the Multidisciplinary Wegener’s Granulomatosis clinic with our Rheumatology colleagues and the Multidisciplinary Skull Base conference. Both of these occur monthly.

Weekly Schedule: On an average week, the Fellow will be in the operating room 2-3 days. The remaining days are spent in the office. At the outset of the Fellowship, the Fellow will shadow the clinical faculty in the OR and the office. However, the Fellow will quickly be responsible for his/her own clinics and OR days, both under the supervision of Fellowship faculty, but with a high degree of independence as well.

Research Responsibilities: Although primarily focused on clinical aspects, the Fellowship also strongly encourages clinical or outcomes based research. The Fellow will be expected to present at least once at a major meeting during the course of the year. The Fellow will also be provided time and funds to attend conferences or courses throughout the year.

Diversity of Cases: Orange County Kaiser Permanente currently has almost 550,000 members in its catchment area. In addition, it serves as a referral center for skull base and advanced sinus disease for the 4+ million KP members in Southern California. Over the course of the 12-month program, the Fellow should have a significant exposure to basic and advanced sinus conditions, skull base disorders, orbital disease, and other related conditions. The Fellow will be exposed to up-to-date equipment and procedures in the OR and the office.

Call Schedule: Fellow will be phased into faculty call, which includes typically 3-4 overnight calls/month and 1/15 weekends. One major holiday to be covered during the year. Additional call duties available at the discretion of the Fellow and Fellowship director.

Additional Information: The Fellow will have the opportunity to work with HNS Residents through our affiliation with UC Irvine. The Fellow will also have the opportunity to work at other KP sites and with communty rhinologists locally. The Fellow will be provided office space and other accoutrements necessary for a successful practice.

current and past fellows
Amelia Clarke, 2017-2018
Duc Tien, 2016-2017
Rickul Varshney, 2015-2016
Jack Liu, 2014-2015
Agnieszka Janisiewicz, 2013-2014
Joseph Brunworth, 2012-2013
Rohit Garg, 2011-2012

requirements for appointment
Board Certification/Board Eligible, California Medical License, All appropriate Visas/Work permits as applicable

application information
Applications will be reviewed primarily in Winter and Spring. Applicants of interest will be invited to Orange County for a day long visit to meet the faculty members, tour the facilities and to become familiar with other aspects of the Fellowship

application deadline
February 1

contact information
Rohit Garg, MD
(714) 644-2357
(714) 748-2751 (Fax)