UNIVERSITY OF MIAMI

Jackson Health/UHealth Systems International Advanced Rhinology Fellowship Program (outside the SF Match)

INSTITUTION & ADDRESS

University of Miami Miller School of Medicine
Department of Otolaryngology
1120 NW 14th Street, 5th Floor
Miami, Florida 33136
Phone: (305) 243-5290
FAX: (305) 243-2009

FELLOWSHIP DIRECTOR

Roy R. Casiano, M.D., F.A.C.S
Professor and Vice Chairman
1120 NW 14th Street, 5th Floor
Miami, Florida 33136
Phone: (305) 243-5290
FAX: (305) 243-2009
[email protected]

DEPARTMENTAL MISSION STATEMENT

To educate and nurture medical students, residents and fellows, to create knowledge, and to provide service to our international community and beyond. Committed to excellence and proud of the diversity of our University family, we strive to develop future leaders of our nation and the world.

OVERVIEW OF FELLOWSHIP

The Jackson Health/UHealth Systems Advanced Rhinology Fellowship is a 12 month training program  . It is designed for international otololaryngologists that have completed their residency, and desire to advance their fund of knowledge and surgical skills in the otolaryngology subspecialty area of advanced rhinology and related disorders, including allergy and sleep. It requires completion of the first 2 steps of the USMLE and TOEFL exams (ECFMG certification required). It also requires a J1 VISA. 

FELLOWSHIP DESCRIPTION

Fellowship Duration: 1 Year

Fellowship Term: Flexible with start dates in the spring or fall of every year. 

Goals and Objectives for Training:

• To further develop the fellow’s endoscopic sinonasal surgical skills, required for the performance of advanced endoscopic surgical procedures.
• To develop the fellow’s expertise in the multidisciplinary treatment of common ailments afflicting the upper and lower respiratory system (asthma, chronic rhinosinusitis, allergies, sleep disorders, and other common airway disorders), with an emphasis on chronic inflammatory diseases of the nose and paranasal sinuses.
• To enhance the fellow's understanding about the multidisciplinary treatment of common inflammatory and neoplastic disorders of the nose and paranasal sinuses
• To develop the fellow’s expertise in the diagnosis and management of allergies and immunologic disorders affecting the upper airway.
• To enhance the fellow’s understanding about the appropriate workup, indications and potential adverse side-affects of pharmacotherapy versus immunotherapy, for patients with allergies.
• To enhance the fellow’s understanding of surgical sleep medicine and build their skills for procedures and surgeries utilized to treat obstructive sleep disorders (optional)
• To enable the fellow to establish a strong foundation in the use of clinical quality improvement databases, which they can choose to incorporate into their own practice in the future.

Faculty: 

• Dr. Roy R. Casiano (rhinologist with special interest in advanced rhinology and endoscopic skull base surgery)
• Dr. Corinna Levine (rhinologist with special interest in advanced rhinology and endoscopic skull base surgery)
• Dr. David K. Lerner (rhinologist with special interest in advanced rhinology and endoscopic skull base surgery)
• Dr. Zoukaa Sargi (Head and Neck Surgery/microvascular reconstruction, endoscopic skull base surgery)
• Dr. Aura Acosta (rhinologist with special interest in allergies and office-based procedures)
• Dr. Maria Suurna (Sleep Medicine Surgery); OPTIONAL ROTATION
• Dr Ricardo J. Komotar (neurosurgeon with special interest in endoscopic skull base surgery)
• Dr. Michael E. Ivan (neurosurgeon with special interest in endoscopic skull base surgery)
• Dr. Carolina G. Benjamin (neurosurgeon with special interest in endoscopic skull base surgery)
• Dr. Ashish H. Shah (neurosurgeon with special interest in endoscopic skull base surgery)

Hospital and Clinic Facilities:

• Clinical Research Building (CRB): main outpatient clinic facility for UM rhinology, neurosurgery, on the medical center campus
• University of Miami Hospital and Clinics/Sylvester Comprehensive Cancer Center (UMHC/SCCC)
• UHealth Tower (UHT; University Hospital)
• Sethi Medical Center Bldg on the medical center campus
• Jackson Memorial Hospital (JMH)
• UHealth Plantation Outpatient Facility, Plantation Florida
• Lennar Outpatient Facility in Coral Gables, Florida
• Doral Outpatient Facility in Doral, Florida

Clinical/Surgical Rotations:

Rotations in the operating room are primarily with Drs Casiano, Levine, Lerner, Sargi, Suurna, (see weekly schedule). Clinic rotations are primarily with Drs Casiano, Levine, Lerner, Acosta, and Suurna (at CRB, Sethi, Lennar, or Doral).

CURRICULUM

Didactics and Teaching Responsibilities:

The fellow will actively participate with the residents and faculty in the department’s weekly departmental grand rounds and pertinent monthly journal clubs. They will be provided Dr Casiano's Advanced Rhinology Dissection Textbook along with a series of lectures provided by the rhinology faculty. He/she will participate as faculty in the department's annual University of Miami International Advanced Endoscopic Sinonasal and Skull Base Anatomy Course (meeting held in South Florida every winter), as well as our annual residents' and fellows' course (All-Florida Residents/Fellows Endoscopic Surgical Anatomy Course in the Summer). Also, the fellow will be responsible for presentation of future designated surgical skull base cases at our weekly Tuesday skull base multidisciplinary skull base conference for discussion amongst the skull base team to determine the best surgical and/or nonsurgical treatment strategies for the patient.

In addition, he/she practices advanced procedures, and helps teach our international “minifellows”, in our state-of-the-art endoscopic sinus surgery cadaveric lab at the medical examiner’s office on campus. The fellow also has access to the latest endoscopic skull base equipment in our C.A.N.E.S microsurgical lab at the medical school on campus to practice advanced endoscopic skull base surgical techniques on cadaveric specimens. It is here where the fellows practice their skull base drilling technique on formalin-fixed specimens, further refining their understanding of the complex skull base anatomy.

Supervisory and Patient Care Responsibilities:

The fellows will personally be mentored and supervised in the operating room and clinics by UM rhinology faculty, as required for American Rhinologic Society rhinology program certification, as well as to assure patient safety. The degree of faculty supervision is dependent on the fellow’s surgical experience and surgical skills. To this end, the fellow is required to assist the faculty in the training of residents on basic sinus cases as part of their teaching responsibilities. Patient care is restricted to the hospitals and outpatient clinics listed above. The fellow will assist the faculty on their private rhinology cases in University of Miami (UHealth) operating rooms and clinic facilities and establish long-term continuity of care and follow-up on all patients preoperatively, operatively, and postoperatively. Fellows will be trained on the use of EPIC and CERNER electronic health records and REDCap Databases. 

Surgical Case Load and Diversity of Cases:

Every year the fellow is expected to perform, as surgeon of record, a minimum of 150-200 patients (300-400 sinonasal surgical procedures). Approximately 60% of these are advanced inflammatory cases, and 20% are sinonasal and/or skull base neoplasms (in addition to pituitaries). Of the inflammatory cases, 80% are very destructive CRS with polyps, which are very endemic in our geographic area (examples: AERD, AFS, Eosinophilic CRS with polyps). Specific advanced endoscopic surgical procedures performed include extended frontal, sphenoid, and maxillary sinusotomies; management of sinonasal benign and malignant neoplasms; repair of CSF leaks and isolated skull base defects with local/regional flaps and/or grafts; endoscopic removal of pituitary neoplasms or lesions.

Endoscopic skull base surgery will not be the focus of this fellowship . However, most of the advanced endoscopic surgical skills that are acquired as part of this training program (extended sinusotomies, pituitary surgery, and CSF leak repair) can be applied to skull base cases as well.

Research Responsibilities:

Research projects, appropriate for presentation at one of several national otolaryngology meetings and suitable for publication in peer-reviewed journals, are mandated. A variety of anatomic, clinical, and basic science research projects are available under faculty supervision. Historically, the fellow has completed a minimum of 2 clinical research projects during his/her 12-month rotation, suitable for publication in one of the Otolaryngology peer review journals.  Opportunities for publication of book chapters, monographs, and other forms of media, will also be available. All fellows are required to take appropriate IRB mandated online courses including CITI, in order to participate in human research projects. 

Weekly Schedule

* Schedule subject to adjustments depending on rhinology team needs and fellow interest in sleep 

CURRENT AND PAST FELLOWS

*International fellows

SALARY AND FRINGE BENEFITS

This program is self-funded.  That means, the applicant must provide proof of funding, which includes salary, fringe benefits, and an annual tuition payment to the Department of Otolaryngology. This is required by the Department of Otolaryngology prior to starting their fellowship year. Failure to meet these financial obligations may result in suspension from the program. 

REQUIREMENTS FOR APPOINTMENT

ECFMG requirements (includes passing USMLE and TOEFL). Interest in rhinology and rhinologic research, as demonstrated by prior experience.
J1 VISA

APPLICATION INFORMATION

Applications are reviewed year around for a position generally beginning November 1 of the new cycle. Start dates are flexible depending on the applicant’s specific situation. Selected applicants may be invited to travel to Miami for an individual interview with the faculty, and spend time with our current fellow, observing his/her surgical skills and interactions with the faculty, staff, and residents. However, phone or virtual interviews are also available.

APPLICATION DEADLINE

Fellowship ideally starts either in the fall (November 1) or the spring (April 1) of each year . However, start dates are flexible November through April. Applications (curriculum vitae and 2 letters of references) must be submitted at least 12 months prior to the anticipated start of the fellowship. 

CONTACT INFORMATION

Fellowship Program Administrator:
Danierys Font
[email protected]
Phone: (305) 243-4932
Fax: (305) 243-1651
Department website: www.otolaryngology.med.miami.edu
Residency/Fellowship Program website: https://graduate.jacksonhealth.org/program/otolaryngology-head-and-neck-surgery/