The Head and Neck Fellowship at WayneStateUniversity, which is accredited by The American Joint Council for Advanced Training, was established in 1991. Although the program encourages 2 year applicants, a 1 year experience is also offered.  Those seeking 2 years of training will have opportunities to be involved in various research opportunities.  The program is clinically based at the Karmanos Cancer Institute.  This is one of the first designated comprehensive centers in the National Cancer Institute program, and has held this prestigious designation since 1978.  The institute supports over 200 physician scientists, 300 researchers, 5 research programs and 10 core facilities.  Fifteen multidisciplinary medical teams treat more than 5,500 new patients annually, of which roughly 400 are head and neck cancer patients.  The Karmanos Cancer Institute operates as a free-standing cancer-only inpatient hospital with 123 beds.  This is the only free-standing cancer hospital in the State of Michigan.  Roughly 6,000 patients a year are placed in clinical trials.

Having a carefully structured evaluation system, these programs are site-visited, reviewed, and approved by the Executive Council of the American Head and Neck Society. A diploma is awarded by the Society to those candidates who follow the rigid criteria and successfully complete the fellowship. An additional diploma is issued by the Wayne State University School of Medicine.

Appointment Requirements
For applicants from the United States and Canada, the fellow must be board-certified or board eligible in Otolaryngology, General Surgery or Plastic Surgery by the ACGME or Royal College of Surgeons.  International candidates who are not Board eligible are also welcome and should apply directly to our program director below.  Completion of USMLE Steps 1, 2 and 3 is required.  Competitive international applicants are usually already serving as junior faculty at their academic institutions. 

Clinical Experience
The scope of clinical practice involves the entire head and neck from skull base down into the chest.  Training is provided in classic extirpation, minimally invasive surgery, endoscopic skull base and salivary surgery, transoral laser microsurgery, transoral robotic surgery, endocrine surgery, and microvascular reconstructive surgery.  Outpatient experience is limited to the evaluation/management of the head and neck cancer patient in surgical oncology.  Outpatient experience in ultrasound techniques and procedures is available. Familiarity with medical oncology, radiation oncology, and rehabilitation techniques will also be provided.  This occurs in the outpatient clinical area of the Karmanos Cancer Institute.  The fellow does not see patients independently nor participate on the call schedule with the house staff.  It is, however, anticipated that he/she will be available for emergency procedures in the head and neck cancer population. 

The fellow also participates at the multidisciplinary conference which occurs weekly.  At this conference all new oncology patients are presented and evaluated as a group.  The departments of Radiation Oncology, Medical Oncology, Endocrinology, Prosthodontia, Speech Therapy, Nursing, Pathology and Radiology participate.  Following that conference a smaller group representing the primary treatment modalities and other services as required meet with the patient and family on an individual basis to discuss the recommended treatment program and the alternatives.

The fellow will play an important role in teaching and training residents in the management of head and neck cancer patients both clinically and surgically.  The fellow will serve as an Associate Director to Courses in Advanced Surgical Dissection in Head & Neck Oncology and Craniofacial Reconstruction, which involve fresh cadaveric dissections throughout the year. 

Research Opportunities
This fellowship will provide advanced training in head and neck oncology including not only patient management, but also appreciation of the research foundation upon which the specialty exists. This program is directed toward the development of future academic leaders in the field.  There are multiple opportunities for both basic science and clinical research.

It is anticipated that the fellow will develop and publish clinical manuscripts.  For those fellows who are interested and have the appropriate background in the basic sciences, opportunities are available in a wide variety of fields.  This included but are not limited to: areas of biomarkers, molecular biology of the tumor cell, theraputic trials, gene therapy and biomedical engineering. Block time is available upon the interests and type of project selected.  There is an opportunity for mentorship outside of the department, once again depending upon the fellow's interests and background.  It is anticipated that the fellow will present at the annual department research day held in the spring of each year.  Past fellows have presented their work nationally and internationally.  The fellow will also participate in the quarterly research protocol meetings.  At these meetings the status of ongoing trials are reviewed, and new potential trials are presented for approval and prioritization by the group.

If interested, the fellow will have an opportunity to gain exposure to all aspects of drug development from phase I to phase III trials.   There is a long-standing interest in rehabilitation of the head and neck cancer patient with possible funding for the interested fellow to participate in.

Strengths of the Program
There are strong interdisciplinary clinical activities between members of Radiation Oncology, Medical Oncology, Thoracic Surgery, Neurological Surgery, Endocrinology and Dermatology.  The fellow will have an opportunity to be trained in all aspects of head and neck cancer management including endoscopic skull base surgery, sialendoscopy, TLM, TORS, endocrine surgery, craniofacial reconstruction, cutaneous oncologic surgery and sentinel lymph node biopsies, Mohs reconstruction, and a diverse array of microvascular reconstructive techniques.  Outpatient ultrasound training and exposure is also available. Clinical time with Medical Oncology and Radiation Oncology is also included.

Goals of the Program
To provide advanced training in head and neck oncology including not only patient management, but also appreciation of the research foundation upon which the specialty exists. The surgical experience will include exposure to all current techniques including microvascular and skull base resection. Familiarity with medical oncology, radiation therapy, and rehabilitation techniques will also be provided.
This program is directed toward the development of future academic leaders in the field. In addition to instruction in the latest techniques in the management of the head and neck cancer patient, an appreciation of the research foundation upon which future developments depend will be established.

Program Experience
Given the fellowship is built around a residency training program, it is anticipated that the fellow will add to, rather than detract from, the existing residency program experience. This requires that the fellow be prepared to act more as an instructor as opposed to solely being a student. This is critical to the training of our residents at all levels.  

Deadline for Application & Ranking:  Please review deadlines on the AHNS website at https://www.ahns.info/residentfellow/fellowships/ . The match results will be announced to candidates annually on July 1.   Please make sure all your application materials have been sent to the ATC office well before the program interview dates.  

Please contact AHNS Associate Executive Director JJ Jackman (jj@ahns.info)  or 310.437.0559, x154) for any questions regarding the Fellowship match.