Fellowship

Brochure

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Article

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Eligibility

The eligible candidate must have sufficient knowledge and technical skills to manage patients with minimal supervision. The fellowship position requires the applicant to have completed residency training in Otolaryngology and to have successfully passed licensing examinations in their country of origin. The fellowship is open to Canadian Otolaryngologists, as well as non-Canadian trained Otolaryngologists who are able to obtain a training/working visa for Canada and an educational license for British Columbia.

Accreditation

This fellowship is accredited by the American Rhinologic Society.

Objectives and Training

A fellow at the St. Paul’s Sinus Centre will work under the direct supervision of Dr. Amin R. Javer with potential participation/supervision 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 to the surgical and medical treatment of sinus and skull base disorders. It is the dedicated 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

  • Complete at least one advanced (bench or clinical) research project and present/publish it at a major national or international Rhinology / Skull base meeting.
  • Help in organizing and participate in the biannual advanced sinus course offered by the St. Paul’s Sinus Centre.
  • Help in organizing and participate in the annual national resident sinus course.
  • Carry out biweekly cadaver dissection teaching rounds for all residents.
  • Attain an exceptional degree of expertise in endoscopic sinus and skull base procedures.
  • Carry out at least one weekly fellow clinic during the second half of the fellowship year.
  • Help in organizing and teaching the sinus component of the UBC resident’s teaching schedule.
  • Attain an exceptional degree of expertise in clinical endoscopic skills and procedures in the outpatient setting.
  • 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

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

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. Greater than 95% 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.

Financial Arrangements for Fellows

Currently, there is no official funding available for this position. However, there is a potential for this fellowship to become fully funded through a private donation in the near future. The exact date of when funding will start is currently unknown but anticipated to be within the next one to two years.

Ad hoc funding (i.e. through on-call and teaching clinic coverage) has been sought and successfully obtained for previous candidates.

Applying for a Fellowship at the SPSC

The following documentation is required to make an application for fellowship:

All candidates selected for an interview will be expected to visit the centre for a week long observer-ship and interview process.

For further information, please contact Dr. Amin R. Javer at the following address:

St. Paul’s Hospital, Sinus Centre, Providence 2
1081 Burrard St, Vancouver BC Canada V6Z 1Y6
Tel: 604-806-9926, Fax: 604-806-9690
sinussurgeon@stpaulssinuscentre.com

Fellowship Program: Weekly Timetable

Monday

  • 0700: Rounds at the ENT Clinic St. Paul’s Hospital. Every third week is dedicated to rhinology rounds.
  • 0800 – 1700: Rhinology outpatient clinic at St. Paul’s Sinus Centre

Tuesday

  • 0800 – 1700: Surgery, False Creek Surgical Centre

Wednesday

  • 0700: ENT city wide rounds at Vancouver General Hospital.
  • 0800 – 1700: Clinic at St. Paul’s Sinus Centre (occasionally a surgery day)

Thursday

  • 0730 – 1700: Surgery, St. Paul’s Hospital OR’s (occasionally a clinic day)

Friday

  • 0800 – 1700: Surgery/Clinic at St. Paul’s Hospital – This day will eventually turn into a fellow clinic day in the latter half of the year

SPSC Rhinology Research Fellow

The SPSC will accommodate ENT doctors who have an interest in spending dedicating time towards research in Rhinology and Skull Base. At SPSC there are a number of opportunities to do clinical and basic science research. The research fellows will commit to a minimum of 3 months (preferable is 6-12 months). Research fellows will be in charge of one study (minimum). We aim to have each fellow achieve the first authorship of the study they are in charge of. Based on the individual’s skill set, they may be able to do multiple studies.

Drs. Thamboo and Javier will help with research ideas for every fellow, however, we highly promote the fellow’s novel ideas as well. The fellow must play an integral role in each aspect of the study from project development to publication in a credible journal. The process of running a study will include:

  1. Developing research methodology for every novel idea which includes:
    1. Protocol development to ensure:
      1. all the important factors for a comprehensive study have been considered;
      2. all aspects have been well thought out and the outcomes could be easily evaluated using universal qualification and quantification methods;
      3. all possible methods for evaluating the outcomes have been carefully investigated before selecting one for the study;
  2. Lead the data collection through the terms of the study to make sure all co-investigators follow the designed methodology
  3. Provide weekly updates at the research meeting so that the entire team can have a clear idea of the progression of the research project.
  4. Lead the data analysis at the end of the study and review all the results
  5. Lead the manuscript writing at the end of the study and make sure the appropriate journal has been targeted for the publication.

Current Fellows

Salahuddin Alsalihi

Salahuddin Alsalihi

Fellow

Rami Al-Salman

Rami Al-Salman

Fellow

Warren Mullings

Warren Mullings

Fellow

Email: warren.mullings@gmail.com

Alumni

Looking for the Fellowship alumni? They have their own dedicated page with contact information to stay in touch.