Dr. Andrew Thamboo’s Fellowship Program

Institution & Address

University of British Columbia
St. Paul’s Sinus Centre
Room 2600 Providence Building, 2nd Floor
1081 Burrard Street
Vancouver, BC
V6Z 1Y6

Fellowship Director

Andrew Thamboo, MD FRCSC MHSc
Clinical Associate Professor

St. Paul’s Sinus Centre Mission Statement

To provide the highest quality of care for patients suffering from sinus and skull base diseases by establishing a strong and stable research center. To foster an environment where research and innovation thrive in pursuit of excellence in patient care. The evidence-based practices established at this centre will serve as a model of exemplary clinical and research training for national and international fellows, residents, medical and graduate students.

The overarching goal of the fellowship is to ensure that, by its completion, fellows are able to independently and efficiently perform complex inflammatory and skull base procedures. Fellows are expected to develop proficiency in appropriate diagnosis, clinical decision-making, and the selection and execution of optimal surgical management strategies.

Fellowship Mandate

The UBC Endoscopic Sinus and Skull Base Surgery Clinical-Research Fellowship is a one-year intensive clinical and research experience meant for applicant pursuing an academic practice that manages sinonasal and skull-base disorders.

Clinical and Surgical Locations

• St Paul’s Hospital (SPH) – Hospital inpatient, on-call and Operative
• Burnaby Hospital (BH) – Hospital inpatient, on-call and Operative
• Surrey Memorial Hospital (SMH) – Hospital inpatient, on-call and Operative
• Jim Pattison Outpatient Surgical Centre – Operative
• Royal Columbia Hospital
• Vancouver General Hospital (VGH) – Hospital inpatient and Operative
• False Creek Health Care Centre (FCHCC) – Operative

Objectives

The objectives are divided into clinical, research and academic activity. These objectives described in detail below are reviewed on a weekly basis in order for the fellow to reach their potential at the completion of their fellowship.

Clinical

• Complete work-up of patients presenting with sino-nasal disorders, tumors and skull base lesions
• Surgical management of patients presenting with sino-nasal disorders, tumors and skull base lesions
• Management of complex recalcitrant chronic sinus patients
• Perform basic allergy testing and interpretation of results

Research

• Be able to conduct prospective trials and publish in reputable journals
• Be able to critically appraise journal articles
• Complete 3 research studies as primary author and present research studies at national/international meetings
• Provide guidance and leadership to undergraduate and medical students and residents with their research studies associated

Academic Activity

• To be able to construct a professional presentation at a number of academic events, which include but not limited to: UBC Division of Otolaryngology – Head and Neck Surgery, city-wide rhinology rounds, rhinology lectures for residents, BC Otolaryngology Division’s P.J. Doyle Annual Research Day
• To be able to teach and supervise residents in their clinical and surgical rotation in rhinology
• Partake in multidisciplinary rounds at provincial wide tumor board rounds at the cancer agency
• Participate in consulting, leadership and academic endeavors important to an academic practice

Weekly Schedule

Approximately 4 days per week in the operating room, assisting Dr. Thamboo. 1 full clinic day per week in a high-volume clinic, managing 50+ patients. One clinic per month includes a combined Complex Upper Airway Clinic in collaboration with an allergist and a Respirologist. Additionally, 1 Saturday per month includes a dedicated AERD clinic, working alongside two respirologists to manage patients with aspirin-exacerbated respiratory disease. In addition, the fellow will have 5 days a week of tele visit consultations (approximately 5–7 per day).

Case Load

Training is conducted with one of the highest-volume sinus surgeons in North America, with approximately 350–400 cases performed annually.

The vast majority of cases (~95%) are advanced in complexity, including primary, revision, and comprehensive (“full-house”) functional endoscopic sinus surgery (FESS). As a tertiary referral center, routine procedures such as septoplasty alone or a limited ESS are seldom performed.

The surgical experience includes:

• Approximately 15–20 outside-in Draf III procedures annually for inflammatory disease, with an additional 10–15 inside-out Draf III approaches for sinonasal tumors
• Approximately 10 dacryocystorhinostomy (DCR) procedures per year
• 1–2 septal perforation repairs annually
• Skull base exposure is extensive and varied, ranging from pituitary adenomas to complex anterior skull base pathology. Fellows participate in approximately 6–8 skull base operating lists per month in collaboration with neurosurgery. The program involves working with three different neurosurgeons, providing exposure to diverse surgical techniques and approaches.
• At least 40 transphenoidal pituitary surgeries. The fellow will be comfortable with various reconstruction techniques, such as a nasoseptal flap, fascia lata graft, nasal floor graft, inferior and middle turbinate grafts, and more.
• 10–15 CSF leak repairs
• 3–5 nasopharyngectomies
• 5–10 endoscopic craniofacial resections
• There is consistent exposure to sinonasal tumor surgery (approximately 40 benign and 30 malignant cases), with frequent cases ranging from inverted papilloma to advanced malignancies such as squamous cell carcinoma, olfactory neuroblastoma, adenocarcinoma, and adenoid cystic carcinoma. These cases may require extended endoscopic approaches, including modified Denker approach, prelacrimal, medial maxillectomy, and advanced frontal sinus procedures (e.g., inside-out Draf III, frontal trephination), as well as combined open and endoscopic approaches with neurosurgery.
• The fellow will also be exposed to and comfortable with miscellaneous cases such as posterior nasal neurectomies, eustachian tube injections, and empty nose syndrome injections.
• Additionally, fellows gain experience in multidisciplinary surgery, including approximately 1–2 cases per month performed in conjunction with oculoplastics using combined endoscopic approaches for sinonasal tumors.

Call Schedule

Required to be on call when Dr. Thamboo is on-call. A number of emergency rhinological cases do occur on days when not on call and the fellow is encouraged to attend.

Duration

1 year + 2 weeks overlap with previous/upcoming fellow (July to June)

Requirements for Appointment

• Completion of the TOEFL examination for licensing (or equivalent test required by the college)
• Be able to obtain a medical education license with BC College of Physician and Surgeons.

Additional Information

• This fellowship is funded.
• A car is recommended but car-share programs are available to get from site to site.
• Vacation days should be coordinated on days when Dr. Thamboo is away

Application Deadline

There is no deadline. This is a rolling acceptance for the fellowship and will be filled once an appropriate candidate is identified. If interested please reach out to:

Dr. Andrew Thamboo, MD FRCS(C)
Division of Otolaryngology – Head & Neck Surgery
St. Paul’s Sinus Centre – St. Paul’s Hospital
Room 2600 Providence Building, 2nd Floor
1081 Burrard St., Vancouver, BC, V6Z 1Y6
Phone: 604-806-8353
Fax: 1-866-308-2123
Email: andrew.thamboo@gmail.com

Sincerely,

Dr. Andrew Thamboo, MD, FRCSC, MHSc
Clinical Associate Professor, UBC
Rhinology & Endoscopic Skull Base Surgeon