Minimally Invasive Fellowships

[The Pill Counter]

Can the GS residents, fellows and the rest shed some light on what a laparoscopic fellowship entails, the benefits of completing one, the scope in private practice, and the competitiveness of obtaining a fellowship.

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[njbmd]

Hi there,
At my institution, UVa, the minimally-invasive surgery fellowship is one year long and is at the attending-physician level as opposed to the "fellow" level (read higher paying level). The folks who applied for the fellowship this year had finished their General Surgery residency and some had been practicing. In terms of competitiveness, I can't speak for specifics but there were more than 100 applicants for the one slot here.

njbmd

 

[droliver]

Pill Counter,

With the explosion of new advanced laparoscopy procedures, many people have felt that they did not recieve enough training in a number of techniques that a pretty common in practice. The two procedures really driving this in the United States are the laparoscopic colon work & the laparoscopic bariatric procedures. (Hernias, Gallbladders, appendectomy, & Nissen Fundoplication are pretty common @ this point & do not require additional training at most quality programs). There are some other cases that are rare enough in common practice that most people would not take a year off just to learn - Spleenectomy, adrenalectomy, splanchnichectomy, nephrectomy, prostatectomy, CBD exploration, hepatectomy, choledochoenterostomy, distal pancreatectomy.

At present there are a relative paucity of fellowships relative to people looking for more training & the are fairly competative. There is no additional board-certification or CAQ available in Laparoscopy & there likely will never be as these skills filter down into more common useage in training programs for general surgery

As an aside, the laparoscopy in Australia & Europe is a bit more integrated into surgical care then stateside. One of my attendings spent a year in Brisbane,Australia with Dr. George Fielding, who without a doubt is the finest laparoscopist I've ever seen. If you're interested in some great exposure down there, I'd look him up. I assisted him during a course he taught on Bariatric surgery here & I left with my jaw dropping @ how skilled he was

 

[The Pill Counter]

Thanks for the info DrOliver,
I'll definitely keep an eye out for Dr. Fielding during my Surgery rotation next year. Do you know which hospital in Brisbane he's based at?
Do you feel the States are moving towards integrating laporoscopy into GS programs to a degree that would not necessitate fellowships?

 

[droliver]

It's already somewhat integrated, but there are several generations of surgeons practicing in teaching programs who trained before the laparoscopic era (~1990) & are caught up in the transition themselves. Many don't have the skills or time available to retrain with many of the advanced or less-common techniques

 

[Carbon]

Originally posted by droliver
As an aside, the laparoscopy in Australia & Europe is a bit more integrated into surgical care then stateside. One of my attendings spent a year in Brisbane,Australia with Dr. George Fielding, who without a doubt is the finest laparoscopist I've ever seen. If you're interested in some great exposure down there, I'd look him up. I assisted him during a course he taught on Bariatric surgery here & I left with my jaw dropping @ how skilled he was

There's an incredible laparoscopic fellowship available at NineWells hospital in Dundee, Scotland, with one of the three original creators of laparoscopy. It has been highly recommended to me in the event that I decide against a peripheral vascular surg fellowship.

 

[droliver]

Originally posted by Carbon
There's an incredible laparoscopic fellowship available at NineWells hospital in Dundee, Scotland, with one of the three original creators of laparoscopy. It has been highly recommended to me in the event that I decide against a peripheral vascular surg fellowship.

Yes, that's Sir Alfred Cushieri's (sp?) program. Funny you should mention that. Three of my professors did fellowships with him over in Scotland, and he's a frequent visitor here (he holds some kind of endowed visiting professor chair here). I'm told he's one of the premier living physicians in the UK. He comes to Louisville ~2 weeks every year as a visiting professor. I had the pleasure of being his driver/guide this past July for a week & did a number of cases with him. He's a very & interesting man. Lives on the golf course @ St. Andrews in Scotland (Lucky bastard!)