OMFS Head and Neck Fellowship Overviews?

[piratewow]

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Hello everyone, I saw this thread on cleft/cranio fellowships and was hoping we could make a similar one for Head and Neck/MORS. Here's a list of info I have, which is admittedly pretty bare bones and possibly outdated. If people have more info on duration, volume, faculty, vibes, general overview feel free to chime in. Will update this thread when I get more time.

LIJ or somewhere in NY- Not sure but I believe they started or are starting one

Ascension Macomb - I believe now it's Henry Ford but still going.

UMich- 1 year

Moe- Not sure if it's a fellowship but I believe she was taking non-cats last yr. Grand Rapids,Michigan.

Maryland- 1 or 2 yr fellowship with Drs. Joshua Lubek and Donita Dyalram.

Willis Knighton- 2 yrs but get dual cert in cleft and craniofacial as well. 1 fellow a year. Faculty include G.E Ghali, Stavan Patel, Brett Shirley, Ross Brockman.

LSU Health Shreveport- Possibly defunct? Not really sure honestly.

LSU NOLA- I believe Zaid started one in the past yr. Technically in Baton Rouge.

JPS- 2 yr fellowship Faculty: Dr. Fayette Williams and Roderick Kim

El Paso- 2 year fellowship with Drs.Brockhoff and Kaleem.

UTHealth Houston- 2 year with Drs. Jonathan Shum and James Melville. Work with the ENTs as well in MD Anderson. They do a lot of tissue engineering/BMAC.

Knoxville- Carlson left, not sure if the fellowship is still going.

UAB- 2 yr fellowship. Morlandt and Ying. Think they hired a recent fellow grad too

Jacksonville- 1 yr fellowship. 2 Fellows a yr. Dr. Rui Fernandes and Anthony Bunnell

UCSF Fresno- 2 yr fellowship

OHSU- Not sure on current status

 

[dentpinned]

Is Ascension Macomb, aka Henry Ford Warren, still offering the H+N Fellowship without Ramirez there? Thought he ran that, and they lost him amongst others.

 

[lefortwon]

Is Ascension Macomb, aka Henry Ford Warren, still offering the H+N Fellowship without Ramirez there? Thought he ran that, and they lost him amongst others.

No the fellowship unfortunately is no longer offered.

 

[Masterus]

I meant to post this a while ago, but got busy. The head and neck fellowship landscape has changed substantially in the last 10 years. The OG fellowships have fallen and now newer fellowships have risen to the top. Order does not matter. The world of OMFS head and neck is divided between full scope head and neck and oral cavity “head and neck”. Most OMFS fellowships are oral cavity and most OMFS head and neck surgeons are oral cavity cancer surgeons. The average OMFS fellowship does about 50 free flaps. The average ENT fellowship does about 100 free flaps. Also, I will say, the misconception of head and neck not making money is really only the places that give you a flat salary. Places where attendings are getting RVUs to operate, the attendings are making 600k+, some places even breaking 1 mil.

Willis Knighton - 1 to 2 year fellowship. I would say you know it is good because it is Ghali. This is one of the broadest scope OMFS fellowship in the country that you can get in a one year fellowship. They do Anterior skull base, TORS, thyroid, larynx, oral cavity, facial cosmetics. They have 3 craniofacial/head and neck fellowship trained attendings which I think gives you more perspective on everything. They do not drown in cases but you will get enough to be comfy. I think they do about 50-60 free flaps a year. They do more than your stereotypical reconstruction as Stavan Patel can do perforator flaps. Ghali is one of the greats of OMFS in our time.The hospital is private so there is good support. It seems like Willis Knighton took all of the cases from LSU Shreveport once Ghali left. There is extremely good autonomy here to cut. No moonlighting but you will be busy here. There is a residency program that started which helps with covering the patients.

Houston - This is one of the more underrated fellowships but is oral cavity focused. I’m actually not sure why no one has picked up how good it is. It is 2 years. You can get a ton of recon experience. The current fellow is graduating with 150 flaps in 2 year. (And this is with the first yellow fellow racking in his own 50-60+). You start raising flaps first year and continue to do more second year. They’re doing a ton of ALTs on the ENT side and a lot of fibula/forearm on the OMFS side. Unlike other fellowships where it is split, you can do ablative or recon. I think the ablative volume was weak than other fellowships due to it being really recon heavy. The relationship with ENT is phenomenal. They’ve developed a relationship with Baylor ENT to help them do their flaps. I think the issue is the ENT started a fellowship so this experience may go down. It is the only institution where the ENT openly let you raise a flap for them on your own with no omfs attending staffing the case. Baylor is getting an ENT fellow which cuts down the flaps the fellow will likely get exposed to. Prior to them starting the Baylor AHNS fellowship, the second year fellow would spend their entire year as the ENT fellow (I thought this was amazing). This may change though with the addition of ENT's own fellow. The faculty are great. Melville does big tissue engineering cases as well which is part of recon these days. He is gone sometimes but he will stack the days he is here. The PD Shum is very supportive and the mentorship is there. They hired a new attending from HNSA who you will work with as well so it may be less freedom to go to ENT cases.

UAB - 2 year fellowship. this is one of the cushiest 2 year fellowships with probably the highest flap volume of all of the OMFS fellowships. It is oral cavity focused. The fellows graduate with over 150 flaps (potentially more now with a new attending). OMFS does more flaps than ENT here and does all the oral cavity recon. ENT got completely boxed out of oral cavity here and it is so crazy that this happened that it is known throughout the ENT head and neck world because UAB ENT head and neck used to be a top 10 AHNS fellowship in ENT prior to 2015. There is 0 scutwork. You have residents that are used to working hard, 2 head and neck dedicated PAs with a 3rd inpatient PA and a dedicated OR first assist that can close all the legs and raise skin grafts. There is 2 days clinic a week and 3 days OR. This has some of the highest volume free flaps among OMFS fellowships for oral cavity. Attendings have to trust you to be less hands on and you have to work fast. They now have 4 attendings doing head and neck OR cases 5 days a week. Moonlighting is theoretically allowed to an extent. You do have to take some trauma call as well but not much. I suspect the flap and OR numbers are about to increase than what is mentioned above with the addition of the 4th faculty.

UCSF Fresno - 2 year fellowship with very good autonomy to cut. This is the widest scope 2 year fellowship and I think one of the best fellowships for head and neck. Basically some Shreveport guys came over and joined Robert Julian and made another Shreveport in California. They are the OMFS and ENT for the hospital. They control the ENT portion so much that the OMFS residents are doing tonsillectomy and adenoidectomies in the OR. It is similar to Willis Knighton in some regards. There is 3 days clinic and 2-3 days OR. The attendings are very chill. They graduate with a crap ton of diverse ablative procedures including TORS and anterior skull base and about 90ish flaps over 2 years. Overall, one of the best 2 year fellowships especially with its diverse training and volume. You do have to cover trauma call here. They pretty much own head and neck surgery in this area. This is a very busy fellowship.

Knoxville - 1 year fellowship. This is also a sleeper fellowship because no one knows they have hired a ablative/recon surgeon that has built up volume the last 2 years. Michael Winstead is a stud and a genuinely good person. They own parotids and oral cavity in this region. Carlson is now gone but that actually means more autonomy for the fellow now. They do some thyroid as well. There’s no ENT competition. They do all the airways for the hospital. The fellowship is very educational. They do about 50-60 free flaps a year but the ablative volume including parotids is high. Autonomy here as a fellow is great. Fellow does not have to take trauma call. Clinic is about 1 day and a half a week. Winstead is a great guy and very supportive of the fellow. Moonlighting may be allowed. There is a lot of resident support and the fellow does not have much scutwork to do. I suspect the fellowship will continue to grow. There is no ENT competition in Knoxville and Carlson built good relationships with everyone and this will continue to last.

El Paso - 2 year fellowship. I think you will graduate with 50-60 flaps. It is a full scope fellowship where you will do everything. The volume is good but it is not the busiest fellowship of the ones available. I do believe this is one of the better fellowships. The volume is solid and autonomy is great. The attendings are very chill here. I do believe you have to do some dentoalveolar in their clinics to support your salary. It is an interesting model where it is based out of a private practice similar to HNSA but now there is also a residency program which will likely reduce the workload on the fellow. Prior to having residents, the fellow had to do everything.

JPS - 2 year fellowship. Historically, this is a good fellowship but it is not quick paced and there is plenty of time to learn. The volume is lower than other fellowships that break over 100 flaps. There is autonomy to this fellowships. The fellow will graduate with about 50-60 flaps in 2 years. It has extended scope head and neck with some exposure to thyroidectomy and laryngectomy, but the focus is pretty much oral cavity. You will go over to the ENT hospital and assist with their fellows occasionally to get more cases. (It is the busiest ENT head and neck fellowship in the country but you are still secondary to their fellows). There is a lot of call to take for the faculty and you’ll have to staff a lot of trauma and infection. This is not the norm. Most fellowships protect you from this. While you’ll do jaw in a day here, you do not work with the jaw in a day guy much he’s pretty much always gone lecturing and working in his private practice making money. (It is funny because he is the face of the fellowship but he is never around) You’ll mainly work with Kim.

Michigan - This fellowship is no longer the beast it was 15 years ago. It has always been only oral cavity. It is totally different with Helman gone and Justine Moe who were major driving forces for the fellowship. Justine Moe has started her own fellowship about an hour and a half away which will likely eat some of the oral cavity volume at Michigan as a whole. Ward has slowed down and stepped down as chair and it is now staffed with two younger faculty fresh out of fellowship. One is just graduated and the other is 4 years out. They only do oral cavity and are pretty second to the ENT at this hospital as they will get noon starts sometimes. ENT is still doing oral cavity and control all the flaps. They barely do any parotids as well. The fellow is treated like a chief resident and there is 3 days of clinic a week and 2-3 days of OR. They are always operating with the attending. They do about 50-60 free flaps a year. They are educational and want to teach the fellow in the OR. The resident support is not great as the fellow is expected to do everything outside of flap checks. You have to consent and check the patient in the morning. The clinics are chaotic and are not separated between head and neck and rest of OMFS so you are seeing trauma patients and other workups and sometimes the residents are not always there. You do not take any call. It is definitely clinic heavy. Residents do not have to come help cases so sometimes you find yourself with just the fellow and attending. Moonlighting is not allowed. They are extremely old school and were not doing any implants into fibulas before this last year but the fellow who is also prosth trained has pushed for it but who knows if it remain a thing now that he is gone.

Jacksonville - 1 year fellowship. This fellowship has fallen off the map. They are barely doing 40 free flaps a year. 2 major ENT head and neck centers opened up which basically divided the volume down a lot. And it’s all extremity recon and no oral cavity. Fernandes is rarely there and you only work with two younger fellowship attendings. When he is there, he is only doing thyroids. They do about 40 free flaps a year split between 2 fellows. The attendings are tough to work with. This is a scut heavy program for the fellow. You have to do all the insurance and scheduling. There is no support. There is multiple days of clinic and a good amount of down time. There’s been a lot of drama the last 2 years and a lot of attendings have left. It has a name because of the fellowship used to be like 10 years ago.

HNSA - 2 year fellowship. This fellowship has really fell off the map ever since the dual trained attendings retired. It has slowly declined over the years. While it was the OG fellowship in head and neck, it is no longer strong. Most graduates struggle with flaps when they are first out because of poor autonomy. Very hands on attendings with attendings doing large parts of the procedures. Bell is no longer there. Trouble retaining or matching fellows. There is a lot of scut. You have to be on primary call for free flaps, write notes, discharge patients, do flap checks at night. This is no longer the fellowship it was 15 years ago. The scope has narrowed and they are doing more extremity flaps than oral cavity. The volume is not high either. They are doing 40-50 flaps and you may have rotate with a plastic surgeon for more.

Maryland - 1 to 2 year fellowship. They have more chill newer attendings but the overall vibe has always been malignant because of the senior attending. It seems like the attendings are more hands on for the more rare flaps and the fellow suctions for the attending. There is a reason a lot f the fellows at this fellowship are foreign, but honestly people like having a fellowship in the northeast so they are willing to endure this. This fellowship has been around for a very long time. You expect 80 free flaps. It is also out of the match now and takes residents. You will get trained in TORS here as well. I would say the autonomy is okay but you also get a lot of resident support so the scutwork is minimal on the fellow.

LSU - Newer fellowship. 2 years fellowship. Mostly oral cavity. Probably around 50 free flaps a year I think you have to travel between Baton Rouge and New Orleans, but really there is no reputation about this fellowship yet. It is probably middle of the road.

Justine Moe - Newer fellowship likely 30-40 free flaps. Has a private practice dentoalveolar and full scope OMS aspect to it. It's good for someone that wants to try head and neck in private practice and practice full scope OMS.

Minnesota - Unknown about this fellowship. I think time is spent with ENT and plastics along with the fellowship attendings.

Ascension - Closed

Shreveport - Closed

BU - Closed

LIJ - Supposedly opening a head and neck fellowship. TBD.

 

[toothgrinder]

Supposedly LSU NOLA fellowship may be closing down soon.

Fellowship director Waleed Zaid has lost privileges indefinitely at the hospital. He has been unable to operate for the last few months.

 

[702]

Supposedly LSU NOLA fellowship may be closing down soon.

Fellowship director Waleed Zaid has lost privileges indefinitely at the hospital. He has been unable to operate for the last few months.

Why?

 

[Bolt_Up_23]

Thank you for a such a great overview. Curious if anyone can touch on what the job market looks like for graduates after finishing head and neck fellowships.

Is there currently a big demand? Is private practice a realistic option or is it almost always tied to an academic institution with OMFS already doing these cases?

 

[toothgrinder]

Why?

I do not know the details, all I’ve heard is it has something to do with a mortality

 

[Wisetoothshucker]

Can someone do an overview for the facial cosmetic fellowships?

 

[C.elegans]

I meant to post this a while ago, but got busy. The head and neck fellowship landscape has changed substantially in the last 10 years. The OG fellowships have fallen and now newer fellowships have risen to the top. Order does not matter. The world of OMFS head and neck is divided between full scope head and neck and oral cavity “head and neck”. Most OMFS fellowships are oral cavity and most OMFS head and neck surgeons are oral cavity cancer surgeons. The average OMFS fellowship does about 50 free flaps. The average ENT fellowship does about 100 free flaps. Also, I will say, the misconception of head and neck not making money is really only the places that give you a flat salary. Places where attendings are getting RVUs to operate, the attendings are making 600k+, some places even breaking 1 mil.

Willis Knighton - 1 to 2 year fellowship. I would say you know it is good because it is Ghali. This is one of the broadest scope OMFS fellowship in the country that you can get in a one year fellowship. They do Anterior skull base, TORS, thyroid, larynx, oral cavity, facial cosmetics. They have 3 craniofacial/head and neck fellowship trained attendings which I think gives you more perspective on everything. They do not drown in cases but you will get enough to be comfy. I think they do about 50-60 free flaps a year. They do more than your stereotypical reconstruction as Stavan Patel can do perforator flaps. Ghali is one of the greats of OMFS in our time.The hospital is private so there is good support. It seems like Willis Knighton took all of the cases from LSU Shreveport once Ghali left. There is extremely good autonomy here to cut. No moonlighting but you will be busy here. There is a residency program that started which helps with covering the patients.

Houston - This is one of the more underrated fellowships but is oral cavity focused. I’m actually not sure why no one has picked up how good it is. It is 2 years. You can get a ton of recon experience. The current fellow is graduating with 150 flaps in 2 year. (And this is with the first yellow fellow racking in his own 50-60+). You start raising flaps first year and continue to do more second year. They’re doing a ton of ALTs on the ENT side and a lot of fibula/forearm on the OMFS side. Unlike other fellowships where it is split, you can do ablative or recon. I think the ablative volume was weak than other fellowships due to it being really recon heavy. The relationship with ENT is phenomenal. They’ve developed a relationship with Baylor ENT to help them do their flaps. I think the issue is the ENT started a fellowship so this experience may go down. It is the only institution where the ENT openly let you raise a flap for them on your own with no omfs attending staffing the case. Baylor is getting an ENT fellow which cuts down the flaps the fellow will likely get exposed to. Prior to them starting the Baylor AHNS fellowship, the second year fellow would spend their entire year as the ENT fellow (I thought this was amazing). This may change though with the addition of ENT's own fellow. The faculty are great. Melville does big tissue engineering cases as well which is part of recon these days. He is gone sometimes but he will stack the days he is here. The PD Shum is very supportive and the mentorship is there. They hired a new attending from HNSA who you will work with as well so it may be less freedom to go to ENT cases.

UAB - 2 year fellowship. this is one of the cushiest 2 year fellowships with probably the highest flap volume of all of the OMFS fellowships. It is oral cavity focused. The fellows graduate with over 150 flaps (potentially more now with a new attending). OMFS does more flaps than ENT here and does all the oral cavity recon. ENT got completely boxed out of oral cavity here and it is so crazy that this happened that it is known throughout the ENT head and neck world because UAB ENT head and neck used to be a top 10 AHNS fellowship in ENT prior to 2015. There is 0 scutwork. You have residents that are used to working hard, 2 head and neck dedicated PAs with a 3rd inpatient PA and a dedicated OR first assist that can close all the legs and raise skin grafts. There is 2 days clinic a week and 3 days OR. This has some of the highest volume free flaps among OMFS fellowships for oral cavity. Attendings have to trust you to be less hands on and you have to work fast. They now have 4 attendings doing head and neck OR cases 5 days a week. Moonlighting is theoretically allowed to an extent. You do have to take some trauma call as well but not much. I suspect the flap and OR numbers are about to increase than what is mentioned above with the addition of the 4th faculty.

UCSF Fresno - 2 year fellowship with very good autonomy to cut. This is the widest scope 2 year fellowship and I think one of the best fellowships for head and neck. Basically some Shreveport guys came over and joined Robert Julian and made another Shreveport in California. They are the OMFS and ENT for the hospital. They control the ENT portion so much that the OMFS residents are doing tonsillectomy and adenoidectomies in the OR. It is similar to Willis Knighton in some regards. There is 3 days clinic and 2-3 days OR. The attendings are very chill. They graduate with a crap ton of diverse ablative procedures including TORS and anterior skull base and about 90ish flaps over 2 years. Overall, one of the best 2 year fellowships especially with its diverse training and volume. You do have to cover trauma call here. They pretty much own head and neck surgery in this area. This is a very busy fellowship.

Knoxville - 1 year fellowship. This is also a sleeper fellowship because no one knows they have hired a ablative/recon surgeon that has built up volume the last 2 years. Michael Winstead is a stud and a genuinely good person. They own parotids and oral cavity in this region. Carlson is now gone but that actually means more autonomy for the fellow now. They do some thyroid as well. There’s no ENT competition. They do all the airways for the hospital. The fellowship is very educational. They do about 50-60 free flaps a year but the ablative volume including parotids is high. Autonomy here as a fellow is great. Fellow does not have to take trauma call. Clinic is about 1 day and a half a week. Winstead is a great guy and very supportive of the fellow. Moonlighting may be allowed. There is a lot of resident support and the fellow does not have much scutwork to do. I suspect the fellowship will continue to grow. There is no ENT competition in Knoxville and Carlson built good relationships with everyone and this will continue to last.

El Paso - 2 year fellowship. I think you will graduate with 50-60 flaps. It is a full scope fellowship where you will do everything. The volume is good but it is not the busiest fellowship of the ones available. I do believe this is one of the better fellowships. The volume is solid and autonomy is great. The attendings are very chill here. I do believe you have to do some dentoalveolar in their clinics to support your salary. It is an interesting model where it is based out of a private practice similar to HNSA but now there is also a residency program which will likely reduce the workload on the fellow. Prior to having residents, the fellow had to do everything.

JPS - 2 year fellowship. Historically, this is a good fellowship but it is not quick paced and there is plenty of time to learn. The volume is lower than other fellowships that break over 100 flaps. There is autonomy to this fellowships. The fellow will graduate with about 50-60 flaps in 2 years. It has extended scope head and neck with some exposure to thyroidectomy and laryngectomy, but the focus is pretty much oral cavity. You will go over to the ENT hospital and assist with their fellows occasionally to get more cases. (It is the busiest ENT head and neck fellowship in the country but you are still secondary to their fellows). There is a lot of call to take for the faculty and you’ll have to staff a lot of trauma and infection. This is not the norm. Most fellowships protect you from this. While you’ll do jaw in a day here, you do not work with the jaw in a day guy much he’s pretty much always gone lecturing and working in his private practice making money. (It is funny because he is the face of the fellowship but he is never around) You’ll mainly work with Kim.

Michigan - This fellowship is no longer the beast it was 15 years ago. It has always been only oral cavity. It is totally different with Helman gone and Justine Moe who were major driving forces for the fellowship. Justine Moe has started her own fellowship about an hour and a half away which will likely eat some of the oral cavity volume at Michigan as a whole. Ward has slowed down and stepped down as chair and it is now staffed with two younger faculty fresh out of fellowship. One is just graduated and the other is 4 years out. They only do oral cavity and are pretty second to the ENT at this hospital as they will get noon starts sometimes. ENT is still doing oral cavity and control all the flaps. They barely do any parotids as well. The fellow is treated like a chief resident and there is 3 days of clinic a week and 2-3 days of OR. They are always operating with the attending. They do about 50-60 free flaps a year. They are educational and want to teach the fellow in the OR. The resident support is not great as the fellow is expected to do everything outside of flap checks. You have to consent and check the patient in the morning. The clinics are chaotic and are not separated between head and neck and rest of OMFS so you are seeing trauma patients and other workups and sometimes the residents are not always there. You do not take any call. It is definitely clinic heavy. Residents do not have to come help cases so sometimes you find yourself with just the fellow and attending. Moonlighting is not allowed. They are extremely old school and were not doing any implants into fibulas before this last year but the fellow who is also prosth trained has pushed for it but who knows if it remain a thing now that he is gone.

Jacksonville - 1 year fellowship. This fellowship has fallen off the map. They are barely doing 40 free flaps a year. 2 major ENT head and neck centers opened up which basically divided the volume down a lot. And it’s all extremity recon and no oral cavity. Fernandes is rarely there and you only work with two younger fellowship attendings. When he is there, he is only doing thyroids. They do about 40 free flaps a year split between 2 fellows. The attendings are tough to work with. This is a scut heavy program for the fellow. You have to do all the insurance and scheduling. There is no support. There is multiple days of clinic and a good amount of down time. There’s been a lot of drama the last 2 years and a lot of attendings have left. It has a name because of the fellowship used to be like 10 years ago.

HNSA - 2 year fellowship. This fellowship has really fell off the map ever since the dual trained attendings retired. It has slowly declined over the years. While it was the OG fellowship in head and neck, it is no longer strong. Most graduates struggle with flaps when they are first out because of poor autonomy. Very hands on attendings with attendings doing large parts of the procedures. Bell is no longer there. Trouble retaining or matching fellows. There is a lot of scut. You have to be on primary call for free flaps, write notes, discharge patients, do flap checks at night. This is no longer the fellowship it was 15 years ago. The scope has narrowed and they are doing more extremity flaps than oral cavity. The volume is not high either. They are doing 40-50 flaps and you may have rotate with a plastic surgeon for more.

Maryland - 1 to 2 year fellowship. They have more chill newer attendings but the overall vibe has always been malignant because of the senior attending. It seems like the attendings are more hands on for the more rare flaps and the fellow suctions for the attending. There is a reason a lot f the fellows at this fellowship are foreign, but honestly people like having a fellowship in the northeast so they are willing to endure this. This fellowship has been around for a very long time. You expect 80 free flaps. It is also out of the match now and takes residents. You will get trained in TORS here as well. I would say the autonomy is okay but you also get a lot of resident support so the scutwork is minimal on the fellow.

LSU - Newer fellowship. 2 years fellowship. Mostly oral cavity. Probably around 50 free flaps a year I think you have to travel between Baton Rouge and New Orleans, but really there is no reputation about this fellowship yet. It is probably middle of the road.

Justine Moe - Newer fellowship likely 30-40 free flaps. Has a private practice dentoalveolar and full scope OMS aspect to it. It's good for someone that wants to try head and neck in private practice and practice full scope OMS.

Minnesota - Unknown about this fellowship. I think time is spent with ENT and plastics along with the fellowship attendings.

Ascension - Closed

Shreveport - Closed

BU - Closed

LIJ - Supposedly opening a head and neck fellowship. TBD.

Is the LIJ fellowship the ENT one helmed by Brett Miles that just opened this year or is there a separate OMFS H&N fellowship with Hirsch and Salama?