Institution: Duke University Medical Center
Duration of Fellowship: One clinical year, possibly an additional year in health services research.
Number of Available Fellowship Positions: 1
Program Director:
Program Director Email:
Sanziana Roman MD FACS
sanziana.roman@duke.edu
Secondary Contact Name:
Secondary Contact Title:
Secondary Contact Email:
Carla Thompson
Program Coordinator
carla.thompson@duke.edu
Address/Phone: Section of Endocrine Surgery, Dept. of Surgery,
Duke University School of Medicine
Durham, NC

Phone: (919) 668-1767
Fax: 734-936-5830
Objectives of the Program: Our objectives for the Endocrine Surgery fellow are to acquire knowledge and understanding of endocrine gland anatomy and normal and abnormal physiology; to acquire excellence in clinical acumen for endocrinopathies and develop knowledge in rare endocrine disorders, such as inherited syndromes; to understand the need for genetic counseling and testing; to understand the molecular developments in endocrine malignancy, and learn how to apply them in clinical care; to understand current controversies and areas of future exploration, and become well versed in current endocrine surgery literature; and finally, to demonstrate by the end of the fellowship good clinical judgment and perform routine and complex endocrine operations appropriately and safely, to understand his/her own limitations, and be willing to ask for help when necessary.
Highlights of the Fellowship: Our objectives for the Endocrine Surgery fellow are to acquire knowledge and understanding of endocrine gland anatomy and normal and abnormal physiology; to acquire excellence in clinical acumen for endocrinopathies and develop knowledge in rare endocrine disorders, such as inherited syndromes; to understand the need for genetic counseling and testing; to understand the molecular developments in endocrine malignancy, and learn how to apply them in clinical care; to understand current controversies and areas of future exploration, and become well versed in current endocrine surgery literature; and finally, to demonstrate by the end of the fellowship good clinical judgment and perform routine and complex endocrine operations appropriately and safely, to understand his/her own limitations, and be willing to ask for help when necessary.
Our fellowship provides extensive exposure to standard and advanced/minimally invasive techniques in endocrine surgery, medical endocrinology, pathology, ultrasonography, and laryngoscopy. We incorporate opportunities for clinical/health services research for academic advancement. The fellow has weekly outpatient clinics with the respective mentoring attending. These clinics are conducted in a multidisciplinary fashion in conjunction with medical endocrinology and cytopathology. The fellow has the opportunity to perform surgeon-directed ultrasound for patients with thyroid and parathyroid diseases under the direction of Drs. Randall Scheri, and Michael Stang, and performs ultrasound-guided FNAs on the patients in clinic in conjunction with the endocrinology or cytopathology attending. We have integrated exposure to ultrasonography and cytopathology on a weekly basis in order to show the fellow how to incorporate these adjuncts into the daily life and practice of an endocrine surgeon.

In the latter part of the fellowship year, the fellow will rotate at the Duke Raleigh Hospital, which is an hospital of Duke University Health System in Raleigh, NC, where the fellow will gain experience in robotic thyroidectomy, adrenalectomy, and advanced ultrasonography of the cervical lymph nodes with Dr. Michael Stang.

The fellow gains exposure to multi-institutional clinical trials of novel chemotherapy agents for advanced thyroid cancers under the direction of Dr. Sosa.

The fellow has the opportunity to prepare cases and present them at multidisciplinary and tumor board conferences. The fellow is expected to present at least four conferences on the topic of their interest in endocrine disease/surgery. Depending on the fellow’s interests, there is opportunity to participate in the multidisciplinary Hepato-Pancreatic-Biliary tumor board, and the Hereditary Conference Group, which deals with hereditary tumors and disorders.

The fellowship provides extensive exposure to benign and malignant thyroid disease (projected number of cases: 280) advanced thyroid cancer operations, robotic thyroidectomy, parathyroidectomy and minimally invasive techniques (including MIP under local analgesia, radioguided surgery, reoperative surgery, 180), central and lateral neck dissections (25), laparoscopic and posterior retroperitoneoscopic adrenalectomy (20-40), and neuroendocrine tumors of the GI tract/pancreas.
The fellow has dedicated time on affiliated specialties as a dedicated rotation for two months, including thyroidology and endocrinology, bone disease and calcium metabolism, radiology, pathology and voice disorders.

RESEARCH:
The fellow has at least one day a week reserved for non-operative endeavors, including research opportunities. Under the direction of Dr. Julie Ann Sosa, who is the Director of Clinical and Health Services Research in Surgery, we have a robust endocrine surgery research program which provides outstanding opportunities for a fellow to establish their academic career. We expect the fellow to be actively engaged in clinical research as part of their training. The fellow would be involved in the CESQIP (Collaborative Endocrine Surgery Quality Improvement Program). This would allow the fellow to become engaged in multi-institutional collaborations, which hopefully they would carry forward after completion of the program. Our research group is supported by the Duke Clinical Research Institute (DCRI), the Duke Cancer Institute (DCI), the Department of Surgery, and other. The support comes in the form of not only discretionary funds but also personnel to help run and build a robust clinical trials program and database. For fellows interested in pursuing additional research training/mentorship in clinical or health services research, there could be opportunities available within our department and the Duke Clinical Research Institute (DCRI) for the potential of a second research year.

FACULTY:
Sanziana Roman MD, Endocrine Surgery, Fellowship Director
Julie Ann Sosa MD MA, Chief, Endocrine Surgery
Randall Scheri MD, Endocrine Surgery
Michael Stang MD, Endocrine Surgery
Sabino Zani MD, Surgical Oncology
Additional affiliated faculty in Medical Endocrinology:
Jennifer Perkins MD, Faculty
Sara Ahmadi MD, Faculty
International Medical Graduates: Graduates of international medical schools with H1B visa are eligible to apply for the fellowship.
Special Considerations: Fellows will be required to obtain a medical license for the State of North Carolina, and will be required to apply for privileges at the Duke University Hospital and Duke Raleigh Hospital.
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Previous Fellows: 2013-14 Adwoa Opoku Boateng, MD (Ochsner Medical Center, New Orleans, LA; currently on faculty at Ochsner MC, NOLA)
2014-15 Christa Jillard, MD (Medical University of South Carolina, Charleston, SC; currently in private practice in Savannah, GA)
2015-16 Ammer Shah, MD (Albert Einstein, NY, NY; currently on faculty at VCU, Richmond, VA)
2016-17 Athos Konstantinidis, MD (USC Keck SOM. Los Angeles, CA)