Dr. Amin Javer’s Fellowship Program

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/board examination(s) in their country of origin. The fellowship is open to Canadian Otolaryngologists, as well as non-Canadian trained Otolaryngologists who are eligible to obtain a training/working visa for Canada, as well as 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 Dr. Andrew Thamboo as well as 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

1. Complete at least one advanced (bench or clinical) research project and present/publish it at a major national or international Rhinology / Skull base meeting.
2. Help in organizing and participate in the biannual advanced sinus course offered by the St. Paul’s Sinus Centre.
3. Help in organizing and participate in the fellow/resident sinus courses held throughout the year.
4. Actively participate in and carry out monthly rhinology teaching rounds for all rhinology fellows/residents.
5. Actively participate in weekly rhinology professor teaching rounds/lectures.
6. Actively participate in weekly rhinology CT review rounds.
7. Attain an exceptional degree of expertise in endoscopic sinus and skull base procedures.
8. Carry out at least one weekly fellow clinic during the second half of the fellowship year.
9. Help in organizing and teaching the sinus component of the UBC resident’s teaching schedule.
10. Attain an exceptional degree of expertise in clinical endoscopic skills and procedures in the outpatient setting.
11. 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 and frontal sinus surgery, 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 decades, 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 weekly CT/Radiology rounds as well as a bi-weekly one-hour fellow teaching session will occur on Monday mornings and Friday mornings respectively. A monthly city-wide rhinology rounds is held on the first Wednesday evening of every month.  A weekly research rounds with the research team is held every Thursday morning.

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. The fellow is expected to deliver at least one grand rounds to the entire UBC division of otolaryngology-head and neck surgery during his/her year at the centre.

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

Applying for a Fellowship at the SPSC

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

1. CV and cover letter: please email to sinussurgeon@drjaver.com
2. Reference letters: A total of three reference letters should be sent via email to the attention of Dr. Javer at sinussurgeon@drjaver.com

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: Dr. Amin R. Javer, MD FRCSC 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: Weekly CT/Radiology Review Rounds at the ENT Clinic St. Paul’s Hospital.
• 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 – 1200: Clinic at St. Paul’s Sinus Centre (occasionally a surgery day)
• 1300 – 1700: Surgery at False Creek Surgical Centre

Thursday

• 0730 – 0800: SPSC Rhinology Research Meeting/Rounds
• 0800 – 1700: Clinic, St. Paul’s Hospital (occasionally a clinic day)

Friday

• 0800 – 1700: Surgery at St. Paul’s Hospital OR’s.