Laparoendoscopic Surgery

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This is a busy clinically based fellowship with the unique feature of combining advanced laparoscopic surgery with flexible endoscopy. Laparoendoscopic Surgery is a fully independent section within the department of surgery with two full-time faculty, one part-time faculty, one voluntary faculty, two residents, an intern and one fellow. Fellows participate in a broad range of laparoscopic surgical procedures including fundoplication, esophageal myotomy, splenectomy, adrenalectomy, donor nephrectomy, ventral hernia repair, inguinal hernia repair, cholecystectomy, and bile duct exploration. The service also features an independent Surgical Endoscopy Center where all forms of flexible endoscopy are performed by surgeons. The objective of the Fellowship Training Program in Laparoendoscopic Surgery is to provide an academically and clinically rigorous training program to give the trainee outstanding skills in advanced training in Laparoscopic Foregut Surgery and Surgical Endoscopy.

The aim of the program is to provide the trainee with the basic and clinical knowledge, procedural skills, clinical judgment, logistical understanding and interpersonal skills required as a specialist in Laparoendosopic Surgery and Surgical Endoscopy.  The training will prepare our fellows to function not only as highly competent Surgeons, but also as investigators in the field of Laparoendocopic Surgery.

ACGME Accredited:  No – Accredited by The Fellowship Council
Residents or Fellows per year:  One
Duration:  One year
Postgraduate Training Required: Post Graduate training must have been done in USA, Puerto Rico or Hawaii.
U.S. Citizenship Required: Yes

Teaching Hospitals
Jackson Memorial Hospital
University of Miami Hospital
University of Miami Hospital and Clinics

Residents/Fellows who have graduated our program in the last 10 years obtained faculty positions at:

University of Miami Miller School of Medicine - Miami, Florida
Veterans Administration Hospital – Miami, Florida
Cleveland Clinic – Cleveland, Ohio
Mount Sinai Hospital - Miami Beach, Florida
Mercy Hospital – Joplin, Missouri

Requirements
USMLE 1, 2, 3, National Board Exams or Flex examination results
ECFMG Certificate if foreign graduate
Medical School Certificate
Curriculum Vitae
BLS and ACLS
Copy of visa, work permit, or permanent residency
NPI Number
Letters of recommendation

Application Deadline
December through February
Apply for fellowship match at https://fellowshipcouncil.org/applicants-for-fellowship/

Clinical - Fellows will participate in the pre-operative, operative, and post-operative care of the surgical patients on the service.

One half day per week, the fellow will be responsible for running an outpatient surgery clinic for county patients. He/she will supervise two residents and an intern in conducting this clinic. Residents will present cases to the fellow who will then review the history and physical findings with the resident and guide the formulation of a care plan. A nurse liaison, clinical nurse assistant, and clinic clerk are available to assist in implementing the care plan. Teaching faculty is assigned to each clinic for consultation and support.  While the fellow is considered to be faculty during this clinic, he/she always has appropriate backup by a teaching faculty.

Independent operative experience the fellow is assigned one block day per week at Jackson Memorial Hospital to perform surgery on patients that he/she has seen in the JMH outpatient clinic. Cases for which the fellow has received operating privileges from the credentials committee at JMH will be conducted independently while supervising the residents. Advanced laparoscopic procedures will be done with the presence and assistance of the teaching faculty. While the fellow is considered to be faculty during some of the cases, he/she always has appropriate backup by a teaching faculty.

Board Exam Requirements
Must be American Board of Surgery eligible.


Educational & Other Experience

Educational responsibilities
It is important that the fellow contribute to the educational mission of the Division. Toward this end he/she will participate in or facilitate a number of educational initiatives.

Weekly Conferences
All conferences are mandatory for teaching faculty, fellow and residents.

Preoperative conference
This weekly conference reviews all of the planned surgical and endoscopic procedures for the service for the upcoming week. The cases are briefly presented by the Senior Resident on the service so that all members have a clear understanding of the planned procedure and its indications. Complete patient preparation is also ensured.

Surgical Grand Rounds
The fellow will be responsible for giving a grand rounds presentation during the second half of the fellowship.

Morbidity and Mortality Conference
Fellows will prepare and present any cases in which they were involved.

Cognitive
While there is no set reading curriculum for the fellow, a number of resources are made available outside of the clinical arena to aid in understanding the patient problems managed by the service.

Suggested readings
The SAGES Manual, Carol Scott-Conner, MD – editor
Atlas of Minimally Invasive Surgery, Frantzides editor
SOARD Journal
Surgical Endoscopy Journal
SAGES Fundamentals of Laparoscopic Surgery (FLS)
American College of Surgeons On-line Video Library
Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) On-line Video Library
McGill Laparoscopic Cases DVD

Non-clinical technical training
Simulation laboratory - The Sim Lab is available 24/7. It contains the FLS program, two box trainers, two Lap Sim VR simulators, and a Simbionix GI Mentor VR simulator for flexible endoscopy. The fellow is encouraged to use the resources in the Sim Lab to hone his/her technical skills and prepare for upcoming cases.

Animate sessions
The fellow is involved in various courses and training sessions in our Center of Excellence in Laparoscopic and Minimally Invasive Surgery.Porcine or appropriate model, Opportunity to practice and develop laparoscopic and endsocopic techniques.

Operative Experience/Technical Skill
The fellow will review the operative schedule daily.
The fellow will take the Primary Surgeon or Teaching Assistant role in all index cases.
The fellow will utilize the Surgical Skills Lab, both for laparoscopic skill improvement and in the teaching capacity.

Research
The fellow is expected to not only participate in clinical and laboratory research, but to also independently formulate and implement his/her own research program during the fellowship year. These programs are generally centered around the expertise of the faculty in the Division and include but are not limited to projects:

• Advancing minimally invasive procedures
• Evaluating the use of simulation technology for education and training
• Device design for laparoscopic, endoscopic, and translumenal procedures
• Validation of clinical assessment tools
• Outcomes after surgical endoscopy

Novel investigation in any area of minimally invasive medicine is encouraged. The Division will supply animate laboratory space for work with porcine models, a simulation laboratory, IRB approved access to electronic medical records and an endoscopic data base, physical and on-line access to a library and publication resources, and consultation with a statistician for designing studies and evaluating results.

Call
There will be some call in general surgery to allow for confidence development, interaction with the residents, expansion of teaching capabilities, and to manage patients in a quasi-independent fashion. Teaching faculty are responsible for their own patients during the week. Weekends and holidays are covered by the on-call faculty member. The call schedule is arranged in advance and distributed to all members of the team, the department of surgery (for posting on the web site), the JMH page operator, and the answering service for the Division. No formal emergency room coverage is required for the fellow or for the division.

Jose Martinez, M.D.
Program Director

Lilliam Dana
Program Coordinador
Phone: 305-243-2424
Fax: 305-243-4670

Prospective Residents

Physicians Services / Housestaff Office
Jackson Memorial Hospital
East Tower Room 1004
1611 NW 12th Avenue, Miami, Florida 33136
Phone: 305-355-1122
Fax: 305-355-1123

Graduate Medical Education Office
Jackson Memorial Hospital
Institute 118B
1611 NW 12th Avenue, Miami, Florida 33136
Phone: 305-585-4310
Fax: 305-585-4309

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