Comprehensive Endocrine Surgery Fellowship

Mission & Vision

Fellows will have clinical responsibilities both in private and public clinics devoted entirely to patients with endocrine problems. Our mission is to enable fellows to become proficient in the diagnosis and treatment of endocrine surgical problems; thereby, equipping them with the expertise to pursue a variety of career opportunities within surgical endocrinology.

Mission & Vision

Fellows will have clinical responsibilities both in private and public clinics devoted entirely to patients with endocrine problems. Our mission is to enable fellows to become proficient in the diagnosis and treatment of endocrine surgical problems; thereby, equipping them with the expertise to pursue a variety of career opportunities within surgical endocrinology.

Program Director’s Welcome

The University of Miami/Jackson Health System Comprehensive Endocrine Surgery Fellowship Training Program was established in 2001 by Dr. George L. Irvin III. In 2003, the Division of Endocrine Surgery began to accept one fellow each year for training. The fellowship program, one of the first of its kind established in the U.S., serves a large number of patients with thyroid, parathyroid, adrenal and endocrine pancreas disease in greater South Florida, the Caribbean and Central and South America. Our fellowship program is one of only 23 endocrine surgery fellowships accredited by the American Association of Endocrine Surgeons.

Program Director’s Welcome

The University of Miami/Jackson Health System Comprehensive Endocrine Surgery Fellowship Training Program was established in 2001 by Dr. George L. Irvin III. In 2003, the Division of Endocrine Surgery began to accept one fellow each year for training. The fellowship program, one of the first of its kind established in the U.S., serves a large number of patients with thyroid, parathyroid, adrenal and endocrine pancreas disease in greater South Florida, the Caribbean and Central and South America. Our fellowship program is one of only 23 endocrine surgery fellowships accredited by the American Association of Endocrine Surgeons.

The Division of Endocrine Surgery sees more than 1,000 clinic patients with endocrine diseases each year. The annual average caseload for fellows consists of about 175 thyroid, 85 parathyroid, 15 to 20 adrenal and two to four neuroendocrine pancreatic tumor cases. Fellows become well versed in office and intraoperative ultrasound, and perform more than 500 studies for thyroid and parathyroid disease. Fellows average approximately 20 to 30 operative hours per week. Due to the ample volume of endocrine surgery cases, fellows and surgical residents never compete for cases in the operating room, and all surgical trainees participate in all stages (preoperative, operative and postoperative) of the individual patient’s management.

Additional experience includes targeted parathyroidectomy, laparoscopic anterior and retroperitoneal adrenalectomy, modified radical neck dissection and ultrasound-guided fine needle aspiration. Fellows also play an active role in subspecialty conferences, research and manuscript preparation. Research is centered on the utilization of rapid intraoperative parathormone assays (the “Miami Criterion”) and the study of adrenal and thyroid tumors. Opportunity for other clinical research is also available.

The practice of endocrine surgery throughout Miami continues to be known both nationally and internationally for its contribution of “Minimally Invasive or Focused Parathyroidectomy” and the use of intraoperative monitoring of parathyroid hormone pioneered at the University of Miami/Jackson Memorial Hospital by George L. Irvin III, MD in the early 1990s. Since 1993, there have been more than 100 peer-reviewed publications on this subject from the Division of Endocrine Surgery. Research papers have been presented over the years at many meetings, including those for the American Association of Endocrine Surgeons, Society of Surgical Oncology, American Surgical Congress, Central and Western Surgical Association, and the Annual Fellow, Resident and Medical Student Surgical Research Forum of the South Florida Chapter of the American College of Surgeons. This surgical approach and corresponding research has truly changed and improved the way parathyroidectomy is being performed worldwide.

We appreciate your interest in our fellowship program and look forward to meeting and sharing with you what makes us very proud of the UM/Jackson Health System Comprehensive Endocrine Surgery Fellowship.

-John I. Lew, MD, FACS

Description

Additional experience includes targeted parathyroidectomy, laparoscopic anterior and retroperitoneal adrenalectomy, modified radical neck dissection and ultrasound-guided fine needle aspiration. Fellows also play an active role in subspecialty conferences, research and manuscript preparation. Research is centered on the utilization of rapid intraoperative parathormone assays (the “Miami Criterion”) and the study of adrenal and thyroid tumors. Opportunity for other clinical research is also available.

The practice of endocrine surgery throughout Miami continues to be known both nationally and internationally for its contribution of “Minimally Invasive or Focused Parathyroidectomy” and the use of intraoperative monitoring of parathyroid hormone pioneered at the University of Miami/Jackson Memorial Hospital by George L. Irvin III, MD in the early 1990s. Since 1993, there have been more than 100 peer-reviewed publications on this subject from the Division of Endocrine Surgery. Research papers have been presented over the years at many meetings, including those for the American Association of Endocrine Surgeons, Society of Surgical Oncology, American Surgical Congress, Central and Western Surgical Association, and the Annual Fellow, Resident and Medical Student Surgical Research Forum of the South Florida Chapter of the American College of Surgeons. This surgical approach and corresponding research has truly changed and improved the way parathyroidectomy is being performed worldwide.

We appreciate your interest in our fellowship program and look forward to meeting and sharing with you what makes us very proud of the UM/Jackson Health System Comprehensive Endocrine Surgery Fellowship.

-John I. Lew, MD, FACS

Fast Facts

Accreditation

American Association of Endocrine Surgeons

Number of Fellows per Year?

1

Duration of Fellowship?

1 year

Program Highlights

1 of the first comprehensive endocrine surgery fellowships established in the country

Home of the “Miami” criterion & minimally invasive parathyroid surgery

175 thyroid, 85 parathyroid, 15 to 20 adrenal & 2 to 4 neuroendocrine pancreatic tumor cases seen by fellows annually

Clinical Experience

Year 1

The University of Miami/Jackson Health System Comprehensive Endocrine Surgery Fellowship is a one- to two-year funded program limited to surgeons who have completed residency training in general surgery and are board certified or board eligible by the American Board of Surgery.

The division has always had a strong, broadly-based, busy clinical program. Most clinical rotations in the course of the fellowship are spent at Jackson Memorial Hospital and the Sylvester Comprehensive Cancer Center. Both are situated within the University of Miami Health District in Downtown Miami, and are within five minutes walking distance of each other. Jackson Memorial Hospitalis a 1,600-bed tertiary care teaching hospital where both simple and complex endocrine surgery procedures are performed. Most private outpatient care is rendered at SCCC, along with a substantial volume of surgery not requiring intensive care. In December, 2007, the medical school acquired a new 560-bed facility, UHealth Tower, a University of Miami Hospital and Clinics Facility across from SCCC.

This fellowship offers a flexible and balanced workload with exposure to other disciplines including endocrine pathology, medical endocrinology and nuclear medicine. Fellows train with experienced endocrine surgeons and have access to, and staff, an independent public clinic. Devoted entirely to caring for patients with endocrine tumors and diseases, fellows have the opportunity to see 250-300 patients per year at the clinic. Additionally, fellows see patients with program faculty members in private clinics weekly where they may see 15 to 20 additional patients per week. Fellows also gain a strong experience in laparoscopic anterior and retroperitoneal adrenalectomy. Opportunity exists for additional exposure to pancreatic exocrine cases with additional University of Miami surgical faculty. Fellows also play an active role in subspecialty conferences, clinical and translational research and manuscript preparation and publication. The program is designed to give fellows graded independence with the expectation that they will be able to practice independently at the end of the fellowship year.

Fellows serve as clinical instructors to surgical residents and medical students rotating on the endocrine surgery service. More often, fellows operate with program faculty and medical students with no conflict of operative cases with surgical residents.

Clinic-Based Cases

Ultrasound
>500/year as performer (surgeon-performed ultrasound)

FNA’s
10-15 (extra experience available if fellow desires)

Laryngoscopy/Vocal Cord Evaluation
5-10/year as observer (extra experience available if fellow desires)

In the course of their clinical training within the division, fellows have the option to rotate between the preceptor-based services and off-service rotations. Fellows have the opportunity to work and rotate on mutually agreed weekly blocks during the fellowship year with endocrinology for medical management of endocrine problems; pathology for histopathology of endocrine diseases; ear nose and throat/voice therapy for laryngoscopic and medicalization procedures and radiology for nuclear scans and conventional imaging studies associated with endocrine conditions.

Your Faculty

Diego Castilla, MD
Assistant Professor, Surgery

Josefina C. Farra, MD, FACS
Assistant Professor, Surgery
Associate Director, Comprehensive Endocrine Surgery Fellowship Program

John I. Lew, MD, FACS
Chief, Division of Endocrine Surgery
Director, Comprehensive Endocrine Surgery Fellowship Program
Professor and Vice Chair, Surgery

Alumni Placements Include:

Drexel University College of Medicine
University of Miami Leonard M. Miller School of Medicine
University of South Florida College of Medicine
West Virginia University School of Medicine

Alumni Placements Include:

Drexel University College of Medicine
University of Miami Leonard M. Miller School of Medicine
University of South Florida College of Medicine
West Virginia University School of Medicine