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The Endocrine Surgery Fellowship Program was established by Massachusetts General Hospital and Brigham and Women's Hospital in accordance with guidelines from the American Association of Endocrine Surgeons (AAES). One fellow will be chosen at each institution, where he or she will spend approximately 11 months. For the other month, the fellows will switch institutions.
The first year of this two-year program is clinical and is mandatory for all fellows. The second year is an optional research year, based upon the specific interests of the fellow and the availability of funding. In the second year, 80% of the time will be devoted to research activities. The other 20% of the time will be spent in clinically related activities that will include participation in clinical teaching rounds and conferences and outpatient clinical activities.
The second-year fellow will continue to work on the clinical research projects selected during the first year and will be actively involved in maintaining the endocrine surgery database and coordinating specific research projects. Ample opportunity also exists for basic science research in endocrine diseases. In addition, the second-year fellow is expected to exert leadership in the teaching activities within the division. The fellow will work under the guidance and mentorship of Fellowship Program Director Dr. Sareh Parangi, along with the other Endocrine Surgery faculty.
Candidates for the fellowship must be board-eligible graduates of a general surgery residency program.
This section describes objectives and curricula for the first and second years of the Endocrine Surgery Fellowship.
A. Develop an understanding of the normal anatomy, histology, physiology, biochemistry of each of the following endocrine glands. Be able to discuss the secretion and homeostasis of the pertinent hormonal secretion of these glands in both the normal and pathological disease states:
B. Endocrine Cytopathology and Histopathology
C. Discuss the pathophysiology, clinical presentation, work-up, and treatment (include both surgical and medical options) of the following diseases. Describe the natural history and list any prognostic factors associated with the disease.
D. Discuss the peri-operative management of the following:
E. Outline the differential diagnosis of:
F. Be able to describe and develop the surgical skills to perform safely many of the following surgical procedures. Recognize the potential complications and alternative treatment options of each procedure:
G. Identify and discuss potential areas of controversy in the field of endocrine surgery, including:
H. Understand the role and apply the appropriate utilization of the following imaging and diagnostic studies in the surgical management of endocrine surgical disease:
I. Research and Critical Appraisal
A. Complete a detailed evaluation of patients suspected of having an endocrine disease. Collaborate in the diagnostic work up of patients and direct the appropriate investigations. B. Participate and manage the pre- and post-operative care of patients undergoing surgery of the thyroid, parathyroid, adrenal and neuroendocrine tumors. C. Perform and / or assist in the performance of the following surgical procedures:
D. Be able to interpret and appropriately order endocrine diagnostic testing and imaging studies for each of the following endocrine glands:
E. Spend quality time working under the direct supervision of a cytopathologist and anatomical pathologist. F. Spend quality time with the Endocrinology service, focusing on pre-operative evaluation of endocrine surgical diseases. Knowledge gained should include the peri-operative management of hormones, including insulin, octreotide, and thyroid hormone. G. To have exposure to and/or to work with colleagues in other disciplines related to the diagnoses and treatment of endocrine surgical disease, such as:
H. Be able to evaluate patients with complex endocrine disease and present a differential diagnosis and an appropriate algorithm for their care. I. Gain experience in performing clinical and/or basic science research. Be able to collect and analyze data. Participate and/or present at journal club and surgical rounds related to endocrine surgical diseases. Develop experience in writing articles and orally presenting research studies at local and national meetings.
All fellows are required to attend and participate in the weekly conferences and meetings, including:
The fellow will meet two days per week with the project mentor and the program director to go over the research plan, new ideas and any difficulties. These meetings will be one on one; recent research will be reviewed as well as discussing recent work from other labs, important unsolved questions in the field and strategies for approaching them. The fellow will meet with the program director on a quarterly basis to assess whether or not personal goals and objectives are being met and to review the evaluations from the previous quarter.
The fellow should anticipate participation in more than 300 operations, including thyroidectomy, parathyroidectomy, neck dissections, adrenalectomy, and pancreas cases. Training will include a broad experience in complex endocrine surgery cases, including re-operative parathyroid surgery, laparoscopic adrenalectomy and extensive neck dissections. The fellow will be an integral part of the surgical team and will follow patients in the hospital post-operatively. He/she should expect to participate in the endocrine surgery clinics 2-3 times per week. This includes training in office-based ultrasound and U/S guided FNA techniques, as well as fiberoptic laryngoscopy.
The fellow will also participate in weekly conferences devoted to Endocrine Surgery and Surgical Oncology. There will be opportunity for the fellow to both attend and present patients at these conferences. We will also provide the opportunity for exposure to endocrinology, radiology, pathology/cytology and nuclear medicine.
The fellow will have the opportunity to participate in both basic and clinical research initiatives in endocrine surgery, including ongoing studies that use an endocrine surgery database. We expect that the fellow will have the opportunity to present their data at national meetings and submit manuscripts to peer-reviewed journals. The second year of the fellowship is optional, based upon the interests of the fellow and the availability of funding, and will be devoted to clinical and/or basic research.
Heather Wachtel, MDDr. Wachtel received her undergraduate degree from Harvard University, graduating magna cum laude. She then received her MD degree from the Yale University School of Medicine. She completed general surgery residency at the Hospital of the University of Pennsylvania, including two years of clinical and translational research in Endocrine Surgery, with numerous national presentations and peer-reviewed publications. Her research interests include primary hyperaldosteronism, pheochromocytoma/paraganglioma, adrenal malignancies, and thyroid and parathyroid disorders.
View select publications from our fellows:
Our clinical fellowship program is sponsored by the American Association of Endocrine Surgeons (AAES).
Please contact us with any questions.
Sareh Parangi, MDMassachusetts General Hospital15 Parkman Street, WACC 460Boston, MA 02114 617-643-4806 (phone)617-643-4802 (fax)Assistant: Paula Bono Based on the information, we will offer on-site interviews over the summer that will simplify application to both Brigham and Women’s Hospital and Mass General.
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