The training is one full year of clinical activity concentrated in reconstructive plastic surgery using microsurgical techniques. It gives the trainee the opportunity to combine clinical activities in operative microsurgery, patient care, clinical research, and optional laboratory activities when desired. The estimated time spent between the research (clinical or laboratory) and clinical activities would be between 30 percent and 70 percent, respectively. There would be 1-2 days dedicated for research activity and 3 to 4 days dedicated to clinical activities in each week.
The fellowship training in reconstructive microsurgery is a specialized training opportunity for those who have interest in the practice of complex and state of the art reconstruction. This fellowship provides additional training for residents who have graduated from other plastic surgery programs to further excel and explore into this field. Cleveland Clinic Plastic Surgery is a world-renowned medical center. The comprehensive training is designed to provide an in-depth experience in clinical microsurgery, with emphasis in breast reconstruction, reconstruction of the head and neck, trunk, as well as extremities. This position does not lead to board certification, as there is not subspecialty certification in Microsurgery. The year is designed to provide a broad exposure to clinical microsurgery and research opportunities for applicants intending to pursue a career in plastic surgery with an emphasis on microsurgery.
The fellow will have exposure to numerous microsurgical literatures to enrich the knowledge of complex reconstruction and numerous variations in surgical techniques. Significant emphasis will be placed on detailed anatomy for the site of reconstruction following an applied anatomy into surgery itself.
Prerequisite Training/Selection Criteria
To qualify for our reconstructive microsurgery fellowship, the candidate must be a boardeligible graduate of an ACGME-accredited plastic surgery residency prior to the July 1st start date of any given year or hold an ECFMG certification to qualify for clinical training. Prospective candidates who have completed applications are interviewed the year prior and the selection is made shortly thereafter. International applicants are also welcome with outstanding qualifications. Eligible applicants must have completed the following requirements: ECGMG or USMLE.
Goals and Objectives
The fellow will start with a one-week course of gaining proficiency operating under the microscope in the laboratory. This will provide the opportunity for the trainee to gain proficiency both through didactic and practical training under the direction of our full-time microsurgery laboratory director. The fellow will become a skilled micro-surgeon by repeated practice in the Microsurgery Laboratory. When desired, the clinical microsurgery fellow will have the opportunity to join other research fellows in the lab under guidance of Dr. Bassiri to participate in a research project in the lab during the first month. This will familiarize the fellow in designing and conducting a project that would involve the use of the microsurgery lab for the rest of the year.
Protected time is available for a minimum of one day per week for the clinical fellow to collaborate research project in the lab. A research project (clinical or laboratory) commences in the beginning of the year and carried on throughout the remainder of the year, with the intent of having at least one project completed for publication and presentation.
As the clinical experience with the patient progresses, the fellow will gain clinical expertise in microsurgical techniques and surgical planning. This will as well provide the opportunity to develop prospective clinical research studies. Participation in the ongoing activities within the department will round out the entire experience; augmenting the overall training in Plastic and Reconstructive Microsurgery. This comprehensive training will provide the fellow with a mature experience to allow him/her subsequently enter a private or academic practice confidently.
Educational Program - Basic Curriculum
Clinical microsurgical experience would involve activities with Drs. Djohan, Bernard, Schwarz, Moreira, Gastman, Bassiri, and Rampazzo. The fellow will also have protected time for clinical research activities with any of the staff members. The fellow will work with all members of the staff of the Department of Plastic Surgery, but will report directly to Dr. Risal Djohan, Director of the Microsurgery Fellowship Program.
At the beginning of the fellowship almost all of the time will be spent in the Microsurgery Laboratory until sufficient technical skill is gained to allow operating room activity. All patients who are admitted for reconstructive microsurgical procedures, either micro vascular or micro-neural, will be seen and evaluated by the fellow along with the resident on the service and followed closely in the postoperative period.
The fellow will attend all of the teaching activities of the department. They are expected to participate in teaching and presenting cases involving any area in Microsurgery. The fellow would be actively involved in teaching the residents in complex management of the patients. Quarterly evaluation are performed by all participating staff attendings toward the fellow, based on their knowledge base of the literature reading, patient care, operating skill under the microscope as well as the ability to perform flap dissections.
Evaluations are done on a quarterly basis after each rotation. The fellow is required to meet with the program director twice a year usually in December and June for an overall evaluation.
Risal Djohan, MD
Reconstructive Microsurgery Fellowship Program Director
Fellowship Program Director