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- The OHSU microvascular fellowship was founded in 1999. It is designed to teach fellows the fundamentals of microvascular surgery and patient management. An emphasis on basic and clinical research is incorporated into the program to complement the experience.
- Mark K. Wax, MD, FACS is the fellowship director. The microvascular service under his direction performs an average of 8-10 flaps each month. Additional reconstructive and facial plastic procedures are included in the training.
- This program is accredited by the American Academy of Facial Plastic and Reconstructive Surgery. One fellow is selected each year through the AAFPRS match. Interested applicants may contact the Department for further information at 503-494-5355.
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Goals and Clinical Duties of the Fellowship
The Fellows' primary duties and responsibilities will be in the reconstructive and rehabilitative aspects of the Otolaryngology Service. The Fellow will have primary responsibility to the Microvascular Reconstruction Team, which works in close conjunction with the Head and Neck Oncology Ablative Team. It is expected that the Fellow will obtain expertise in, and clinical exposure to, all reconstructive aspects of patients who have undergone major ablative procedures. Secondarily, exposure to a broad spectrum of facial plastic surgery and reconstructive procedures will also be obtained.
While on the Clinical Service, the Fellow will participate in the preoperative assessment, intraoperative management, and postoperative follow-up of all patients who are seen by the Service. The Fellow's clinical and administrative responsibilties will progress as their technical and academic excellence improves. Responsibilities can be divided up into three aspects: research, clinical, and operative.
Research
The Fellow will have access to a fully equipped microvascular laboratory with ACUC-approved protocols for rat experimentation. There is also the potential for rabbit tracheal airway research to be performed in the comparative medicine lab facilities. Recently, a collaborative study involving the Department of Plastic Surgery with tissue engineering using gene therapy has been initiated. Grants have been obtained from the AAO and further research is going on in this field. The laboratory will be involved in a number of microvascular projects, which it is expected the Fellow will both initiate and complete. It is the expectation of the Preceptors that the Fellow will finish a minimum of two basic science/research projects that will be presentable during the fellowship year or in the year following it. Funding for these projects will be through the Department and various other sources.
Clinical
The Fellow will run a joint clinic with the Preceptor to maintain both preoperative and postoperative evaluations of patients who are evaluated and/or undergo surgical procedures. The Fellow will participate in the clinical decision making, as well as have broad latitude as experience is gained in the management of these patients. It is expected that the Fellow be involved in the ongoing clinical research protocols that have been developed. It would be expected of the Fellow to complete two or three clinical projects and participate in a number more, all of which would be presented and hopefully eventually published.
Operative experience
The Fellow will participate in the operating room with microvascular reconstruction in all cases. Participation will naturally depend upon his technical expertise, but it is expected by three months after laboratory and clinical exposure that most Fellows will be able to perform the majority of these procedures under direct supervision as a first assistant or as a surgeon. Teaching of residents of Otolaryngology, as well as Plastic Surgery, will be a responsbility as experience is gained. The Fellow functions as a junior attending at the Portland VAMC. Here the Fellow is responsible for patients with head and neck cancer that require reconstruction and is also intimately involved with the other Facial Plastic and Reconstructive Fellow in the cosmetic aspects of VA patient care.
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