Pediatric Surgery

Name of Host Institution: Cincinnati Children’s Hospital Medical Center

Program Specialty / Subspecialty: Surgical Oncology and Vascular Anomalies 

Program Mailing Address:
3333 Burnet Avenue, MLC #2023
Cincinnati, OH 45229-3039

Other Program Address::
None

Program Phone Number: 513-636-7365

Program Fax Number: 513-636-7657

Program Email: roshni.dasgupta@cchmc.org

Program Director: Roshni Dasgupta, M.D.

Alternate Program Contact: Meghan Wiesner, Program Coordinator, meghan.wiesner@cchmc.org

History

This new program was approved by the Graduate Medical Education Committee on August 31, 2006. The first trainee began in July 2007.

Duration

One or two years. The second year is optional and would include an opportunity to obtain a Master’s Degree as an incidental component to the training.

Prerequisite Training / Selection Criteria

The trainee should preferably be a fully trained surgeon. They must have completed a residency in pediatric surgery, general surgery, otolaryngology or plastic surgery.

Goals & Objectives

Individuals will participate in the broad clinical and academic experience now available in surgical oncology and vascular anomalies under the supervision of Dr. Dasgupta and other pediatric surgical oncology attendings.

The surgical oncology fellowship will provide a comprehensive understanding of tumors commonly treated by pediatric surgeons. Faculty involved will include Dr. Dasgupta, Dr. Tiao, and Dr. von Allmen. The oncology program at Cincinnati Children's Hospital Medical Center is one of the largest in the country. There are content experts and leaders in COG both on the medical and surgical side for all solid tumors that are seen by surgeons. The fellow will develop a complete understanding of diagnosis, treatment (surgical and non surgical) and surgical procedures in pediatric cancer. The fellow will have rotations on the medical oncology service, radiation oncology, and spend time with the survivorship program and pathology. These experiences, as well as being involved in research projects both from the institution and pediatric surgical research collaborative (PSDRC), will provide an excellent background for a future career in pediatric surgical oncology.

Vascular anomalies are very common disorders that affect approximately 15% of all  children. Throughout the USA, vascular anomalies are frequently misdiagnosed and often inappropriately treated. There is a significant need to train subspecialists with expertise in managing these types of patients. Our program is one of two formal training programs for vascular anomalies in North America.

Currently, the Hemangioma and Vascular Malformation Clinic (HVMC) has more than 6,000 active patients and new patient accrual is exceeding 700 patients per year. Our Center is one of 5 comprehensive Vascular Anomalies programs in North America and sees one of the largest volumes of patients from all over the world. The fellow will interact with a  superb interdisciplinary faculty with internationally acclaimed expertise in this field. The faculty members are engaged in clinical and translational research.

Program Certifications

None at this time.

Teaching Staff

Oncology

• Pediatric Surgery - Drs. Roshni Dasgupta, Gregory Tiao, Daniel von Allmen
• Hematology / Oncology - Drs. Joe Pressey, Brian Turpin, James Geller, Rajaram Nagarajan
• Radiation Oncology - Dr. Luke Pater, Dr. John Brennaman
• Pathology - Dr. Sara Szabo
• Survivorship/Fertility - Dr. Karen Burns

The training program director, Dr. Dasgupta, coordinates all aspects of the fellowship training program for the oncology fellow. All of the other listed faculty will be involved in specific training experiences. The surgical faculty (pediatric general, plastic and otolaryngology surgeons) will supervise the oncology fellow on all operative cases as well as on inpatient and outpatient care. The fellow will be expected to attend the three solid tumor boards during the week and participate our teaching conferences.

Vascular Malformations

• Pediatric Surgery – Roshni Dasgupta
• Hematology / Oncology – Dr. Kiersten Ricci, Dr. Adrienne Hammill
• Pediatric Otolaryngology – Dr. Charles Myer, IV
• Plastic Surgery – Dr. Ann Schwentker
• Interventional Radiology – Dr. Manish Patel
• Pathology – Dr. Anita Gupta
• Pulmonology – Dr. Christopher Towe

The training program director, Dr. Dasgupta, coordinates all aspects of the fellowship training program for the vascular anomalies fellow. All of the other listed faculty will be involved in specific training experiences. The surgical faculty (pediatric general, plastic and otolaryngology surgeons) will supervise the vascular anomalies fellow on all operative cases as well as on inpatient and outpatient care. Dr. Anita Gupta in pathology will instruct the trainee on gross and microscopic pathology for this complex spectrum of vascular tumors and malformations. Dr. Patel will be involved in the educational process in both diagnostic and interventional radiology. These individuals all participate in our teaching conferences.

Facilities

All training is conducted at the Cincinnati Children’s Hospital Medical Center. The Cincinnati Children’s Hospital Medical Center is a private medical center providing 678 inpatient beds. The hospital is one of the largest children’s care facilities in the United States in several categories: number of beds; number of emergency room visits; and number of operative procedures.

During the training period, this individual will be expected to participate in the oncology educational programs, vascular anomalies clinic, routine outpatient and inpatient care, routine and complex surgical procedures, interventional radiology procedures, and pain management. 

The trainee will also be involved in clinical research projects.  The trainee may also participate in shared general pediatric surgery clinical and educational experiences with our current pediatric surgery trainees when deemed to be beneficial.

The goal of this fellowship position is to enable the trainee to gain expertise in the diagnosis, medical and operative management of a wide spectrum of complex pediatric solid tumors and vascular anomalies. This experience will first and foremost expand the pool of specialists who will be able to care for these unique groups of patients. 

Participant’s supervisory and patient care responsibilities: The ultimate responsibility for care of the patients is the attending surgeon. No patient is admitted to the hospital, undergoes a procedure, or procures a consultation without the attending surgeon being made fully aware and assuming the responsibility for this. The fellows interact with the attendings on a daily basis to go over the patient’s progress or to raise any concerns. If necessary, the attending surgeon is called directly by the fellow. The fellows round with the attendings, frequently on patients that are complicated. There is frequent communication both at the bedside and in the department regarding patient management decisions. 2 weeks will be spent on the oncology service, 1-2 days will be spent with radiation oncology, and 2 week rotation in interventional radiology will also be required as outside rotations during this one year fellowship.

The operative procedures and skills require at least four years of general surgery training or its equivalent. The trainees will be performing major surgical procedures including major soft tissue resections in all regions of the body (except in the intracranial position).

Daily

• Bedside rounds

Weekly

• Tumor Boards - solid tumor, sarcoma, and neuroblastoma
• Pediatric Surgery Grand Rounds, Morbidity & Mortality Conference
• Vascular Anomalies Conference
• Pediatric Surgery / Radiology Conference
• Textbook Chapter Review

Monthly

• Pediatric Surgery Pathology Conference
• Trauma Case Review
• Trauma Morbidity & Mortality Conference

Fellows are evaluated every six months by the Program Director, and a summary evaluation is conducted at the conclusion of the fellowship. In addition, the subspecialty residents are expected to provide formal evaluations of the individual faculty members, the program of learning, and the program resources on an annual basis. This information is collated and presented to the faculty in an anonymous fashion.