Goals & Objectives
The goal of the MIS Fellowship is to provide the fellow with the necessary training and education to be comfortable in the performance of a wide variety of minimally invasive operations. The fellow will be exposed to the broad applications of minimally invasive surgery, including bariatric surgery, surgery for gastroesophageal reflux disease (GERD), hernia surgery, and solid organ surgery. The clinical focus is approximately 30% bariatric, 40% complex abdominal wall, and 40% foregut and general surgery. There will be a strong focus on robotic surgery, although there is a component of laparoscopic, endoscopic and open surgery as well. The fellow will have ample opportunity to participate in both basic science and clinical research, and scholarly activity with presentations in national and international symposia is expected. The fellow will be provided with the necessary stimuli to pursue a successful career in either private practice or academic surgery upon completion of the fellowship.
Components of the Program
The activities of the fellow will be a blend of clinical experience, research, and teaching responsibilities for medical students and general surgery residents. Clinical experience is to include both operative time and clinic hours. Prior fellows have performed both basic science research, as well as clinical research. Topics have varied from surgical education to virtual reality simulation. Teaching responsibilities will range from formal Grand Rounds presentations for the Department of Surgery to informal clinical instruction in the operation room and surgical clinic. The activities of the fellow will be a blend of clinical experience, research, and teaching responsibilities for medical students and general surgery residents. Clinical experience is to include both operative time and clinic hours. Prior fellows have performed both basic science research, as well as clinical research. Topics have varied from surgical education to virtual reality simulation. Teaching responsibilities will range from formal Grand Rounds presentations for the Department of Surgery to informal clinical instruction in the operation room and surgical clinic.
The activities will be divided as follows:
- Clinical 60%
- Research 20%
- Teaching/Education 20%
Clinical Experience
The Fellowship offers a broad clinical experience which may be tailored to the needs or goals of the specific fellow. As a tertiary referral center, we are provided with a broad range of surgical pathology. The fellow will be exposed to a large volume and array of the surgical pathology and learn the minimally invasive applications to treating the diseases.
Operative Experience
The Fellowship operates with a mentor system. The fellow will act as the assistant surgeon early during the training period. As the fellow’s skill increases, she or he will graduate to the role of Primary Surgeon under supervision and assist the surgery resident in performing procedures. The fellow will also be responsible for teaching the surgery resident in open general surgery cases and minor surgical operations. In addition, the Fellow will become familiar with robotic-assisted surgery and eventually perform operations as Primary Surgeon using the robot.
Endoscopy
The fellow will perform under the supervision of attending surgeons from Minimally Invasive Surgery. The fellow will also supervise resident performed endoscopy.
Clinic
Office hours are to be attended on a regular basis. This will include follow-up on existing patients, as well as the evaluation of new patients. Minor procedures (e.g. adjustable gastric band fills) are occasionally performed in the clinic.
Research
The fellow is expected to actively engage in research throughout the Fellowship. There is ample opportunity to initiate both basic science and clinical research projects.
The Division of Minimally Invasive Surgery actively collaborates with the Department of Mechanical, Aerospace, and Nuclear Engineering at Rensselaer Polytechnic Institute and the Adirondack Area Network. Additional collaborative research efforts are encouraged.
Prior areas of investigation:
Natural Orifice Translumenal Endoscopic Surgery (NOTES)
Robotic surgery outcomes
Gastric bypass outcomes
Surgical virtual reality simulation
Methods of laparoscopic training
Educational Responsibilities
The fellow will be expected to intellectually engage both medical students and residents in clinical settings. The fellow will also be responsible for weekly interactive problem-based discussions with the medical students during an eight-week period. These topics are presented in the "Surgery III Course Book" for medical students.
The fellow will also be responsible for a one-hour Minimally Invasive Surgery presentation for grand rounds for the Department of Surgery.
MIS Training Laboratory
The Minimally Invasive Surgery training laboratory is located in the Patient Safety and Clinical Competency Center. The Fellow has access via ID-Swipe, and a key to the office will be given to the Fellow. The laboratory contains box trainers, videoscopic equipment, re-usable and disposable instruments, virtual reality simulators, and open surgery training equipment. There is also a robotic stand-alone simulator adjacent to the operating rooms in the basement to allow for easy access to training in between cases or after hours.
Fellows must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Fellows are expected to perform the following:
- Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families
- Gather essential and accurate information about their patients
- Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment
- Develop and carry out patient management plans
- Counsel and educate patients and their families
- Use information technology to support patient care decision and patient education
- Perform competently all medical and invasive procedures considered essential for the area of practice
- Provide health care services aimed at preventing health problems or maintaining health
- Work with health care professionals, including those from other disciplines, to provide patient-focused care
Fellows must demonstrate knowledge about established and evolving biomedical, clinical, and cognitive (epidemiological and socio-behavioral) sciences and the application of this knowledge to patient care. Fellows are expected to perform the following:
- Demonstrate an investigatory and analytic thinking approach to clinical situations
- Know and apply the basic and clinically supportive sciences which are appropriate to their discipline
Fellows must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices. Fellows are expected to perform the following:
- Analyze practice experience and perform practice-based improvement activities using a systematic methodology
- Locate, appraise, and assimilate evidence from scientific studies related to their patients’ health problems
- Obtain and use information about their population of patients and the larger population from their patients are drawn
- Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and of information on diagnostic and therapeutic effectiveness
- Use information technology to mange information, access on-line medical information, and supplement their own education
- Facilitate the learning of students and other health professionals
Fellows must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their patients’ families, and professional associates. Fellows are expected to perform the following:
- Create and sustain a therapeutic and ethically sound relationship with patients
- Use effective listening skills and elicit and provide information using effective nonverbal, explanatory questioning, and writing skills
- Work effectively with others as a member or leader of a health care team or other professional group
Fellows must demonstrate a commitment to carrying out professional responsibilities and sensitivity to a diverse patient population. Fellows are expected to perform the following:
- Demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients and families that supersedes self-interest; accountability to patients, society, and the profession; and a commitment to excellence and ongoing professional development
- Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical treatment, confidentiality of patient information, informed consent, and business practices
- Demonstrate sensitivity and responsiveness to patients’ culture, age, gender, and disabilities
Fellows must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value. Fellows are expected to perform the following:
- Understand how their patient care and other professional practices affect other health care professionals, the health care organization, and the larger society and how these elements of the system affect their own practice
- Know how types of medical practice and delivery systems differ from one another, including methods of controlling health care costs and allocating resources
- Practice cost-effective health care and resource allocation that does not compromise the quality of care
- Advocate for quality patient care and assist patients in dealing with system complexities
- Know how to partner with health care managers and health care providers to assess, coordinate, improve health care and know how these activities can affect system performance
Didactics
First Thursday of the month 7 a.m.: Grand Rounds ME-700
Includes departmental Grand Rounds, invited guests, faculty lectures, senior and chief resident presentations, and Journal Club.
Second and fifth Thursday of the month 7 a.m.: Morbidity & Mortality Huyck Auditorium ME-100
Deaths and complications from the previous week are reviewed. The senior resident from each service is responsible for case presentation.
MIS Case Conference
Video review of cases performed by residents and the fellow are performed 1-2 times a month depending on the rotation schedule. Technical pearls and nuances in operative management are a focus of discussion.
Conferences
Fellows are encouraged and to attend fellowship-level courses held by surgical societies and industry such as SAGES, Intuitive, and Ethicon. Financial support is avilable when applicable. In addition, fellows are encouraged to attend appropriate conferences such as the annual SAGES, SSAT, ASMBS, or AHS meetings. Financial support for conferences is available if the fellows has an abstract or video that is accepted but must be approved by the program in advance of the meeting.
Facilities & Affiliations
The Minimally Invasive Surgery Program at Albany Medical Center uses "tubular" devices that are inserted into the body to perform surgery. Advantages for using minimally invasive surgery for such procedures includes less scarring; less trauma; quicker recovery time for patient; and shorter length of stay within hospital.
Albany Medical Center offers a vast array of complex minimally invasive surgical procedures to treat a variety of surgical needs including:
- Appendix
- Gall Bladder
- Repair of knee ligaments
- Some heart surgeries
- Repair of aneurysms (repairing sections of arteries that may rupture)
Albany Medical Center offers a minimally invasive surgical option using robotics. With the use of a robot, surgeons have a three-dimensional view of vital organs and uses wrist-like instruments to improve surgical precision, dexterity and maneuverability.
- Albany Medical Center's Bariatric Surgical Center has been cited as having outcomes higher than the national average for its minimally invasive gastric bypass surgical procedures.
- Albany Medical Center's hernia repair recurrence rate is well below the national average following minimally invasive hernia repair.
Learn more about the facilities in the Albany Med Health System.