Duke University Medical Center Breast Fellowship

Durham, North Carolina

Program Directors: Jennifer Plichta, MD, MS, FACS (PD); Astrid Botty, MD (APD); Akiko Chiba, MD (PD)

Duke University Medical Center has long been recognized as a premier academic institution and leader in academic surgery. Located in central North Carolina, the Duke Cancer Institute serves as a tertiary referral center for the mid-Atlantic region, drawing patients from Virginia, North Carolina, and South Carolina. Across the Duke Health Care system, almost 1200 breast cancers are diagnosed and treated annually.

The Breast Fellowship seeks to educate surgeons in the management of both benign and malignant breast disease. Graduating candidates will be confident in the skills acquired during their fellowship year and be trained to become leaders in either the academic or community setting.

Program Goals

Fellows will achieve competence in the elements of a system-based practice through their daily clinical activities within a complex academic environment over three clinical sites. Interactions with medical students and residents occur in the research setting and clinical setting, including the operating room, outpatient clinic, and inpatient ward. In addition, it is anticipated that the fellow will see a broad spectrum of patients from our diverse local community with different socioeconomic and cultural backgrounds enabling them to treat breast disease in multiple different stages. Participation in the weekly multi-disciplinary conference (tumor board) reinforces quality patient care and enhances patient safety, and the fellow will routinely present cases for discussion.

The fellow will also have opportunities to engage in community activities through nationally sponsored events, such as the Komen Race for the Cure and the Making Strides event with the American Cancer Society. The fellow will also participate in locally sponsored events, including the community focused “Women’s Health Awareness” conference (sponsored by the National Institute of Environmental Health Sciences and “What’s Best for Breast?” (sponsored by Duke). These activities promote breast cancer awareness, education, and research, and encourage the development of the fellow’s leadership skills.

Rotations

The rotations emphasize the importance of the multidisciplinary approach to breast cancer prevention, diagnosis, and treatment, and they are designed to provide a strong foundation for the fellow that will help them succeed in independent practice. The rotations will consist of the following: Breast Surgery (24 weeks), Breast Imaging (4 weeks), High Risk Clinic/Genetics/Cancer Support Services (4 weeks), Pathology (2 weeks), Plastic Surgery (4 weeks), Medical Oncology (4 weeks), and Radiation Oncology (4 weeks). Importantly, the fellow will also have several months where they will have a half day of independent clinic each week, which will include the evaluation and treatment of patients with both benign and malignant diseases, as well as breast cancer risk assessments. During this clinic, the fellow will counsel patients, development treatment plans, and personally conduct all related follow up, including surgery when indicated. Throughout the year, the fellow will also have ample time to complete research projects in collaboration with our faculty and statistician colleagues.

Courses & Meetings

Regularly scheduled conferences of the Breast Surgical Oncology group includes both clinical and research meetings and are presented below. The fellow’s attendance at the following meetings will be mandatory and will be aimed towards training in a multidisciplinary integrated evidence-based approach to the practice of Breast Surgical Oncology:

• Breast Surgical Oncology Fellow Didactic Lecture Series, presented by faculty (monthly)
• Multidisciplinary tumor board (weekly)
• Breast Surgery Research Meeting (weekly)
• Research Protocols and Clinical Trials (monthly)
• Fellow Case Presentations and Literature Review (quarterly)
• Literature Deep Dives during one-on-one faculty meetings (bi-monthly)

In addition to the above, the fellow will have monthly meetings with the program director, aimed at maximizing the fellowship experience and ultimately preparing for independent practice. The fellow will also have bi-monthly meetings with the associate program directors to further supplement their experience and development. Within the Duke Department of Surgery, the fellow will also have the opportunity attend traditional Morbidity and Mortality conferences, as well as the General Surgery Grand Round series, both of which are held weekly in a hybrid format and offer CME credit.

The Breast Surgery fellow will be granted travel to one national conference during the fellowship year. Goals of the meeting will be to encourage networking, explore new collaborations, and provide career opportunities. The fellow will attend the meeting in conjunction with one of the Duke Breast Surgery faculty who will provide mentorship. In addition, if the fellow is presenting their research at a national meeting, additional funding will be provided.

Research

The fellow will be expected to initiate, conduct, and publish a minimum of one, and preferably more than one, research project during the fellowship year. This requirement can be met with research in any of the following areas of investigation:

• Breast Cancer Outcomes
• Review of Surgical Techniques
• Translational Research
• Clinical Trials
• Basic Science
• Decision Science
• Health care policy research
• Other areas of interest to the fellow, in collaboration with a faculty member

Research concepts will be developed in collaboration with one of the faculty members and further refined during the weekly Breast Surgery Research Meeting. The fellow will have access to multiple clinical data sets, including both institutional and national cohorts. A statistician will be available to help analyze data and can also provide more complex statistical support for data modeling and analysis. Once the data has been analyzed, the fellow will again be expected to present their findings and receive feedback at the weekly research meeting for further refinement of the project prior to presentation and/or publication. The research meetings are routinely attended by multiple breast surgical oncology faculty, at least one statistician, members of other specialties (such as breast imaging, plastics, medical oncology, etc.), and other trainees

Eligibility

Candidates must have completed either an accredited general surgery residency and be American Board of Surgery eligible, or an accredited OB/GYN residency and be American Board of Obstetrics and Gynecology eligible. Interviews will take place through the SSO-sponsored Match Process, often occurring in the year prior to a resident’s final year of training.

The application materials are the same required by the SSO and uploaded to the SSO website.

Contact Information