Surgical Endocrinology Fellowship

This unique, multispecialty fellowship is designed to provide a solid foundation for a career in academic endocrine surgery. The program is a collaborative effort within the Department of Surgical Oncology that focuses on multidisciplinary care at a large academic cancer center. The fellowship's mission is to provide training through three primary modalities:

1. Clinical exposure. The fellow will have a graded clinical experience through an apprentice model with expert faculty in the operating room and the outpatient clinic. Along with the dedicated time on the Surgical Endocrinology, Head and Neck, and HPB services, the fellow will have 2 months of clinical experience in nonsurgical areas working one-on-one with faculty who are international leaders in their disciplines.
2. Formal didactics. The fellow will attend organized weekly multidisciplinary conferences that offer dialogue and education on clinical endocrinologic issues.
3. Research. The program provides for integrated research under the mentorship of one or more members of our multidisciplinary faculty.

Candidates must have completed a general surgery residency and must be board eligible.

The fellow will spend 8 months working with the Surgical Endocrinology faculty (Dr. Sarah Fisher, Dr. Paul Graham, Dr. Elizabeth Grubbs, Dr. Jeffrey Lee, Dr. Nancy Perrier), 1 month working with the Head and Neck Surgery faculty (Dr. Mark Zafereo and Dr. Jennifer Wang), and 1 month with HPB services. Advanced surgical techniques, particularly retroperitoneal and laparoscopic adrenalectomy, minimally invasive parathyroidectomy, reoperative cervical procedures, and surgical treatment of advanced thyroid tumors, will be part of the surgical curriculum.

Fellows will have broad exposure to endocrine neoplasias and will participate in several separate weekly multidisciplinary case-based and research conferences with themes such as advanced thyroid cancer, general endocrine neoplasia, parathyroid and adrenal diseases, genetics, and neuroendocrine pancreas and carcinoid tumors.

The tertiary level of multidisciplinary care, the complexity of patients treated at this institution, and the expertise of multidisciplinary faculty involved in daily clinical care allows for a comprehensive clinical experience with dedicated rotations for 2 months in nonsurgical disciplines. Nonsurgical rotations include Endocrine Neoplasia and Hormonal Disorders, Pathology (including frozen section evaluation and immediate assessment of FNA cytology), Neuroendocrine Gastrointestinal Oncology (carcinoid and adrenocortical carcinoma), Radiology (including Nuclear Medicine and ultrasound-guided FNA), Voice Pathology, and Genetic Counseling.

Number of Cases: The fellow will perform more than 200 cases during the fellowship (anticipated 100+ thyroidectomies, 70+ parathyroidectomies, 20+ adrenalectomies, 15 lateral neck dissections, up to 5 GI/pancreas neuroendocrine).

Research: The program emphasizes training future leaders in endocrine surgery. Training in and practice constructing manuscripts, protocols, grants, and presentations will be an essential component. The fellow will have regular, independent access to research support staff in statistics, scientific publications, grant writing, and IRB preparation. Attendance at national and international endocrine surgery meetings and Endocrine Surgical University will be supported. The option for a second year focusing on further research and academic development is available.
 

One fellowship position is offered each year, with the potential for extension to a second year to focus on further research and academic development. Candidates should be board eligible in general surgery and should apply through the American Association of Endocrine Surgeons fellowship match.

Sarah Fisher (2019)– The University of TX MD Anderson Cancer Center, Houston, TX
Jonathan Zagzag (2018) – New York Surgical Partners, Roslyn, NY
Minerva Romero (2017)–Weill Cornell Medicine, Brooklyn, NY
Kristin Long (2016)– University of Wisconsin School of Medicine and Public Health, Madison, WI
Ashley Stewart (2015)– Atrium Health Carolinas Medical Center, Charlotte, NC
Ashley Cayo (2014) – Aurora Healthcare, Milwaukee, WI
Lilah Morris (2013)– Johns Hopkins University, Baltimore, MD
Shabir Abadin (2013) – Amita Health Medical Group, Aurora, IL
Paxton Dickson (2011)–The University of Tennessee Health Science Center, Knoxville, TN
Christine Landry (2010)– Baylor Scott & White Health, Dallas, TX
Glenda Callendar (2009) – Hartford Healthcare Medical Group, Bridgeport, CT

MD Anderson is located within Houston's Texas Medical Center – the largest medical city in the world. Located in central Houston, Texas, the area is rich in academic and cultural opportunity. The Medical Center lies adjacent to Rice University, the Museum of Fine Arts, the Museum of Contemporary Arts, and is near Houston’s prestigious symphony orchestra, opera, theater, and ballet. There are also numerous parks, including neighboring Hermann Park which has an outdoor theater and large zoo.

Other sites that are close to the Medical Center are Sam Houston Raceway Park, Downtown Aquarium, Space Center Houston, Lone Star Flight Museum, NRG Stadium, Minute Maid Park, Toyota Center, and the George R. Brown Convention Center. For more information, go to Visit Houston.

Our trainees live throughout the various neighborhoods of Houston, including West University/Rice Village, Montrose, the Houston Heights, the Museum District, or immediately adjacent to the Medical Center.

Temporal Trends in Outcomes in Patients with Adrenocortical Carcinoma: A Multidisciplinary Referral Center Experience.
Daher M, Varghese J, Gruschkus SK, Jimenez C, Waguespack SG, Bedrose S, Altameemi L, Bazerbashi H, Naing A, Subaiah V, Campbell MT, Shah AY, Zhang M, Sheth RA, Karam JA, Wood CG, Perrier ND, Graham PH, Lee JE, Habra MA.J Clin Endocrinol Metab. 2022 Jan 29:dgac046. doi: 10.1210/clinem/dgac046. Online ahead of print.PMID: 35092681

Recurrence after successful parathyroidectomy-Who should we worry about?
Shirali AS, Wu SY, Chiang YJ, Graham PH, Grubbs EG, Lee JE, Perrier ND, Fisher SB.Surgery. 2022 Jan;171(1):40-46. doi: 10.1016/j.surg.2021.06.035. Epub 2021 Jul 31.PMID: 34340820

Evaluation of risk factors, long-term outcomes, and immediate and delayed autotransplantation to minimize postsurgical hypoparathyroidism in multiple endocrine neoplasia type 1 (MEN1): A retrospective cohort study.
Landry JP, Pieterman CRC, Clemente-Gutierrez U, Grubbs EG, Fisher SB, Graham PH, Waguespack SG, Perrier ND.Surgery. 2021 Dec 21:S0039-6060(21)01079-5. doi: 10.1016/j.surg.2021.10.046. Online ahead of print.PMID: 34952716

A Blood-based Polyamine Signature Associated With MEN1 Duodenopancreatic Neuroendocrine Tumor Progression.
Fahrmann JF, Wasylishen AR, Pieterman CRC, Irajizad E, Vykoukal J, Murage E, Wu R, Dennison JB, Krishna H, Peterson CB, Lozano G, Zhao H, Do KA, Halperin DM, Agarwal SK, Blau JE, Del Rivero J, Nilubol N, Walter MF, Welch JM, Weinstein LS, Vriens MR, van Leeuwaarde RS, van Treijen MJC, Valk GD, Perrier ND, Hanash SM.J Clin Endocrinol Metab. 2021 Nov 19;106(12):e4969-e4980. doi: 10.1210/clinem/dgab554.PMID: 34318891

It's not a mystery, it's in the history: Multidisciplinary management of multiple endocrine neoplasia type 1.
Shirali AS, Pieterman CRC, Lewis MA, Hyde SM, Makawita S, Dasari A, Thosani N, Ikoma N, McCutcheon IE, Waguespack SG, Perrier ND.CA Cancer J Clin. 2021 Sep;71(5):369-380. doi: 10.3322/caac.21673. Epub 2021 Jun 1.PMID: 34061974

Parathyroid Surgery: What Radiologists Need to Know.
Shirali AS, Clemente-Gutierrez U, Perrier ND.Neuroimaging Clin N Am. 2021 Aug;31(3):397-408. doi: 10.1016/j.nic.2021.04.011.PMID: 34243873

The North American Neuroendocrine Tumor Society Consensus Guidelines for Surveillance and Management of Metastatic and/or Unresectable Pheochromocytoma and Paraganglioma.
Fishbein L, Del Rivero J, Else T, Howe JR, Asa SL, Cohen DL, Dahia PLM, Fraker DL, Goodman KA, Hope TA, Kunz PL, Perez K, Perrier ND, Pryma DA, Ryder M, Sasson AR, Soulen MC, Jimenez C.Pancreas. 2021 Apr 1;50(4):469-493. doi: 10.1097/MPA.0000000000001792.PMID: 33939658

Pathology data set for reporting parathyroid carcinoma and atypical parathyroid neoplasm: recommendations from the International Collaboration on Cancer Reporting.
Williams MD, DeLellis RA, Erickson LA, Gupta R, Johnson SJ, Kameyama K, Natu S, Ng T, Perren A, Perrier ND, Seethala RR, Gill AJ.Hum Pathol. 2021 Apr;110:73-82. doi: 10.1016/j.humpath.2020.07.008. Epub 2020 Jul 17.PMID: 32687943

Impact of the COVID-19 pandemic on the practice of endocrine surgery.
Beninato T, Laird AM, Graves CE, Drake FT, Alhefdhi A, Lee JA, Kuo JH, Grubbs EG, Wang TS, Pasieka JL, Lubitz CC.Am J Surg. 2021 Jul 21:S0002-9610(21)00389-5. doi: 10.1016/j.amjsurg.2021.07.009. Online ahead of print.PMID: 34315576

ATF4 loss of heterozygosity is associated with poor overall survival in medullary thyroid carcinoma.
Williams MD, Ma J, Grubbs EG, Gagel RF, Bagheri-Yarmand R.Am J Cancer Res. 2021 Jun 15;11(6):3227-3239. eCollection 2021.PMID: 34249457

Patient Perspectives on the Extent of Surgery and Radioactive Iodine Treatment for Low-Risk Differentiated Thyroid Cancer.
Lubitz CC, Kiernan CM, Toumi A, Zhan T, Roth MY, Sosa JA, Tuttle RM, Grubbs EG.Endocr Pract. 2021 May;27(5):383-389. doi: 10.1016/j.eprac.2021.01.005. Epub 2021 Jan 16.PMID: 33840638

Neoadjuvant selpercatinib for advanced medullary thyroid cancer.
Jozaghi Y, Zafereo M, Williams MD, Gule-Monroe MK, Wang J, Grubbs EG, Vaporciyan A, Hu MI, Busaidy N, Dadu R, Waguespack SG, Subbiah V, Cabanillas M.Head Neck. 2021 Jan;43(1):E7-E12. doi: 10.1002/hed.26527. Epub 2020 Nov 9.PMID: 33169506

Understanding the clinical course of genotype-negative MEN1 patients can inform management strategies.
Pieterman CRC, Hyde SM, Wu SY, Landry JP, Chiang YJ, Christakis I, Grubbs EG, Fisher SB, Graham PH, Waguespack SG, Perrier ND.Surgery. 2021 Jan;169(1):175-184. doi: 10.1016/j.surg.2020.04.067. Epub 2020 Jul 20.PMID: 32703679

Perceptions of opioid use and prescribing habits in oncologic surgery: A survey of the society of surgical oncology membership.
Lillemoe HA, Newhook TE, Aloia TA, Grubbs EG, Chang GJ, Katz MHG, Vauthey JN, Lee JE, Tzeng CD.J Surg Oncol. 2020 Nov;122(6):1066-1073. doi: 10.1002/jso.26106. Epub 2020 Jul 6.PMID: 32632993

Risk of thyroid cancer after therapeutic irradiation in adult patients: An Age-Based surveillance, epidemiology, and end results analysis.
Dalwadi SM, Dorman C, Fisher SB, Bonnen M, Grubbs E, Ludwig MS.Laryngoscope. 2020 Aug;130(8):2081-2086. doi: 10.1002/lary.28407. Epub 2019 Nov 20.PMID: 31747075

Radiomic mapping model for prediction of Ki-67 expression in adrenocortical carcinoma.
Ahmed AA, Elmohr MM, Fuentes D, Habra MA, Fisher SB, Perrier ND, Zhang M, Elsayes KM.Clin Radiol. 2020 Jun;75(6):479.e17-479.e22. doi: 10.1016/j.crad.2020.01.012. Epub 2020 Feb 20.PMID: 32089260

Primary hyperparathyroidism and hypertension.
Fisher SB, Perrier ND.Gland Surg. 2020 Feb;9(1):142-149. doi: 10.21037/gs.2019.10.21.PMID: 32206606

Risks of Hypoparathyroidism After Total Thyroidectomy in Children: A 21-Year Experience in a High-Volume Cancer Center.
Wu SY, Chiang YJ, Fisher SB, Sturgis EM, Zafereo ME, Nguyen S, Grubbs EG, Graham PH, Lee JE, Waguespack SG, Perrier ND.World J Surg. 2020 Feb;44(2):442-451. doi: 10.1007/s00268-019-05231-4.PMID: 31686157

Comparative Performance of the 7th and 8th Editions of the American Joint Committee on Cancer Staging Manual for Adrenocortical Carcinoma.
Fisher SB, Habra MA, Chiang YJ, Wu SY, Graham PH, Grubbs EG, Lee JE, Perrier ND.World J Surg. 2020 Feb;44(2):544-551. doi: 10.1007/s00268-019-05136-2.PMID: 31493191

New Directions in Treatment of Metastatic or Advanced Pheochromocytomas and Sympathetic Paragangliomas: an American, Contemporary, Pragmatic Approach.
Jimenez C, Xu G, Varghese J, Graham PH, Campbell MT, Lu Y.Curr Oncol Rep. 2022 Jan;24(1):89-98. doi: 10.1007/s11912-022-01197-0. Epub 2022 Jan 21.PMID: 35061191

Cytoreductive Surgery of the Primary Tumor in Metastatic Adrenocortical Carcinoma: Impact on Patients' Survival.
Srougi V, Bancos I, Daher M, Lee JE, Graham PH, Karam JA, Henriquez A, Mckenzie T, Sada A, Bourdeau I, Poirier J, Vaidya A, Abbondanza T, Kiernan CM, Rao SN, Hamidi O, Sachithanandan N, Hoff AO, Chambo JL, Almeida MQ, Habra MA, Fragoso MCBV.J Clin Endocrinol Metab. 2021 Nov 30:dgab865. doi: 10.1210/clinem/dgab865. Online ahead of print.PMID: 34850915