Fellowship Details & Requirements

Our Graduate Medical Education (GME) Office has preliminary eligibility requirements that all prospective trainees must meet before applying for a training program at our institution. In addition to these criteria, our program also has the following requirements:

• Candidates are required to complete a residency in orthopaedic surgery. 
• Graduates of select foreign medical schools and residencies will be considered if they have met the requirements of the Texas Medical Board for licensure. 
• Our fellowship begins on August 1 of every year. Applications must be completed by Dec. 31 of the year preceding the desired start date.
• Application materials consist of:
  • Completed Application Form
  • Current CV
  • Letter of Good Standing
  • Copies of Certificates
  • Transcript
  • Three Letters of Recommendation

Our program participates in the San Francisco Match.

Program Goals

The goals of the Musculoskeletal Oncology are: 1) to teach the fundamentals of the practice of Orthopaedic Oncology, 2) to prepare the trainee for independent academic practice with emphasis in Orthopaedic Oncology, and 3) to prepare the trainee to carry out both clinical and basic science research in Orthopaedic Oncology.

Program Objectives

Demonstrate understanding of the biology, pathology, diagnosis, treatment, and prognosis of neoplastic (benign and malignant) disease. Demonstrate proficiency in diagnosis, preparation, operative treatment, and total management of patients, including long-term follow-up care.

Patient Care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.

Medical Knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.

Practice-Based Learning and Improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care.

Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals.

Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.

Systems-Based Practice, as manifested by actions that 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.

1.  Clinical and Research Components.

Clinical and basic science research opportunities are available to complement the fellow’s clinical experience. Interdisciplinary interactions with bioengineers at Rice University, mechanical engineers at UTHSC- Houston and tumor/molecular biologists at UT MD Anderson as part of ongoing research activities within the Department of Orthopaedic Oncology. 

2. Participant’s supervisory and patient care responsibilities.

The musculoskeletal oncology fellow is expected to be an integral member of the patient management team.

Inpatient

The musculoskeletal oncology fellow will be working with four physician assistants and one nurse practitioner who are current members of the orthopaedic oncology team.  The fellow will be expected to have a general knowledge of all orthopaedic inpatients within the hospital and primarily those inpatients of the faculty members with whom he/she is specifically working.  The fellow will be expected to take second-call from home on a rotating basis with the rotating residents and orthopaedic physician assistants. The fellow will make daily rounds with the attending on whose service he/she is currently on.

Outpatient Clinic

The fellow will be expected to exhibit the ability to take an appropriate history and perform a physical examination of patients seen in outpatient clinics. He/she should be able to describe radiographs, formulate a differential diagnosis and treatment plan.

• The fellow will rotate on one of two services for four months each during the academic year. The remaining four months he/she will be a “super fellow”; participating in the cases he/she finds stimulating and/or challenging. During these four months he/she will facilitate the daily schedules of the physician assistants.
• The fellow is expected to participate in all clinics for the service assigned.  He/she would be responsible for evaluating all new patients with a complete history, physical examination and presentation of radiographic studies to the faculty member. He/she will then be expected to formulate management strategies with assistance for the faculty.  All outpatient clinic activities will be staffed by the faculty member assigned to the clinic.

Acute Care Center:  The fellow is expected to see patients that arrive in the emergency center who have orthopaedic oncology problems when he/she is on call.

Operating Room: 

Major tumor resections and complex skeletal reconstructions for both primary benign and malignant tumors, and metastatic disease are the primary focus of the fellow.  The fellow will assist in all surgeries performed by the faculty member with whom he/she is working.  His/her involvement and responsibility in operative cases are anticipated to increase over the course of the year depending on his/her abilities. The staff will be present for each case.        

• The fellow will be expected to develop a working knowledge of the resection and reconstruction procedures for bone and soft-tissue sarcomas, benign bone and soft-tissue neoplasms, as well as metastatic disease.

3. Procedural requirements.

Technical expertise must be demonstrated in the surgical management of musculoskeletal oncology patients.

4. Didactic components.

Pathology Conference: Monday from 4-5 p.m. (Bi-monthly)

The fellow is responsible for coordinating pathology conference. He/she will collect the case names from the staff the Wednesday before the conference.  She/he will communicate the cases to be reviewed with Dr. Kevin Raymond.  During the conference the fellow will present the history and review the radiographs that correspond to the cases selected.  Staff pathologists, staff radiologists, and staff orthopaedic oncologists, as well as the members of the orthopaedic team (residents, Physician Assistants and students), attend the Pathology conference. 

Sarcoma Conference: Tuesday and Thursday from 4-5 p.m.

This conference deals with multidisciplinary care of the sarcoma patient.  It will give the fellow a good foundation for the multidisciplinary approach to the patient with soft tissue and bone sarcomas. Cases from the orthopaedic service will be presented by the fellow or resident involved in the patients’ care.  The fellow will be responsible for collecting the pertinent imaging studies for the case she/he is presenting. The imaging studies will be given to the sarcoma clinic film coordinator no later than 9:30 a.m. the day of the conference.

Morbidity and Mortality/Indications Conference: Wednesday from 7-8 a.m. 

CME Accredited-Peer Review/Planning Conference

The fellow will coordinate and oversee this conference.  The fellow will initiate the conference and is responsible for presenting the morbidity and mortality events of the week.  He/she will present the cases associated with her/his team and help the resident organize their case presentations.

Multidisciplinary Sarcoma Core Conference: Friday at noon

CME Accredited

Twelve lectures in the months of August - December will cover the basics of adult and pediatric medical oncology and radiation oncology as they relate to sarcoma; radiographic interpretation of bone and soft tissue sarcomas; and pathology and histology of bone and soft tissue sarcoma. 

UT MD Anderson Core Lectures: Monday from 5-6 p.m. 

These lectures are for all fellows of UT MD Anderson on various oncology related topics given by UT MD Anderson staff. Attendance by all MD Anderson Cancer Center fellows is mandatory.

Institutional Grand Rounds:

CME Accredited

When free from clinical responsibilities, the fellows are encouraged to attend.

Morbidity and Mortality and Autopsy:

CME Accredited

• Rarely do patients succumb to their disease while on the orthopaedic oncology service. However, if a patient does die on the service, the opportunity is available to review or observe an autopsy, if performed. Morbidity and Mortality Conference is held weekly. The fellow will initiate the conference and is responsible for presenting the morbidity and mortality events of the week. 
• The fellow is evaluated by the faculty biannually. The faculty and fellows are notified when an evaluation is due and electronic links are provided to complete the evaluation online. 
• The Fellowship Director meets with the fellows bi-annually to review the evaluations and to discuss general issues (i.e., conference performances, attendance, frozen section performances, etc).  If there is a major problem (major deficiency in understanding, diagnostic procedures, orthopaedic knowledge, or general surgical knowledge), the Fellowship Director and the fellow will together try to come up with solutions to the problem (i.e., extra time on certain rotations, additional reading or review of study material). 
• Twice yearly the fellow will undergo competency examinations. The competency examination will evaluate the fellow’s patient care abilities, medical knowledge, practice-based knowledge acquisition, professionalism, and interpersonal skills. This will be done by several methods, including, but not limited to, virtual patient, chart review, faculty observation, oral and written examination. 
• The fellows will be able to evaluate the faculty anonymously biannually to address the faculty’s teaching ability, commitment to the educational program, clinical knowledge and scholarly activities. These evaluations are then reviewed at the following faculty monthly meeting where academic concerns can be addressed. The fellows will also biannually evaluate the educational effectiveness of the program, program content and the fellow’s and the faculties’ goals and expectations. These evaluations will be reviewed with the Fellowship committee and then discussed with the fellows. The program will be amended accordingly.

Hirase T, Rowan C, Jacob T, Vemu SM, Aflatooni JO, Patel SS, Satcher RL, Lin PP, Moon BS, Lewis VO, Marco RAW, Bird JE.  Percutaneous Cementation for Improvement of Pain and Function for Osteolytic Pelvic Metastasis: A Systematic Review.  J Am Acad Orthop Surg. E-Pub 4/2024. PMID: 38709827.

Al Farii H, McChesney G, Patel SS, Rhines LD, Lewis VO, Bird JE.  The Risk of Neurological Deterioration While Using Neoadjuvant Denosumab on Patients with Giant Cell Tumor of the Spine Presenting with Epidural Disease: A Meta-Analysis of The Literature. Spine J. e-Pub 1/2024. PMID: 38301904.

Denu RA, Yang RK, Lazar AJ, Patel SS, Lewis VO, Roszik J, Livingston JA, Wang WL, Shaw KR, Ratan R, Zarzour MA, Bird J, Raza S, Akdemir KC, Rodon Ahnert J, Subbiah V, Patel S, Conley AP. Clinico-Genomic Profiling of Conventional and Dedifferentiated Chondrosarcomas Reveals TP53 Mutation To Be Associated with Worse Outcomes.  Clin Cancer Res 29(23);4844-4852, 12/2023. PMID: 37747813.

Vemu SM, Farii HA, Bird JE, Lin PP, Lewis VO, Patel SS.  The use of Photodynamic bone Stabilization to Tamponade Bleeding in a Pathologic Humeral Shaft Fracture: A Case Report. J Orthop Case Rep 13(9):137-143, 9/2023. PMCID: PMC10519327.

Program Director

Teaching Faculty

In addition to gaining unparalleled education and training experience, UT MD Anderson trainees have access to exceptional resources and benefits to help them build meaningful careers and lead fulfilling lives.

Institutional benefits and support

GME trainees’ salary stipends are updated every year based on the ACGME’s recommendations, and because our trainees are considered workforce members, they also enjoy UT MD Anderson’s employee benefits, including health insurance, retirement planning, disability insurance and six weeks of parental leave.

Our GME House Staff Senate offers trainees the opportunity to experience a leadership role in a medical field career, and the institution’s Academic Mentoring Council provides avenues to secure tailored academic mentoring from faculty. Our GME trainees benefit from the extensive support offered to our research trainees, too; they are invited to participate in grant application workshops, apply for pilot grants to support their research ideas and receive monetary awards for securing extramural grant funding.

Trainee wellness is also of utmost importance at UT MD Anderson.

Our trainees have access to UT MD Anderson’s employee networks, fitness center and other wellness resources provided by the institution. Additionally, our Graduate Medical Education Committee (GMEC), which provides oversight of our accredited programs, regularly assess our trainees’ needs and implements various initiatives, such as providing free call meals and discounted parking to GME House Staff, to address those gaps. The committee even has a subcommittee entirely dedicated to supporting the wellness of our trainees.

Our efforts to ensure a welcoming and supportive education and training experience have been commended nationally. In 2023, the Office of Graduate Medical Education received the DeWitt C. Baldwin, Jr. Award, a prestigious national award that recognizes our institution for its respectful and supportive environment for delivering medical education and patient care.

Beyond MD Anderson

UT MD Anderson’s location has many benefits, too. Our main campus is nestled inside the Texas Medical Center, the world’s largest medical center which boasts about 10 million patient encounters each year. Many of our faculty are involved in interorganizational research collaborations, both within the TMC and across the nation, exposing trainees to groundbreaking advancements in medical care in real time.

Most importantly, the city of Houston is a great place to call home and raise a family. We are one of the most culturally diverse cities in the nation. More than 145 different languages are spoken across the city, placing us behind only New York and Los Angeles. In fact, about 30% of the city’s population speaks a language other than English at home. And, paychecks here stretch farther than most U.S. metro areas, thanks to our low cost of living.

Visit our Why Houston page to learn more about our city’s affordable housing, fine dining, entertainment scene, nationally renowned museums and other great attributes.