The entire fellowship year is dedicated to the practice of orthopaedic oncology.
The fellow typically operates three days a week, with two operative days at UHealth Tower and one at Jackson Memorial Hospital. As the division routinely operates five days a week, the fellow's weekly schedule is intentionally flexible – providing the fellow an opportunity to participate in the most appropriate options for their personalized surgical development.
For example, Dr. Al Maaieh's practice is heavy in spine oncology and offers unique and abundant exposure to complex primary and metastatic spine and spinopelvic surgery. While fellows are routinely in the oncology clinic with Dr. Conway on Mondays, fellows are encouraged to participate in these Monday surgeries whenever interest and surgical needs dictate. Clinic days may be variable to ensure the fellow participates in the most appropriate and challenging surgical cases. Typically, this will include 1.5 to 2 days. Along with our oncology faculty, the fellow also participates in oversight for the weekly orthopaedic oncology clinic at JMH. He or she is expected to participate in the education of the residents in the outpatient setting and the operating room. Orthopaedic surgery residents rotate on the oncology service as a PGY1, PGY3, and PGY5. There is an additional opportunity to mentor medical students who regularly rotate through the oncology service.
The surgical volume is high and captures the wide breadth of orthopaedics oncology, focusing on the surgical management of bone and soft tissue sarcoma. Fellows can anticipate broad exposure to endoprosthetic reconstruction, including noninvasive expandable prostheses and customized prosthetic devices. As surgical reconstructions are individualized to each patient, our surgical team frequently utilizes allografts and autografts for complex bone reconstructions. We receive excellent support and collaboration from our plastic surgery team, which facilitates the utilization of vascularized fibulas in osseous reconstructions and complex flap coverage when needed. Collaborations with our trauma team have allowed us to expand the applications of distraction and limb lengthening techniques to tumor surgery.
In addition to a robust experience in bone and soft tissue sarcoma and complex limb reconstruction, fellows participate in the surgical management of benign aggressive disease (Giant Cell Tumor of Bone, Pigmented Villonodular Synovitis). We apply a multidisciplinary approach to these disease processes to ensure patients benefit from all available modalities, including exposure to innovative medical management options and clinical trials. Fellows can also anticipate adequate essential exposure to complex metastatic disease and both primary and metastatic spine disease. This cumulative experience aims to provide every fellow with the experience and confidence to enter independent practice in all facets of orthopaedic oncology.