Craniofacial Fellowship Training

Which craniofacial fellowship is the best place to train? While a number of personal factors may influence a prospective applicant’s decision where to go for additional training, as a general starting point a couple of basic program factors might be worth considering. The first is program structure. Most programs today offer a residency-type model with multiple attendings all sharing responsibility for a fellow’s training. These types of programs typically offer higher, but more generalized, case volumes. Spending more time in the operating room with different surgeons has its advantages; however, the increased time spent in the operating room has the trade-off of having less time available for preoperative decision-making and analysis, as well as limiting the opportunity to see the results of the observed surgical interventions. These non-operative skills, while generally considered less important by residents, are important for developing good surgical judgment. The other type of program structure is a mentorship-type model, where a single senior surgeon is responsible for fellowship training and less time spent with adjunct faculty. These apprenticeships have the potential to provide a far richer experience in preoperative analysis and planning and afford more time for evaluating postoperative outcomes, yielding insights into the efficacy and risks of various procedures. They may also offer a more focused operative experience that can translate to a subsequent practice-advantage. The mentorship model strengths may come at the expense of lower case volumes with little or no exposure to junior faculty and with fewer opportunities for a diverse exposure to non-craniofacial type cases. Applicants with a stronger plastic surgery residency experience and who are more interested on a focused career treating craniofacial anomalies may be better suited to programs following the mentorship model; whereas, those with a residency experience that was less diverse and who are interested in seeking a broader plastic surgery career, may wish to seek the wider exposure offered by the residency model-type programs. Another important factor that needs to be considered is the type of clinical exposure offered at each program. Craniofacial fellowships vary significantly in the types of cases typically encountered and these unique surgical experiences will have an impact in shaping the type of practice that their graduating fellows are likely pursue. Currently, there are no universally established core curricula followed by craniofacial fellowships, but some might argue that this is not necessarily a bad thing. Applicants interested in pursuing a craniofacial fellowship differ considerably in the breadth of their plastic surgery training, and the types of fellowship experiences they hope to obtain. Craniofacial surgery has been traditionally defined as encompassing those procedures involving intracranial and orbital osteotomies; however, this definition of craniofacial surgery has been significantly expanded. Plastic surgery residents can now choose craniofacial fellowships having a primary strength in trauma, cleft repair, and even programs that primarily augment core plastic surgery training with a heavier emphasis on general pediatric plastic surgery, in addition to the traditional congenital craniofacial experience. Given these differences, it is important for applicants to match the learning experience they strive to obtain with the unique experience offered at each program. What is the best way to do this? Aside from listening to the “buzz” about different programs strengths at their current training programs, another more objective way for applicants to gauge each program’s relative strengths is to review faculty publications. A survey of a center’s publications can help applicants determine the program director and ancillary faculty’s focused interests and the types of patients be treated, so that they can better appreciate, before they match, the specific areas of expertise (and potential deficiencies) they will be exposed to over their one-year commitment.

About the Dallas Fellowship

 The Craniofacial Center at Medical City Dallas Children’s Hospital is one of the busiest pediatric craniofacial centers in the United States. Dr. Fearon’s practice is focused solely on treating congenital craniofacial anomalies, cleft lip and palate, and other general pediatric birth defects. Surgery is scheduled 5-days a week with most afternoons spent evaluating patients. Fellows will receive a very significant experience in treating the single sutural craniosynostoses, the complex craniosynostoses, and a uniquely comprehensive exposure to caring for the syndromic synostoses. Fellows can expect to participate in over 100 intracranial cases per year, in addition to congenital craniofacial orthognathic surgery, cleft lip and palate, general pediatric plastic surgery and microtia reconstruction. Fellows are strongly encouraged to complete one or two clinical research projects targeted for national presentation and publication. This fellowship is ideally suited to those individuals who are intent on pursuing a career focused on craniofacial birth defects.

This fellowship is offered only to applicants who will have completed an accredited plastic surgery residency and will be U.S. board-eligible in plastic surgery. Fellows are required to get an independent Texas license (our office will assist with this process) in order to take advantage of the opportunities for some independent surgical experience. This salaried fellowship includes full health benefits and malpractice insurance.

Please feel free to address any additional questions to Dr. Fearon at cranio700@gmail.com.  Interviews are offered by invitation after a completed application (which can be downloaded from this site) has been submitted electronically to Alondra Tipps: alondrat@thecraniofacialcenter.com, or by standard mail: Alondra Tipps, The Craniofacial Center, 7777 Forest Lane, Suite C-700, Dallas, TX 75230.

Download a fellowship application

Living in Dallas

Dallas is a friendly and welcoming city, and is an easy place to live. It has a strong art culture and a wide variety of restaurants. Dallas was recently ranked as one of the top 10 youthful cities in the world (#4) by YouthfulCities, a global social venture (http://www.huffingtonpost.com/2013/11/25/top-10-youthful-cities-in-the-world_n_4339833.html) and has a low cost of living for a major city. While it is hot in the summer, winters are very mild and rarely do Dallasites need to wear an overcoat.