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Objectives of the Program:
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The mission of the fellowship is to train future leaders and scholars in Endocrine Surgery,focusing on advanced clinical decision-making, research contributions, and teaching abilities.
This one-year fellowship will match one fellow per year. The fellowship will focus on mastery
of surgical techniques including the benign and malignant management of thyroid and
parathyroid disease ranging from minimally invasive techniques to open exploration and neck
dissections. The complexity of case exposure at our institution will empower future Endocrine
Surgeons to independently care for the most challenging of cases at fellowship end. Our focus
on patient outcomes and quality improvement will guide trainees in tracking outcomes, which is
essential for self-improvement guaranteeing a long-term successful career. Developing research
skills will aid fellows in acquiring the skills to conduct research, analyze data and publish
findings. Leading independent research projects that collaborate with residents will offer the
opportunity to participate in the education process and mentorship of surgical residents.
Dissemination of this knowledge via presentations at conference will help fellows learn how to
effectively communicate their knowledge and findings. The teaching skills and leadership roles
will prepare fellows for future positions leading surgical teams, departments, and institutions.
Our robust Endocrine Surgery practice excels at providing care across the region. We offer
clinical opportunities at three areas within the Omaha region. Clinical and surgical practice are
available at the main campus location at the Fred and Pamela Buffet Cancer Center (FPBCC)
within the UNMC and Nebraska Medicine Campus, the Bellevue Medical Center (BMC) located
approximately 15 to 20 minutes south of central Omaha, and the Village Pointe Health Center
located 15 to 20 minutes west of central Omaha within the main suburban region of Omaha. The
FPBCC is the only NCI-designated cancer center in the state. Additional expansion anticipated
to include Kearney, a city in Nebraska’s central region approximately 2.5 hours from the
metropolitan center providing care to the rural region of the state. This plan aligns with the
institution’s growth with the opening of the Nebraska Medicine Fred and Pamela Buffett Cancer
Center in Kearney in 2025 to advance cancer care in central Nebraska and beyond with a 54,000-
square-foot facility for comprehensive on-site care. The Endocrine Surgery clinic at this new
location is expected to begin in early 2026.
The variety of training institutions and geographic areas enhance the Endocrine Surgery
subdivision’s ability to provide patients with every aspect of endocrine surgical care including
benign and malignant treatment of thyroid and parathyroid disorders, and adrenal
pathophysiology. We offer minimally invasive parathyroid surgery and intraoperative
parathyroid hormone assessment with parathyroid autofluorescence monitoring, transabdominal,
retroperitoneoscopic, robotic assisted laparoscopic and open adrenalectomy, as well as central
and lateral compartment excisional lymph node biopsies and dissections. Radiofrequency
ablation technique is utilized for benign thyroid disease and hyperfunctioning nodules. Transoral
thyroidectomy surgery is an advancement available to patients within the region and a rare
educational opportunity for future graduating fellows.
The Complex General Surgical Oncology fellowship trained surgeons within our division are
enthusiastic to provide education and expertise to the incoming prospective endocrine surgery
fellow in gastrointestinal and pancreatic neuroendocrine tumors. They will allow interested
trainees to join operative cases and clinic experience based on the individual desire of the trainee.
The neuroendocrine experience will be tailored based on individual interest and has the
opportunity to include pancreatic operations such as pancreaticoduodenectomies and distal
pancreatectomies. Gastrointestinal resections for neuroendocrine indications are also performed
by these surgeons and available for learning opportunities for future endocrine surgery fellows.
Clinic experience routinely involves assessment and plans regarding benign and malignant
processes of the thyroid, parathyroid, and adrenal glands. Often combined with Endocrine
Oncology colleagues, multidisciplinary care is the expectation at our institution. Patients are
offered real-time in clinic ultrasounds and same day fine needle aspiration with on-site cytologic
adequacy assessments. Flexible fiberoptic laryngoscopy is provided by each of our endocrine
surgeons within clinic for vocal cord assessment for patients with voice complaints or previous
neck operations. Laryngology colleagues collaborate care for complex assessment and treatment
of vocal cord pathologies. Speech language pathology services are readily available for patients
with swallowing and voice concerns exposing trainees on the multidisciplinary services offered
at our institution creating best outcomes for complicated patients.
Multidisciplinary clinic allows patients one visit in early assessment of disease and collaborative
assessment and plans between providers. Trainees are exposed to complicated case discussions
between surgeons and endocrinologists creating real-time comprehensive plans for patients, that
at times, travel significant distances in seeking expert care of their disease. Our schedulers
create same day imaging studies for metastatic disease processes, parathyroid localization
studies, and adrenal specific assessments, which allows for trainee exposure to comprehensive
plans.
The robust case volume is enhanced by the case variety offered at our institution. Thyroid
procedures range from in clinic ultrasound and fine needle aspiration to thyroid lobectomy
procedures, total thyroidectomy procedures with recurrent laryngeal nerve monitoring and frozen
section analysis of lymph nodes, central and lateral neck compartment dissections,
radiofrequency ablation, and parathyroid autofluorescence. Parathyroid surgery experience
ranges from minimally invasive localized single gland removal, four gland exploration, and a
robust re-operative practice requiring extensive preoperative workup including
4DCT/SPECT/fusion studies, venous sampling options, autofluorescence for intraoperative
guidance and intraoperative parathyroid hormone assay. As the only fellowship trained
Endocrine Surgeons in the state of Nebraska, we see an unfortunate disproportionately high
volume of large burden and metastatic thyroid cancer which exposes trainees to challenging
decision making pre-, intra-, and post-operatively. Our high volume of advanced disease leads to a case mix with a large proportion of high complexity.
The adrenal surgical experience is enhanced by high volume referrals for incidental adrenal
lesions, hormonally active lesions, and adrenocortical comprehensive care and collaboration with
Endocrine Oncology. Adrenal vein sampling offered by interventional radiology colleagues
provides accurate lateralization evaluation essential for proper care specifically in primary
aldosteronism patient population. The operative techniques for adrenalectomy at our institution
range from transabdominal laparoscopic resection, retroperitoneoscopic resection, robotic
assisted laparoscopic resection, open resection, and retroperitoneal lymph node dissection
exposure. The inpatient post operative care exposes trainees to the challenging aspects of
hormone fluctuations found in adrenal disease. Again, the collaboration with endocrinology is
highlighted.
Resident and medical student education is an expectation at our institution. Formal educational
lectures are provided from medical student pathophysiology lectures, service specific surgery
lectures, resident board preparation lectures, and cadaver skills labs. The incoming fellow has
endless opportunity to participate and teach students and residents.
The research experience will be an ongoing experience for fellows to engage throughout the
year. Students and residents are available for project collaboration. The division support
includes a dedicated statistician. Funding for research presentation and meeting attendings will
be provided. The expectation will be production which will be assisted by monthly meetings
with the program director to assess progress.
In summary, a fellowship program at UNMC will assuredly be comprehensive and effective.
Our network extends across the nation which will assist in future job placement for graduating
fellows with these elaborate connections.
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Highlights of the Fellowship:
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The University of Nebraska Medical Center Department of Surgery has a long legacy of training the next generation of physicians, surgeons, physician-scientists and academic leaders to provide the highest quality of surgical care. Our faculty members within the Division of Surgical
Oncology, which includes the section of Endocrine Surgery, are dedicated academic leaders who
apply innovated techniques to improve outcomes and accessibility of health care to Omaha and
surrounding areas. This division has the largest number of fellowship-trained surgical
oncologists in the Midwest and the only Fellowship trained Endocrine Surgeons in the state of
Nebraska who are helping to train the next generation of surgeons. We envision expanding this
level of education to future providers within the region by offering an exceptional academic
program that includes a Comprehensive Endocrine Surgery Fellowship program. This is a
natural progression of academia given the level of expansion our Division of Surgical Oncology
has experienced in the recent years. Our residents are wholly satisfied with their academic
experience on service, meeting both their case volumes and clinical expectations. Endocrine
surgery, specifically, has grown from a single surgeon in 2016 to a booming three-surgeon
practice at year 2025 with anticipated additional recruitment of an AAES fellowship trained
surgeon in 2027.
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