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Department of Otolaryngology
State of the Department
The 2013-2014 academic year marked the 23rd anniversary of the Department of Otolaryngology at the State University of New York (SUNY) Downstate Medical Center and affiliated hospitals.
Formed initially from existing services at Long Island College Hospital (LICH) and University Hospital of Brooklyn (UHB), the current academic structure for resident and medical student education includes affiliations with Kings County Hospital Center (KCHC), the Brooklyn Veterans Administration Medical Center (VAMC), Maimonides Medical Center, SUNY at Bay Ridge Ambulatory Surgery Center (SUNY Bay Ridge), and New York Methodist Hospital (NY Methodist). LICH has regrettably closed its doors after 156 years of service.
Last year I wrote about the challenges imposed by the closure of LICH. Yet one year later I can state with confidence our department is stronger than ever, bristling with new faces, top-notch faculty, a fabulous residency training program, and unstinted growth in patient volume, academic faculty, and research productivity. How can this be?
Our success lies in one simple word: synergy. As a cohesive department bound together by a passion for resident training and excellence in patient care we have been able to achieve – and withstand – far more together than could ever been done apart. This synergy transcends the unique talents and ambitions of our individual faculty, who differ in focus, training, personality, and practice location, yet somehow rise above these differences to put teaching, research, and patient care front and center.
Synergy allows us to embrace change and resulting opportunities. We not only have new sites for ambulatory and inpatient activity at SUNY Bay Ridge and NY Methodist Hospital, but have managed to preserve and grow volume at UHB and other core locations. At both new sites we thrive as a unified department, with outstanding resident physicians and a full spectrum of fellowship-trained specialists, providing the coverage, capacity, and volume that justifies major equipment purchases, operative block time, and the logistical and administrative support to ensure success.
A particularly gratifying aspect of our expansion has been the consistently positive feedback I receive from others about our department. Our residents and faculty have been warmly embraced because they excel not only in patient care, but in professionalism and interpersonal skills. The same applies without hesitance to our clinical and administrative staff. My ability as chairman to negotiate for institutional resources and support is deeply enhanced by the synergy of one-stop, full-service, innovative patient care from a unified department committed to excellent care and resident education.
Our success this past year can be attributed to the quality and commitment of our faculty, residents, and staff. We have not only retained all core faculty but have added new faces and new recruits. Our faculty have stepped up to challenge, and opportunity, of new practice sites with poise and gusto. Similarly, our residents have embraced change, quickly adapting to new settings and procedures, yet always representing our department responsively and professionally. Our surgical volume and caseload continues to grow, with of our graduating chief residents exceeding training requirements for all key indicator operative cases. Our staff is the glue holding our massive enterprise together despite seismic logistical changes, rising to each new challenge with solutions, not complaints.
In 1956, shortly after the cornerstone was set for the Basic Science Building at 450 Clarkson Avenue, Alfred E. Neuman (Mad Magazine) immortalized 3 simple words: “What, me worry?” This phrase has graced the magazine cover ever since, and should perhaps be a motto for our department in the mad times we now face. I cannot speak for all others, but as chairman and program director I can say with confidence that I worry very little about our departmental future, a gift inherited from the power of synergy. Let us all continue to harness the power of synergy as we move into a new era of greatness.
Serving Brooklyn with Quality Care
Of the three pillars that support academic medical departments – research, teaching, and patient care – it is the ability of a department of serve the community with quality care that most affects the daily lives of the patients and families. With this in mind, I will briefly summarize the current state of our varied clinical programs.
Facial plastic and reconstructive surgery has shown continued growth and expansion through the leadership of Sydney Butts, Alice Lin, and Richard Westreich, who cover all aspects of trauma, cosmetic, microvascular, and reconstructive surgery. Our cleft and craniofacial initiative continues to blossom, benefiting from an expanded referral base and new practice sites. Our clinical services and training opportunities will be further enhanced in September 2014 when Eli Gordin joins our department as a full-time faculty member.
Head, neck, and skull-base surgery remains a focal point of our department under the leadership of Krishnamurthi Sundaram, Natalya Chernichenko, Alice Lin, and Michael Weiss, with additional expertise provided by Gady Har-El, Jessica Lim, Victor Lagmay, and voluntary faculty. Areas of active growth include microvascular surgery, transoral robotic surgery, and minimally invasive surgery. Endocrine surgery remains a center of excellence, including minimally invasive thyroid and parathyroid surgery.
Otology and neurotology remain vibrant through the leadership of Matthew Hanson, Neil Sperling, Michal Preis, with contributions from Tahl Colen and other voluntary faculty. The division offers comprehensive otologic services, ranging from ambulatory surgery to complex procedures with our neurosurgical colleagues. Abraham Shulman continue to help patients worldwide cope with tinnitus, as one of the few full-time tinnitologists in clinical practice.
Pediatric Otolaryngology remains a highlight of the program with leadership by Nira Goldstein, Joshua Silverman, and Richard Rosenfeld, and additional contributions by Sydney Butts, Paul Vastola, Ari Goldsmith, Mauro Ruffy, and voluntary faculty. We continue to offer a full spectrum of clinical services, including advanced airway reconstruction, voice restoration, and endoscopic surgery. Our cleft team continues to grow in scope and volume, offering surgery and rehabilitative services for children with cleft lip, cleft palate, microtia, velopharyngeal insufficiency, micrognathia, and craniofacial syndromes.
Laryngology and neurolaryngology are well covered under the leadership of Boris Bentsianov and Joshua Silverman, with substantial additional contributions from our pediatric otolaryngologists, head and neck surgeons, and voluntary faculty. A full range of operative and office interventions are available to improve voice-related quality of life for children, adults, vocal professionals, and head and neck cancer patients.
General otolaryngology, allergy, and rhinology continue to expand through the leadership of Marina Boruk who performs advanced endoscopic sinus surgery, complex image-guided procedures, and office balloon sinuplasty. The department offers in-office allergy testing and treatment, including sublingual immunotherapy. Additional contributions come from Victor Lagmay and many of our superb voluntary faculty. Surgery for sleep disorders includes endoscopy, transnasal surgery, palatoplasty, stiffening procedures, and transoral robotic surgery.
Communicative disorders continues to grow through the efforts of John Weigand, Irena DiStasi, and Sal Saleh. Patients with cochlear implants have been well served by our collaboration with the Auditory Oral School of New York, which provides state-of-the-art mapping and support services, including participation in our monthly cochlear implant team meeting. New opportunities exist for patient referrals through oversight services provided at affiliate sites.
Research, Education, and Teaching
Our annual Frank E. Lucente Alumni and Resident Research Day featured keynote speaker Howard Francis, from Johns Hopkins University, and alumni speaker Ramon Franco Jr., from the Massachusetts Eye & Ear Infirmary. In addition to showcasing our resident and faculty research, our invited presentations included cochlear implantation, innovation in laryngology, and managing spontaneous cerebrospinal fluid rhinorrhea. Please review the full Research Day Agenda later in this report for the full agenda.
Nira Goldstein continues as Director of Research, ably coordinating a rich palette of faculty, resident, and medical student projects. She is an incredible resource for navigating the intricacies of funding, IRB approval, and statistical analysis. Nira is assisted by Richard Kollmar, who serves as Director of Basic and Translational Research, and Richard Rosenfeld, who mentors residents in biostatistics, study design, and systematic review. Natalya Chernichenko continues to build her lab and accrue pilot data for grant applications to study perineural invasion of head and neck cancer using a zebrafish model. Krishnamurthi Sundaram and Joshua Silverman continue their funded research on laryngeal nerve regeneration using a rat model.
Nicole Fraser, our educational coordinator, remains an invaluable resource as she completes her fifth year with the department. Her role becomes more critical each year because of increasingly complex residency requirements, expanded medical student programs, and rising interest among SUNY Downstate medical students in otolaryngology as a career choice. Nicole has worked with Richard Rosenfeld, program director, and Nira Goldstein, associate program director, to prepare for the ACGME Next Accreditation System, including milestone assessments, a clinical competency committee, and a program evaluation committee. Sydney Butts has revitalized our Grand Rounds program, which has enjoyed robust attendance since transitioning to SUNY Downstate, including our pre-rounds session focused on resident issues and education.
Krishnamurthi Sundaram, Vice Chairman, organized the highly successful 4th Annual Multidisciplinary Head & Neck Symposium, which focused on an otolaryngology update from multidisciplinary faculty at SUNY Downstate Medical Center and New York Methodist Hospital. The conference agenda is reproduced later in this report and we are particularly grateful for the kind support of Gady Har-el in sponsoring our keynote speaker.
Our residency training program continues to attract the best and brightest candidates, with a 100% board exam pass rate and 100% successful attainment of employment and fellowship positions. We continue to highlight our residency program as the centerpiece of our academic department, always striving to improve our responsiveness to the needs of residents and faculty.
Recognizing Our Faculty and Staff
Since our last report there have been many notable accomplishments, which are fully described in the pages that follow. Some events worthy of emphasis, however, are listed below.
Notable Faculty Accomplishments
Notable Resident, Student, and Other Accomplishments
We are delighted to welcome our three new PGY-1 residents, Anthony Alessi from SUNY Downstate in Brooklyn, George Ferzli from SUNY Downstate in Brooklyn, and Sandra Ho, from Jefferson University in Philadelphia.
We are proud of our three departing chief residents and wish them health, happiness, and success. Anita Konka begins a fellowship in facial plastic and reconstructive surgery with Edward Farrior in Tampa, Florida; Miguel Mascaró begins a fellowship in facial plastic and reconstructive surgery with Daniel Rousso in Birmingham, Alabama; and Niv Mor begins a fellowship in laryngology with Andrew Blitzer in New York, NY.
Despite the many challenges of running a successful academic department in the current healthcare environment I enter the coming year with hope, confidence, and enthusiasm. How can our department not succeed, prosper, and grow when supported by the best and brightest? Many have already been acknowledged, but let me close by thanking our administrative miracle workers, Billy Tang at SUNY Downstate, Carole Facciponti at NY Methodist, and Ruth Pacheco at our Brooklyn Heights Faculty Practice. Their efforts, along with all of our other talented support staff, help fulfill our mission of research, teaching, and patient care to the benefit of our community and all stakeholders.