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Department of OtolaryngologyState of the Department
Another year has leapt by, leaving our department even stronger than the last: more faculty, expanded services, fabulous residents, and renovated facilities. Although it is easy to say simply “in times like these it helps to remember their have always been times like these,” I submit that this past year was indeed a bit different, not the least bit due to a unique institutional merger, described below, 150 years in the making. The 2010-2011 academic year marked a special anniversary – the 20th – of the Department of Otolaryngology at 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), and Maimonides Medical Center. The department benefits from a thirteen full-time faculty, more than two dozen voluntary and part-time physicians, and from strong administrative support at all institutions. As the only otolaryngology training program in a borough of 2.5 million (known) inhabitants we have the keys to a kingdom once called “the forty-ninth state.” Indeed, if the borough were a state it would be the fourth most populous. Brooklyn symbolizes American qualities of ambition, brashness, wiseguy humor, street smarts, and underneath the toughness, a soft touch. This “soft touch” continues to be an undercurrent of our outstanding department, manifest daily in the warm, congenial, and respectful interactions between students, residents, and faculty. An Historic Merger On May 31, 2011 the night shift at LICH arrived to a private, not-for-profit, hospital that was part of Continuum Health Partners. When they left the next morning they exited UHB at LICH, now a state hospital that was part of SUNY Downstate. Never before had such a merger between a private hospital and state healthcare system taken place. I am often asked “what do you think of the merger – is it a good thing?” The answer is an unequivocal yes, because it is a win-win arrangement for both institutions. LICH immediately expanded its patient base to accommodate UHB overflow, acquired enhanced – and sustainable – malpractice coverage for all services, and received a major financial boost from state and federal grants that were tied to the merger. SUNY acquired prime space for medical student education, added over 500 inpatient beds to the overburdened clinical capacity of UHB, and now enjoyed the influence and prestige of a medical staff exceeding 700 clinicians with the broadest geographic sweep of any Brooklyn healthcare system. The SUNY and LICH merger is “historic” not simply because of its unique circumstances, but because of deep historical ties. “History is a guide to navigation in perilous times,” writes American author David C. McCullough, “History is who we are and why we are the way we are.” Since we can likely agree that current times are a bit perilous, a few words are justified about our intriguing past. The Long Island College Hospital was officially named in 1857 and was chartered in 1858 as the first medical school in America associated with a hospital. In 1860 the first graduates emerged, having met the requirements of good moral character, two full courses of lectures, three years of study under a regular practitioner, and a handwritten thesis on some medical subject. After the Flexner Report in 1910 the College enhanced its laboratory instruction and facilities, achieving a Class A rating in 1914 from the Council on Medical Education. A link between Brooklyn Heights and East Flatbush took shape in 1923, when LICH sent students to Kings County Hospital under an affiliation agreement with the New York City Department of Public Welfare. In 1930 the University of the State of New York granted a charter to the Long Island College of Medicine, allowing, for the first time, the college and hospital to exist independently. The college merged with SUNY in 1950, with the cornerstone laid in 1954 for a Basic Science Building at 450 Clarkson Avenue (at a ceremony presided over by President Eisenhower), which would be the most modern college facility of the time. The SUNY-LICH merger, therefore, makes sense at the most fundamental level because, in McCullough’s words, it is “who we are.” We have come full circle, from Brooklyn Heights to East Flatbush and back again, creating an expansive educational network with limitless potential and a rock solid foundation of state support. Although the Department of Otolaryngology had been functionally merged with SUNY Downstate for 20 years, the new fully merged situation has significant benefits that include greater flexibility in recruiting new faculty, enhanced ability to accommodate clinical needs of all faculty with three practice sites (Bay Ridge, East Flatbush, Brooklyn Heights), and a stronger financial position because of a single faculty practice plan with greater transparency. As one of only a few departments with a common chairman at both SUNY and LICH, we have been able to navigate the merger nimbly and are poised to take full advantages of all it offers. Bringing Quality Care to Brooklyn Of the three pillars that support all academic departments – research, teaching, and patient care – it is often 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 through the leadership of Richard Westreich, Sydney Butts, and Afshin Parhiscar, who cover all aspects of trauma, cosmetic, microvascular, and reconstructive surgery. Our cleft and craniofacial initiative is well underway and should be facilitated by the SUNY-LICH merger. Head, neck, and skull-base surgery enjoy continued excellence under the leadership of Krishnamurthi Sundaram, Perminder Parmar, and Michael Weiss, with additional expertise provided by Gady Har-el, Jessica Lim, Victor Lagmay, and voluntary faculty. Dr. Parmar has unfortunately left the department in July 2011, but we have seen robust interest in the open position by many highly-qualified, fellowship-trained applicants. Otology and neurotology remain vibrant through the leadership of Matthew Hanson, Neil Sperling, Abraham Shulman, and voluntary faculty. Patients with cochlear implants have been well served by our partnership with the Auditory Oral School of New York, which provides state-of-the-art mapping, support services, and auditory training. John Weigand provides fabulous leadership and community outreach in audiology at UHB and Stuart Motechin ably coordinates the busy Communicative Disorders Division at LICH, which recently added a full-time speech pathologist, Danielle Nascimiento. Pediatric Otolaryngology remains a highlight of the program with leadership by Ari Goldsmith, Nira Goldstein, and Paul Vastola, and additional contributions by Richard Rosenfeld, Mauro Ruffy, and voluntary faculty. Joshua Silverman joined the full-time faculty in February 2011 after dual fellowships in laryngology and pediatric otolaryngology. Laryngology and neurolaryngology are well covered under the leadership of Boris Bentsianov, with substantial additional contributions from our pediatric otolaryngologists, head and neck surgeons, and voluntary faculty. Joshua Silverman has brought state-of-the-art training and techniques to managing complex voice and airway problems in both adults and children, greatly enhancing our ability to serve the community and train our residents. General otolaryngology, allergy, and rhinology have expanded through the leadership of Marina Boruk who completed a rhinology fellowship, joined the department last year, and is pursuing advanced allergy training. Additional contributions come from Richard Westreich, Frank Lucente, and many of our superb voluntary faculty. Research, Education, and Teaching The past year has offered exciting new opportunities to expand and improve our already excellent research program, featuring 4 months of dedicated block time for resident research in the PGY-4 training year. Even a casual glance at the sections in this report on research and publications shows our ongoing commitment to research as a basis for enlightened patient care. Our annual Frank E. Lucente Alumni and Resident Research Day for 2011 was an unqualified success that featured keynote speakers Sonya Malekzadeh, Education Coordinator Elect for the AAO-HNS, and Dennis Lee, alumnus and fellowship-trained pediatric otolaryngologist. We are fortunate to have Nira Goldstein continue as Director of Research, ably coordinating a rich palette of faculty, resident, and medical student projects. She has been an incredible resource for navigating the intricacies of funding, IRB approval, and statistical analysis, resulting in superb resident presentations at national and international meetings. Joe McPhee retired in fall 2010 from his role as Basic Science Director, but we have compensated through relationships with Richard Kollmar, from the Department of Cellular Biology, and a budding relationship with David Wooten, Director of Mechanical Engineering at Cooper Union. Our educational offerings to residents and medical students continue to expand, building on the incredible foundation laid by former chairman Frank Lucente, who is currently the Vice Dean for Graduate Medical Education at SUNY. Nicole Fraser, our educational coordinator, remains an invaluable resource as she completes here second year with the department. The flow of medical students has blossomed, as Director of Medical Student Education, Nira Goldstein, works to creatively integrate third year students, who can now choose otolaryngology as an elective, into our varied teaching services. We continue to embrace the philosophy of “residents as teachers” in our many interactions with medical students throughout their training. Over the past year we have critically reviewed, enhanced, and revised our processes for resident training, program assessment, and faculty evaluation. We have worked hard to identify, and correct, issues that may detract from resident education, especially the challenging clinical demands of Kings County Hospital, which nonetheless present unparalleled training opportunities. As Associate Program Director, Jessica Lim has done a marvelous job of revamping our program to meet new duty hour requirements of the ACGME by implementing a LICH home night-call schedule and adjusting the resident complement at LICH and KCHC. The Best and Getting Better This past year the leadership at SUNY asked each department to create a list of “bests” worthy of highlighting. We identified eight “bests” in the otolaryngology department that deserve mention in this annual report. The SUNY Downstate Department of Otolaryngology is the:
Additional events worthy of emphasis over the past year include:
An update is also in order on our incoming and outgoing resident physicians. Gennaidiy Vengerovich will join the full-time faculty at Maimonides Medical Center and both Roni Keller and Haidy Marzouk will join leading private practices on Long Island, New York. We are delighted to welcome our three new PGY-1 residents, Sean Lewis from Boonshoft School of Medicine at Wright State University in Dayton, Ohio; Punam Thakkar from SUNY Downstate School of Medicine in Brooklyn, New York; and Jason Wasserman from Jefferson Medical College in Philadelphia, Pennsylvania. This year was unique in that two of our residents decided to pursue career paths outside of otolaryngology: Vikram Saxena entered an anesthesia residency and Christina DiLoreto has embarked upon a career in pathology. We are absolutely thrilled with the replacements we were rapidly able to recruit, namely Marisa Earley who joined us as a PGY-2 resident from the University of Medicine and Dentistry of New Jersey and Niv Mor who joined us as a PGY-3 resident from Geisinger Medical Center in Danville, Pennsylvania. 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 two of our administrative miracle workers, Billy Tang at SUNY and Carole Facciponti at LICH. 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. Respectfully submitted,
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