Interventional Oncology Fellowship

Background

The Interventional Oncology Fellowship program is being created beginning in July 2018 in response to the increase in advances and interest as well as needs for highly trained interventional radiologists with expertise in this field. The Fellowship position seeks to provide a varied experience in interventional procedures with unique exposure on the techniques and therapies provided to the oncologic patient population. Our purpose for the fellowship program is to improve clinical and procedural skills and theoretical knowledge of the Fellow with strong emphasis on interventional oncologic procedures.

The training program addition will be located in the Interventional Radiology section of the Department of Diagnostic Imaging at the H. Lee Moffitt Cancer Center, an NCI-designated Comprehensive Cancer Center. The Cancer Center is comprised of a large ambulatory care facility, a 206 bed hospital, with a 36 bed blood and marrow transplant program, 16 state of the art operating suites, a 30 bed intensive care unit, a high volume screening program, and a basic science research facility. The Moffitt Research Institute is comprised of approximately 150 Principal Investigators, 58 laboratories, and 306,000 square feet of research space.

The IR facility located in the main campus of the Cancer Center consists of 3 IR suites including a state of the art hybrid CT angiography suite, and a 4th C-arm procedure room. A CT scan room dedicated to IR for CT guided procedures is shared by a common control room with the angiography suites. The IR holding area consisting of 13 bays adjacent to the procedure suites is utilized for all patient preparation for IR procedures and post procedure recovery and discharge. The IR division is supported by 6 attending interventional radiologists. There are 4 dedicated advanced practice professionals who assist the IR physicians with clinic, inpatient management, and procedures. Our annual IR procedure volume is 7,800, in addition to over 2,000 CT and US guided procedures, and over 900 outpatient clinic visits in 2017.

Program Content

The trainee will be offered experience in a wide variety of standard vascular and non-vascular interventional procedures as well as oncologic interventions.  Through a clinically oriented Interventional Radiology consultation service and patient admissions to the IR service, the trainee will also be able to improve his or her clinical skills in patient management before and after interventional treatment. Exposure to the multidisciplinary approach to management of complex oncologic patients integrating interventional radiology through different multidisciplinary tumor boards and working group meetings will also be an important part of the training program.

Currently performed procedures include:

  • Transarterial chemoembolization (TACE), bland embolization
  • Yttrium90 radioembolization
  • Percutaneous hepatic perfusion of the liver with isolated hemofiltration
  • Preoperative embolization of bone metastases, certain sarcomas, renal tumors
  • Embolization therapy of active hemorrhage
  • Embolization therapy and sclerotherapy of arteriovenous malformations
  • Angiography
  • Thrombolysis, angioplasty, stenting of arterial and venous occlusive disease
  • IVC filter placement and retrieval
  • Vascular access - port, tunneled and non-tunneled central venous lines placement and removal
  • Image guided thermal and non-thermal ablation - radiofrequency, microwave, cryo, irreversible electroporation
  • Percutaneous gastrostomy, gastrojejunostomy, jejunostomy tube placement
  • Biliary interventions – cholangiogram, stent placement, cholecystostomy tube placement
  • GU interventions – nephrostomy tube placement, ureteral stent placement
  • Percutaneous image guided biopsy, fiducial marker placement, drainage procedures
  • Vertebral augmentation, ablation
  • Lymphangiography and thoracic duct embolization for treatment of chylothorax

Educational Program

  1. Clinical and research components: The Fellow is based in the Interventional Radiology Section of the department performing catheter directed and percutaneous procedures in the interventional suites. The Fellow will participate in a wide variety of catheter directed oncologic treatment procedures including hepatic chemoembolization, bland embolization, radioembolization, and chemoperfusion with isolated extracorporeal hemofiltration. The Fellow will also gain experience in biliary and urologic interventions for management of malignant obstruction as well as procedures required for vascular access and nutritional support. The Fellow will rotate through the CT and US procedure rooms for experience in percutaneous tumor ablations as well as diagnostic needle biopsies. Interventional Oncology clinical practice exposure is provided by consultations d follow-up visits in our outpatient clinic. Research interests are discussed with the fellow at the beginning of the fellowship to determine clinical research interest to provide guidance on research projects. The fellow will be encouraged to work on independent research projects with guidance of the interventional radiologist. Dedicated time for research will be made available based on the project requirements.
  2. Participant’s Supervisory and Patient Care Responsibilities: The fellow will have direct patient care responsibilities including pre and post procedure management. The fellow will work closely with the supervising attending interventional radiologist for one-on-one training with greater independence given depending on the level of clinical skills that are acquired.
  3. Procedural Requirements: As part of routine patient treatment, the fellow will develop specific interventional procedural skills based on the variety of procedures performed under the supervision of the interventional radiologist. The fellow will also need to perform physical exams as part of the work up for interventional procedures as well as clinic consultations. There is no set specific “requirements” (no minima) built into the fellowship.
  4. Didactic Components: There is not specific pre-planned didactic program specifically for the fellow. The fellow will perform various procedures with rotating interventional radiologists working directly with a faculty member, one-on-one. The faculty member will therefore provide ongoing tutelage and directed readings throughout the year. Didactic lectures will be provided as needed to cover specific topics requiring greater explanation or related to specific interests of the fellow. In addition, the fellow can choose to participate in the clinical didactics available to our diagnostic radiology residents as well as those designed for other Moffitt fellows. The fellow will also participate in various weekly multidisciplinary tumor conferences and Wednesday liver working group meetings

Supervision and Evaluation

  1. Supervision and mentoring: Direct supervision for the fellow will be provided for all procedures by the attending interventional radiologist who is working with the fellow. As the fellow demonstrates competence in a given procedure, the fellow will be afforded an opportunity for less direct hands on guidance based on obtained skill set. Mentoring will be provided by one or more attending interventional radiologist for research projects based on the specific project chosen by the fellow.
  2. Evaluation: The expectations of the fellow will be explained o the fellow at the beginning of the training program. The fellow will have quarterly evaluations by the program director. All attending physicians will provide quarterly written and verbal evaluations to the program director. The fellow will complete a self-evaluation assessment form that is reviewed by the program director. In addition, the program director completes a summative evaluation at the completion of the fellowship by ACGME guidelines.

Eligibility:

Completion of ACGME accredited radiology training or equivalent.

Deadline:

Rolling application process.

How to Apply:

  1. A completed application form
  2. Current CV
  3. A letter of recommendation from the director of your radiology residency program directly to our program
  4. Two additional letters of recommendation from physicians of your choice addressed to the fellowship director
  5. Medical school transcripts and USMLE scores (optional)
  6. Personal Statement
  7. Current photo

Contact Information:

If you have questions or would like to submit your application materials, please contact:

Lorie Jennings
Lorie.Jennings@moffitt.org
Phone: (813) 745-2250

Department of Diagnostic Imaging and Interventional Radiology
H. Lee Moffitt Cancer Center and Research Institute
12902 Magnolia Drive
Tampa, FL 33612