The Surgical Fellowship for Advanced Training in Breast Disease at Washington University School of Medicine is intended to train recent graduates from surgical residency programs to become experts in the clinical diagnosis and treatment of patients with breast disease and cancer. When the program is completed, the fellow has the training to assume a leadership role in the multidisciplinary treatment of patients with breast cancer in a community or academic practice. The fellow also develops sufficient research skills to design and implement clinical trials and protocols for patients with breast cancer.

The fellowship stresses a multidisciplinary approach to patients with breast disease and cancer. Faculty members from various disciplines have provided a detailed core curriculum, outlining the essential educational goals of the particular discipline, with specific learning objectives. This core curriculum offers recommended reading material, specifies required reading or writing assignments and specifies required technical objectives where applicable. The curriculum is intended to provide the fellow with a sophisticated, in-depth knowledge of the diagnosis and treatment of patients with breast disease. It is evaluated annually by the fellow and the program director for relevance and currency.

The clinical activities of the fellow reinforce the multidisciplinary approach. The fellow accompanies patients who are newly diagnosed with breast cancer to their subsequent initial visits with medical oncology and radiation oncology, ensuring adequate exposure to the other disciplines involved in the patient’s care. The faculty ensure that the fellow gains an adequate breadth of experience in each particular discipline. The fellowship provides the fellow with the equivalent of one month each in radiology, radiation oncology, medical oncology and pathology. At least three months of training involves the surgical care of the patient, including outpatient clinic and operating room experience. Sufficient time is spent in genetics, nuclear medicine, plastic surgery and psychology/outreach to provide the fellow with appropriate knowledge and experience in these fields.

The trainee is expected to complete all required and some optional courses during the course of the fellowship. Certain courses are required by Washington University, and completion of these courses with documentation of completion is mandatory. These required, on-line educational courses include HIPAA compliance, radiation safety, human studies protection and environmental health and safety. Other courses are required or optional at the direction of the program director, although the fellow is expected to complete both the basic and advanced breast Ultrasound for Surgeons course.

Didactic conferences, lectures, seminars and a journal club are included in the weekly schedule, emphasizing the various disciplines. The fellow is asked to participate, prepare and lead these conferences or schedules as requested by the program director or appropriate faculty.

Research is an essential component of this fellowship and is seen as critical to the fellow achieving a leadership role in the field of breast cancer. The fellow is expected to design and implement a clinical trial or protocol and submit scholarly activity in the form of presentations and publication. The opportunities and support available are outlined in the research section.