Transplant Surgery Fellowship
Overview from Program Director
The University of Maryland Transplant Surgery Program is recognized as one of the largest and most successful transplant centers in the United States, and as a leader in state-of-the art surgical techniques and facilities. The Transplant Fellowship Program is certified by the American Society of Transplant Surgeons and is accredited for training in kidney, pancreas and liver transplantation. The duration of the fellowship is 24 months, typically running July 1st through June 30th of the following two years.
The program will provide instruction in the basic sciences, encompassing anatomy, physiology, pathology and immunology including histocompatibility testing, as they relate to the diagnosis and treatment of end-stage organ diseases. The activity of the training program will include extensive exposure to the surgical procedures applied to transplantation and direct operative supervision by the program director or his designee(s). Trainees will learn management of end-stage organ disease and the specific indications and contraindications for organ transplantation. The trainee will gain an understanding of the function of the histocompatibility laboratory with respect to cross-matching techniques, PRA testing, and tissue typing. The trainee will also have an intimate acquaintance with the laboratory and radiologic procedures used in the diagnosis of rejection, infection and other transplant-related issues. The fellow will also participate in the work-up of living donors, in the procurement and preservation of organs obtained from deceased donors and in the selection of organs for transplantation which are essential aspects of the practice of transplant surgery. The trainee will have the continuity of experience in the postoperative and long-term follow-up of transplant recipients.
The two-year training program is comprised of approximately 80-90% clinical involvement and 10-20% research activities. Clinical activities will include operative experiences such as cadaver organ recovery (both deceased donor and donation after cardiac death), laparoscopic living donor nephrectomies, organ transplantation (kidney, pancreas and liver) and urologic procedures, as well as patient evaluations and work-up, and post-transplant care. UMMC is a high volume transplant center, thus, the case load and diversity available to the trainee will be more than sufficient to satisfy the minimum requirements set forth by the ASTS guidelines. The clinical research component will include opportunities to participate in clinical trials on human subjects, retrospective research analysis and clinical research protocol development. In addition, efforts in the second year will include guidance in grant and manuscript preparation, hypothesis generation and experimental design. The fellow is expected to assist in supervising lower level surgical residents on the transplant service and will assist in patient care activities on the inpatient transplant unit. The trainee is also expected to follow all rules and regulations of the medical center in the provision of patient care and patient safety. Didactic components of the program include a weekly transplant seminar on transplant medicine or immunologic topics, bimonthly conference reviewing the modules of the American Society of Transplant Surgeons Academic Universe and bimonthly journal clubs. Participation in weekly morbidity and mortality, grand rounds, weekly transplant selection committee and weekly inpatient review is required.
The performance of the fellow will be assessed according to the current graduate medical education (GME) evaluation process in place at UMMC. The program director will give written feedback to the trainee at least semiannually to include assessment of the fellow’s competence in patient care, medical and surgical knowledge, practice based learning and improvement, interpersonal and communication skills, professionalism and systems-based practice. The assessment will include the use of assessment results, including evaluation by faculty, peers, self and other professional staff, to achieve progressive improvements in the trainee’s competence and performance. In addition to satisfying the above requirements, the fellow is also expected to keep a detailed surgical log which will be submitted to the ASTS every 6 months during the entire duration of the fellowship. The ASTS will evaluate the number of cases performed by the trainee so as to achieve a minimum of 30 kidney transplants, 15 pancreas transplants and 45 liver transplants, as the primary surgeon, required for certification in each organ.
At the end of the two year period, the program director will provide a final evaluation for each fellow who completes the program. This evaluation will include a review of the fellow's performance during the final period of education, and verify that the fellow has demonstrated sufficient professional ability to practice competently and independently. A separate certificate will be issued by the ASTS.
Candidates for the fellowship program must have satisfactorily completed residency which satisfies the educational requirements for certification by the American Board of Surgery or The American Board of Urology or foreign equivalency in order to be certified in Abdominal Organ Transplantation.
David B. Leeser, MD, FACS
Dr. David B. Leeser took over the Directorship of the Fellowship in Transplantation in 2012. He is an accomplished educator who has earned multiple awards for teaching of residents and medical students during his residency and as a faculty member at Weill Cornell Medical College where he was the Associate Program Director for the General Surgery Residency and the Associate Clerkship Director for Surgery. Dr. Leeser is a member of the Association of Program Directors in Surgery, the Association for Surgical Education and is an Associate Examiner for the American Board of Surgery. He has presented his work in educational research at the combined meetings of the ASE and the APDS.