The two-year fellowship builds upon prior clinical training and research experiences to fully equip the fellow to function effectively as a faculty member in an academic department of otolaryngology. The focus of the training is clinically oriented, with approximately 20 percent of the fellow's time is protected throughout the program to allow for the pursuit of academic projects and the development of new research interests.

Applicants must be eligible for the American Board of Otolaryngology examination or already be board-certified. A training license to practice medicine in the state of Michigan is required for duties related to the training program. An unrestricted license is needed if outside medical activities are planned. Moonlighting is permissible, if approved at the discretion of the program director. The fellow is appointed as a house officer due to ACGME regulations, and thus does not have independent clinical practice duties or routine on-call activities.

During the first two months of training, a structured preceptorship in audiologic and vestibular diagnosis with related assigned readings will be completed. The remainder of the training program is directed toward the active care of neurotologic patients, along with the mentored development of clinical expertise and surgical skills. Significant investment in laboratory temporal bone dissection is anticipated and will be supervised by the program director. Surgical opportunities in the operating room are graduated throughout the training program, with the extent of participation based upon personal preparation and demonstrated competence in temporal bone surgery. The weekly schedule includes:

• Operating room-two days
• Outpatient clinic activities-1.5 days
• Faculty mentored temporal bone dissection-half day
• Academic/research pursuits-one day

The fellow may participate in the care of any otologic surgical patient. The fellow's hands-on operative experience will be focused on inner ear procedures, facial nerve disorders and neurotologic skull base surgery. Our team strongly emphasizes choosing the most suitable approach for vestibular schwannoma tumor resection, rather than surgeon preference or institutional tradition. We believe this to be one of the distinguishing characteristics of the University of Michigan Neurotology training program. We tend not to recommend early stereotactic radiation for healthy patients with unilateral benign tumors.

If the patient elects to pursue surgical resection rather than observation, the translabyrinthine approach is used in over half of our vestibular schwannoma procedures. The other approaches are performed with the goal of hearing preservation using either the middle fossa approach or the retrosigmoid approach, the latter of which is also used for subtotal resection of the largest tumors. The hearing preservation rates in our middle fossa operations are among the best published results.

Surgical case volumes for our recent fellows are as follows:

These advanced neurotologic procedures are performed by fellows and clinical faculty. Middle ear and mastoid surgery are primarily prioritized for resident training while they undertake their ten-week rotations with the otology service. With increasing faculty size, the fellows have been involved in these operations more frequently than in the past. As such, there may be the opportunity to perform cochlear implants or surgery for chronic otitis media on days when there are no advanced temporal bone or neurotologic procedures on the schedule.

The department will provide a travel stipend of $750 to assist the fellow with travel to one major otolaryngology meeting per year. Additional funding may be available at the discretion of the division director, particularly when a paper is to be presented.