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ENVIRONMENT SPECIFIC TO PROPOSED FELLOWSHIP

The Ï㽶ֱ²¥/SWCC in Lubbock offers a comprehensive Breast Center of Excellence that enjoys enormous support from the university and the hospital senior leadership. This has led to the recruitment expertise from all disciplines with a specific focus on academics and scholarship. The SWCC has a vision to target NCI designation; this has put academic programs at the fore front. The clinical practice has a robust multidisciplinary service that works in a cohesive fashion within the women’s oncology area of the SWCC. The BCE is a structured program which is accredited by the National Accreditation Program for Breast Centers. To provide comprehensive women’s healthcare training including reproductive endocrinology exposure for young women with breast cancer and long-term health concerns of survivors, the program works closely with the gynecologic oncology service. This provides an ideal opportunity for a fellow to work directly with the faculty members in a multidisciplinary fashion and get first-hand training. Fellows get the opportunity to take year 1 residents through cases both in clinics and in the operating room. Third year medical students rotate through the breast service and have a vastly different set of objectives that does not conflict with the fellow’s objective and provides an excellent venue for teaching and mentoring skills for the fellow. 

OFFICE OF GRADUATE MEDICAL EDUCATION 

The Texas Tech University Health Sciences Center serves approximately the western half of the state. Core to the mission is developing high quality health care professionals via the schools of Allied Health, Medicine, Nursing and Pharmacy and the Graduate School of Biomedical Sciences. The Health Sciences Center holds a strong commitment to Graduate Medical Education. The School of Medicine hosts 34 residency and fellowship programs with approximately 500 physicians-in-training on campuses in Lubbock, Amarillo, Permian Basin, and El Paso. 

The goal of medical education (residency training) is to become certified by the American Board of Medical Specialties (ABMS) to practice in a medical specialty. The Texas Tech residency programs including the programs that are not currently under the accreditation by the ACGME, are developed in the context of the Physician General Competencies as expressed by the ABMS and the ACGME.  These are:

• Patient Care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health
• Medical Knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care
• Practice-Based Learning and Improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care
• Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals
• Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population
• Systems-Based Practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value

The Texas Tech University Health Sciences Center is a rich and diverse group of physicians, scientists, professionals and support people who share the common goal of learning, caring and healing.

RATIONALE FOR BREAST FELLOWSHIP PROGRAM AT Ï㽶ֱ²¥/SWCC – BREAST CENTER OF EXCELLENCE

Breast cancer is a nation-wide problem that has been addressed with several educational and research projects, including 32 fellowship programs. However, the National Cancer Institute data presented in December of 2007 revealed that about half of the breast cancers are still being diagnosed with excisional biopsies – not a standard of care. This reflects a need for ongoing emphasis on educational programs and sub-specialty training. 

In Texas, approximately 15,400 breast cancers are diagnosed every year, with a cause-specific mortality of about 2,580. West Texas is a unique region in terms of discrepancies in healthcare delivery systems, geographic distances, and socially isolated populations. This requires unique innovative approaches to provide state-of-the-care. The Texas Tech University Health Sciences Center – Breast Center of Excellence serves, on an annual basis, approximately 1,500 new breast clinic patients and performs 5,000 screening mammograms and treats 350 breast cancers, we believe that this is an ideal set-up for a subspecialty training fellowship in breast disease in the West Texas region. This program is designed specifically to addresses the challenges in West Texas; hence it provides a great training opportunity that exemplifies program building with creative approaches to maximize impact. Geographically, the closest breast fellowship program is 346 miles from Lubbock – a clear indication that wealth of learning resourced in West Texas remains untapped. 

Lubbock and the surrounding area have already established itself as a hub for commerce, technology development and higher education. Providing access to comprehensive healthcare is also a part of this growth and the unique research / outreach role that Texas Tech University Health Sciences Center – Breast Center of Excellence plays is one of the primary reasons that establishing an accredited interdisciplinary fellowship in breast surgical oncology in the Texas Panhandle would be beneficial.  

In terms of clinical services, complete breast screening and diagnostic services are provided within the Ï㽶ֱ²¥/SWCC - BCE complement including digital screening and diagnostic mammography, breast ultrasound, image-guided breast biopsies, ductography, whole and partial breast irradiation, oncoplastic surgery and reconstructions and chemotherapy with a full complement of psycho-social and palliative care. 

There are dedicated clinics for cancer risk assessment and prevention, multidisciplinary cancer care planning, and survivorship clinics that provide focused training on each aspect of breast care. This will provide an enormous experience to a growing physician and aspiring instructor with a career focused on breast disease. 

The Ï㽶ֱ²¥-BCE is accredited by the national Accreditation Program for Breast Centers (NAPBC) and is diligently engaged in maintenance of 27 quality standards set forth by the NAPBC. The fellow will have a unique opportunity to learn program building and maintenance in difficult circumstances by being a part of this process.