Laryngology and Care of the Professional Voice Fellowship

Mission Statement

The UPMC Voice Center, under the direction of Dr. Clark Rosen, strives to provide the most comprehensive Laryngology fellowship available to Otolaryngologists in this country.  This fellowship is designed to develop leaders in our field who will promote improvement in the current level of patient care, foster new avenues of research and educate others in the field of Laryngology. The fellowship is comprised of a 12 month clinical training program encompassing all aspects of care of the larynx, pharynx and esophagus.  Specifically, cold knife and laser phonomicrosurgery for benign and malignant lesions, laryngeal framework surgery and rehabilitation of the paralyzed vocal fold, laryngeal airway reconstruction, laryngeal botox, diagnostic laryngeal EMG, in-office laryngeal procedures (injections, bronchoscopy, biopsies, KTP laser), transnasal esophagoscopy, and treatment of swallowing disorders are all emphasized.  The UPMC Voice Center provides education with a “hands on” approach, with little education solely through observation.  Fellows should leave this program with the confidence and skill to practice Laryngology anywhere at the highest level.  An additional year of basic science or clinical research is encouraged but not required.

The Laryngology and Care of the Professional Voice fellowship at UPMC fully supports and is in compliance with the ALA guidelines on Laryngology Fellowship training.

The UPMC Voice Center

The UPMC Voice Center is a state-of-the-art, leading multi-disciplinary facility for the care of all types of voice and airway problems. The Voice Center has been in existence since 1995 and is a tertiary referral center for the region and the nation. The Voice Center sees a variety with laryngologic disorders, including laryngeal malignancies, benign vocal fold lesions, patients suffering from airway restriction problems, and neuro-laryngologic disorders. UPMC Voice Center is located at UPMC Mercy Hospital and is outfitted with equipment for stroboscopy, high speed video, chip-tip flexible laryngoscopy imaging, trans-nasal esophagoscopy, KTP laser equipment, laryngeal electromyography, and singing studios as well as providing services in speech and voice therapy.

Faculty

Clark A. Rosen, MD, is director of the University of Pittsburgh Voice Center and professor of Otolaryngology at the University of Pittsburgh School of Medicine. Dr. Rosen received his undergraduate degree from the University of California, Berkeley, and earned his medical degree at Rush Medical College in Chicago. He received his Otolaryngology training at the Oregon Health Sciences University in Portland, Oregon, and completed a fellowship in Laryngology and Care of the Professional Voice at the University of Tennessee, Memphis, and the University of Tennessee Voice Institute under the direction of Dr. Gayle Woodson. A board-certified otolaryngologist and member of the Scientific Advisory Board of The Voice Foundation, Dr. Rosen specializes in the care of the performing voice and the treatment and research of voice disorders. Dr. Rosen is the chair of the AAO’s committee on voice disorders.

Libby J. Smith, DO, is an assistant professor of Otolaryngology at the University of Pittsburgh School of Medicine. Dr. Smith received her undergraduate degree from the University of California, Santa Cruz, and her medical degree from Kansas City University of Medicine and Biosciences. She received her Otolaryngology training at Grandview-Kettering Medical Center in Dayton, Ohio, and completed a fellowship in Laryngology and Care of the Professional Voice in Philadelphia with Dr. Robert Sataloff. A board-certified otolaryngologist, Dr. Smith specializes in the care of the professional voice and the treatment of voice disorders at the UPMC Voice Center.

VyVy N. Young, MD, is an assistant professor of Otolaryngology at the University of Pittsburgh School of Medicine.  She earned her undergraduate and medical degrees from the University of Louisville, in Kentucky.  She received her Otolaryngology training at the University of Louisville, and then completed a fellowship in Laryngology and Care of the Professional Voice at the University of Pittsburgh.  A board-certified otolaryngologist, Dr. Young specializes in the care of the professional voice and the treatment of voice disorders at the UPMC Voice Center.

Weekly duties

The Laryngology fellow’s weekly duties consist of 4 main areas:  voice clinic, swallowing clinic, OR, and protected academic time.  Depending on the attending to whom the fellow is assigned on a given week, the days of clinic and the OR may vary.  In general, one full day will be spent in the operating room on a weekly basis.  Two days will be spent assisting in the attendings’ voice clinics and office procedures. One half day will be spent in swallowing clinic and one half day will be spent in the fellow’s own voice clinic with the supervision of one of the laryngology faculty.  The other two half days will be spent in academic time including Wednesday morning grand rounds and optional resident didactic sessions as well as a Friday morning voice center planning meeting and educational voice rounds.  One day each week the fellow is responsible for serving as the attending on the consult service.  This typically takes 1-2 hours in the late afternoon on the assigned day. 

The Resident and Fellow Experience

At the University of Pittsburgh Voice Center a PGY-4 resident is always assigned to the Laryngology service.  Fortunately, with three full time voice faculty, the fellow experience is never affected by the resident. The resident and fellow alternate their time with Dr. Rosen on a weekly basis.  When the fellow is not assigned to Dr. Rosen, he or she is working alongside Dr. Libby Smith and Dr. VyVy Young in their OR and clinics.  The advantage of this experience is that the fellow is exposed to more than one way to approach a patient or procedure.    

A typical week with Dr. Rosen:

  • Monday: Botox, in-office procedures and patient clinic with Drs. Rosen and Young. LEMG clinic
  • Tuesday: OR
  • Wednesday: AM grand rounds/didactics, academic time and PM Fellow clinic, swallowing clinic and afternoon consult service rounds
  • Thursday: New and return patient clinic
  • Friday: AM Voice center planning meeting and Voice rounds, PM academic time

If Dr. Rosen’s travel schedule precludes any of the above clinics or OR from happening, the free time can be spent on additional educational activities or in the swallowing center.

A typical week with Dr. Smith and Dr. Young:

  • Monday:  OR with Dr. Smith
  • Tuesday: Clinic with Dr. Smith
  • Wednesday: AM grand rounds/didactics, academic time and PM Fellow clinic, swallowing clinic and afternoon consult service rounds
  • Thursday: New and return patient clinic with Dr. Rosen
  • Friday: AM Voice center planning meeting and Voice rounds, OR with Dr. Young

Voice rounds

Voice rounds are an opportunity each Friday morning to have a laryngology-specific educational session.  The curriculum consists of lectures given by various speakers from within or outside the voice center.  The laryngology fellow and the resident currently rotating on the Laryngology service will be asked periodically to give a talk on a subject of his/her choice or one chosen by the faculty.  These lectures alternate every other week with discussions on interesting clinical cases or literature reviews.  This time is also used to develop new research projects or review results of recent research projects.

Tele voice rounds

Tele voice rounds are a monthly opportunity for multiple institutions to get together for an hour long discussion of a specific laryngologic topic in a tele conference setting.  The host institution is chosen on a rotating basis.  The fellow, under the guidance of Dr. Rosen, will be responsible for preparing the presentations when the University of Pittsburgh is the presenting institution. This will likely be the case 3-4 times during the fellowship year. 

Fellowship reading list and Laryngology journal club

The laryngology fellowship reading list consists of approximately 100 of the most pertinent articles to be read and digested by all future laryngologists.  The articles were hand selected by the Faculty at the UPMC Voice Center. The list is constantly evolving: older articles are being removed and more pertinent articles being added.  Many landmark articles are permanent fixtures of the list and are needed for educational/historic completeness.  The reading list is available on the shared network drive for easy access with PDF files available for all the articles. The fellow and attendings meet in an informal fashion to discuss and highlight these important articles.

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