Auckland Head & Neck Microvascular Fellowship 2012-2013
from Dr Rick Jaggi

presidentIn 2008, I attended the Canadian Society of Otolaryngology annual meeting in Jasper. It was a brilliant meeting both socially and academically, but little did I know how much of an impact it would have on the next few years of my life.

I went to a talk by one of the keynote speakers from New Zealand, John Chaplin. Now, it wasn't by chance that I ended up at this talk I had been researching head and neck fellowship for a few weeks, Head and neck surgery, endocrine surgery, facial plastics, and lots of experience with skin cancer. All the things that I enjoy, rolled into one fellowship, and I get to spend a year in New Zealand.

So, over the last 10 months, I have been involved with almost every aspect of the head and neck service in Auckland. We do 4-5 free flaps per month, mostly mucosal cancer, in addition to endocrine cases, neck dissections, facial reconstruction/plastics, oculoplastics and of course skin cancer. All four supervisors do everything, but they all have there own subspecialty interests as well. The teaching is second to none, at first very methodical step by step you are shown the "Auckland way", as the year progresses you are given more independence. Operating usually 3-4 days a week and coordinating head and neck clinic on Fridays. All head and neck cancer cases go through the Auckland regional head and neck multidisciplinary meeting, which I coordinate. It is a unique model in that the patients are seen in the clinic by the entire team, not just reviewed in a conference room. Other new experiences included using bio-models to pre-bend reconstruction plates, treating osteoradionecrosis and morning rounds, with nurse specialists, wound specialists, speech/swallow therapists and a dietician together making decisions. At the beginning, it seems like such a huge undertaking, but the team is critical, the team works seamlessly together, we debate, we banter, and we buy coffee when we are wrong. It's an amazing group of people, all of whom I will miss very much.

In addition to the fellowship training, I have had the pleasure of spending a year in Auckland with my wife and two year old son. Auckland, we have found, is exceptionally family friendly and has a lot to offer. It also helps that this past summer was noted to have the finest weather in fifty years. We have enjoyed getting to know the local restaurants, beaches and parks. Taking vacations to Fiji, Rarotonga, Queenstown and Milford Sound in the South Island.

I have recently accepted a head and neck oncology position in Saskatoon, Saskatchewan, Canada and look forward starting practice in August. It has been a tremendous experience to see how a head and neck service functions in different part of the world and I hope to take many of these ideas back with me.

I would like to give special thanks to my supervisors, Mr. John Chaplin, Mr. Nick McIvor, Mr. Mark Izzard and Mr. Rajan Patel. It has been an incredible year.

Rick Jaggi MD, FRCSC
Head & Neck Oncology Fellow
Auckland City Hospital
Auckland, New Zealand


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