Complex General Surgical Oncology
Pittsburgh, Pennsylvania
Program Director: Patrick Wagner, MD, FACS
Program Length: 2 years
Fellows per Year: 2
Allegheny Health Network (AHN) opened a new 90,000-square-foot, $78 million state-of-the-art cancer center at Allegheny General Hospital (AGH) in 2020. This facility provides patients with access to leading-edge cancer treatments, while serving as the nucleus of cancer research, clinical trials and medical education for the AHN Cancer Institute.
About the program
The Allegheny Health Network Cancer Institute (AHNCI) is pleased to announce a newly ACGME-accredited fellowship program in Complex General Surgical Oncology (CGSO). The program is directed by Dr. David Bartlett, AHNCI Chair, and Dr. Patrick Wagner, Division Director for CGSO. Two fellows will be accepted per year, although class size is anticipated to grow as our practice expands to cover a regional network of hospitals in Western Pennsylvania. Candidates are required to have graduated from an ACGME-accredited general surgery residency, to be board eligible or board certified in general surgery, and to be eligible for an unrestricted Pennsylvania medical license. Remote interviews will be arranged for qualified candidates.
Clinical Training
AHNCI’s flagship hospitals for surgical oncology include Allegheny General and West Penn Hospitals, which serve as core training sites for complex procedures including upper gastrointestinal, hepatobiliary, colorectal and peritoneal surface procedures. A number of member community hospitals serve as peripheral sites for clinic and outpatient surgical care. AHNCI is active in graduate medical education with ACGME-accredited medical oncology (12 fellows) and radiation oncology (4 residents) training programs. AHNCI surgical oncologists are integral faculty members in the Network’s general surgery residency program which graduates six chief residents annually.
In its first year as an academic division, our surgical oncology practice performed over 1600 cases among 8 faculty members. We are currently training three non-accredited fellows as a transition phase to accreditation. We have active programs in index innovative surgical techniques including robotic pancreaticoduodenectomy, hepatic arterial infusion pump placement, cytoreductive surgery and heated intraperitoneal perfusion (HIPEC) for peritoneal surface malignancy, and intralesional immunotherapy procedures for melanoma. A ninth faculty member is expected to join in 2022, and we anticipate recruiting additional surgeon-scientist faculty in the areas of melanoma, HPB, endocrine and sarcoma.
Research
Fellows are provided with four months of dedicated research time, and are provided exposure to both basic/translational projects as well as clinical/outcomes projects.
AHNCI has an active clinical and translational research profile, with over 100 clinical trials currently accruing.
- Dr. Bartlett serves as a principal investigator of a comprehensive cancer biomarker study examining serial assays of circulating tumor markers in AHNCI patients undergoing cancer treatment, with a goal of enrolling 10,000 patients over three years.
- Dr. Wagner, who holds board certification in pathology as well as surgery, manages a comprehensive tissue biomarker lab that provides molecular analysis of tumor tissue in parallel with the circulating biomarker assays. This prospectively collected material will serve as the substrate for numerous ongoing and future studies of critical interest in surgical oncology, and is expected to provide ample research opportunities for trainees. AHNCI also maintains an active research collaborative relationship with the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, under which 23 clinical trials have been initiated over six years, recruiting more than 180 AHN oncology patients.
Opportunities for basic laboratory research are available within the division.
- Dr. Bartlett’s lab focuses on the development of oncolytic vaccinia viral therapies for cancer, using preclinical animal models, and has a lengthy track record of mentoring surgeon-scientists in training.
- Dr. Wagner’s lab focuses on the immune microenvironment of colorectal and peritoneal surface malignancies, with emphasis on the relationship of the tumor microbiome with tumor immunity. Current fellows are completing projects investigating the microbiome of appendiceal cancers, and the cytokine milieu and proteome of peritoneal fluid in patients with carcinomatosis.
- Dr. Allen, who joined the division in 2021, leads a new and innovative outcomes and value-based research initiative, which is expected to provide exceptional opportunities for mentored projects for surgical oncology fellows. In addition to the development of a novel clinical research platform, he is working alongside institutional leadership to create and build network-wide rehabilitation and enhanced recovery programs for all surgical patients. Together, these efforts will provide our fellows several avenues to perform high-impact clinical research and to be integrally
Learning Environment
The AHNCI CGSO fellowship prioritizes professionalism and leadership skills in its fellows. Fellows lead weekly tumor board discussions in a Metastatic, Molecular and Rare Tumor Board dedicated to the care of complex patients seen in our clinics. Mentored leadership opportunities are provided on institutional committees including the CoC Cancer Committee and the Institutional Review Board. The former is the context in which the ACGME-designated, specialty-specific QI project and community education requirements are met, with ample support from AHNCI staff. Education in ethical principles related to surgical oncology, as well as diversity, equity and inclusion themes in surgical oncology are stressed in the weekly didactic curriculum and journal club article selection.
Curriculum
Didactic Curriculum
Designed to be a comprehensive review of the most relevant information in surgical oncology, we have worked to create a high-yield educational program. With a focus on preparing our fellows for the CGSO board certification exam, our comprehensive education track includes:
- Focused content review of the most relevant data for the exam including updated NCCN algorithms and sentinel trials in surgical oncology.
- Lectures from experienced faculty on specific topics in
oncology. - Faculty led mock oral exams to facilitate the review of high-yield information and to discuss critical decision-making processes in surgical oncology.
Sample Rotation Schedule
Contact us
Training Program Directory
Patrick Wagner, MD
Assistant Professor, Department of Surgery
Program Director, Complex Surgical Oncology Fellowship
Request for information packets may be made to:
Allegheny General Hospital
Surgical Oncology
320 E North Avenue
Level 002, Suite 45
Pittsburgh, PA 15212
FAX: 412.442.2323
EMAIL: patrick.wagner@ahn.org