Curriculum

The American Association of Endocrine Surgeons (AAES) is a representative body of surgeons from North America and South America who have a special interest in the surgery of endocrine (thyroid, parathyroid, adrenal, and pancreas) glands. The association was established in 1981 and continues to grow; its membership now includes resident/fellow members, corresponding members (endocrine surgeons from countries throughout the world), and allied health members (otolaryngologists, urologists, and neurosurgeons who have acquired considerable expertise in the field of endocrine surgery). The AAES is dedicated to the advancement of both the science and art of endocrine surgery. The AAES is committed to maintaining high standards for the practice of endocrine surgery, and to discover and promote the best treatments for endocrine disease in order to improve our patients' lives.

To address the growing need for advanced post-graduate training in endocrine surgery, in 2004 the Executive Council of the AAES mandated the development of a fellowship curriculum to provide a more formalized structure to the existing endocrine surgery fellowships. The goal was to also provide a document to facilitate the development of future fellowship programs, and to ensure similar high quality training across a number of different institutions. The Education & Research Committee of the AAES enumerated the objectives and guidelines for fellowship training in endocrine surgery, and was ratified by the Executive Council in October 2005. This current version has been reviewed and revised by representative members of the AAES Education & Research and Fellowship Committees and is submitted for Council approval.

It is the hope of the AAES Executive Council that these objectives will provide a structure and a framework for endocrine surgery fellows to enhance their postgraduate training. The fellow, the program director and the faculty members of a training unit should utilize this curriculum and strive to meet these objectives. In recognition of the unique strengths and training opportunities at each institution, individual programs also have flexibility in the design of the fellowship rotations and experiences.

Endocrine Surgery Fellowship

In 2013, the AAES Executive Council created a formal accreditation process for clinical endocrine surgery fellowship programs. All AAES-accredited fellowship programs fulfill strict criteria and will be reviewed on a regular basis for compliance and re-accreditation. Information regarding available clinical fellowship programs can be found at http://www.endocrinesurgery.org

Candidates for endocrine surgical fellowship training will consist of surgeons who have successfully completed general surgery residency at an accredited general surgery residency program in the United States (or equivalent training outside of the United States); candidates must be board-eligible or board certified to apply.

An endocrine surgery fellowship will be defined as a clinical experience of one academic year.  Length of training may vary depending on the design of the program and the ultimate goals and type of practice pursued by the trainee. A research component may be included, concurrently or in multi-year fellowship programs. All AAES endocrine surgery fellowships must be directed by one or more surgeons who are members of the AAES and have a dedicated expertise in the field of endocrine surgery. The fellowship must offer the potential for exposure to the management of thyroid, parathyroid, adrenal, and neuroendocrine tumors of the pancreas and gastrointestinal tract. Multidisciplinary exposure to endocrinology, medical oncology, pathology, radiology, and genetics is strongly encouraged.

Throughout the fellowship, the trainee should have the opportunity to participate in journal clubs, tumor boards, and research projects directed towards endocrine surgical disease. It is also suggested that the trainee be given the opportunity to attend the annual meeting of the AAES and other AAES-sponsored educational initiatives (such as Endocrine Surgery University), as well as obtain formal instruction and certification in head and neck ultrasound.

Overall Objectives for an Endocrine Surgery Fellowship

  • Demonstrate knowledge of endocrine gland anatomy and physiology, in both the normal and pathologic states.
  • Diagnose endocrinopathies associated with endocrine surgical diseases.
  • Describe the inherited endocrine disorders and the proper application of genetic counseling and testing.
  • Discuss the current controversies, current areas of research, and clinical literature in endocrine surgical diseases.
  • Safely execute the appropriate workup, operation, and postoperative care for patients with endocrine surgical disease.

CLINICAL CURRICULUM:

Click here to download the Clinical Curriculum (PDF).

Click here to download the Guiding Standards for Successful Completion of an AAES Fellowship (PDF).

Click here to download the AAES Endocrine Surgery Fellowship Experience Log (PDF).

Recommended Reading & Reference List

Endocrine Surgery Textbooks

  • Textbook of Endocrine Surgery (Second Edition)  Edited by: Orlo H. Clark, Quan-Yang Duh, and Electron Kebebew.  ISBN: 978-0-7216-0139-7
  • Endocrine Surgery. Principles and Practice.  Editors: Johnathan Hubbard, William B. Inabnet, Chung-Yau Lo. ISBN: 978-1-84628-880-7
  • Endocrine Neoplasia. Editor: Cord Sturgeon. ISBN 978-1-4419-0857-5

Endocrine Surgery Training

  • Pasieka JL. Kindred spirits of the endocrines: the training of future endocrine surgeons. J Surg Oncol 2005;89(3):202-205.

Thyroid

  • Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association guidelines taskforce on thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19(11):1167-1214.
  • Kloos RT, Eng C, Evans, DB. Medullary thyroid cancer: management guidelines of the American Thyroid Association. Thyroid 2009;19(6):565-612.
  • Smallridge RC, Ain KB, Asa SL, et al. American Thyroid Association guidelines for management of patients with anaplastic thyroid cancer. Thyroid 2012:22(11):1104-1139.
  • Bahn RS, Burch JB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid 2011;21(6):593-646.
  • National Comprehensive Cancer Network Thyroid Carcinoma Guidelines. www.nccn.org
  • Carty SE, Cooper DS, Doherty GM, et al. Consensus statement on the terminology and classification of central neck dissection for thyroid cancer. Thyroid 2009;19(11):1153-1158.
  • Stack BC Jr, Ferris RL, Goldenberg D, et al. American Thyroid Association consensus review and statement regarding the anatomy, terminology, and rationale for lateral neck dissection in differentiated thyroid cancer. Thyroid 2012;22(5):501-508.
  • Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Thyroid 2009;19(11):1159-1165.
  • Rosenthal MS, Angelos P, Cooper DS, et al. Clinical and professional  ethics guidelines for the practice of thyroidology. Thyroid 2013;23(10):1203-1210.
  • Terris DJ, Snyder S, Carneiro-Pla D, et al. American Thyroid Association statement on outpatient thyroidectomy. Thyroid 2013;23(10):1193-1202.
  • Carty SE, Doherty GM, Inabnet WB, et al. American Thyroid Association statement of the essential elements of interdisciplinary communication of perioperative information for patients undergoing thyroid cancer surgery. Thyroid 2012;22(4):395-399.

Parathyroid

  • Bilezikian JP, Khan AA, Potts JT Jr, Third International Workshop on the management of asymptomatic primary hyperparathyroidism. Guidelines for the management of asymptomatic primary hyperparathyroidism: Summary statement from the third international workshop. J Clin Endocrinol Metab 2009;94(2):335-339.
  • Eastell R, Arnold A, Brandi ML, et al. Diagnosis of asymptomatic primary hyperparathyroidism: proceedings of the third international workshop. J Clin Endocrinol Metab 2009;94(2):340-350.
  • Silverberg SL, Lewiecki EM, Mosekilde L, et al. Presentation of asymptomatic primary hyperparathyroidism: proceedings of the third international workshop. J J Clin Endocrinol Metab 2009;94(2):351-365.
  • Udelsman R, Pasieka JL, Sturgeon C, et al. Surgery for asymptomatic primary hyperparathyroidism: proceedings of the third international workshop. J J Clin Endocrinol Metab 2009;94(2):366-372.
  • Khan A, Grey A, Shoback D. Medical management of asymptomatic primary hyperparathyroidism: proceedings of the third international workshop. J J Clin Endocrinol Metab 2009;94(2):373-381.
  • Rubin MR, Bilezikian JP, McMahon DJ, et al. The natural history of primary hyperparathyroidism with or without parathyroid surgery after 15 years. J Clin Endocrinol Metab 2008;93(9):3562-3470.

Adrenal

  • National Comprehensive Cancer Network. Neuroendocrine tumors. www.nccn.org
  • Zeiger MA, Thompson GB, Duh QY, et al. American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons Medical guidelines for the management of adrenal incidentalomas. Endocr Pract 2009;15(Suppl 1):1-20.
  • Funder JW, Carey RM, Fardella C, et al. Case detection, diagnosis, and treatment of pateints with primary aldosteronism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2008;93(9):3266-3281.
  • Nieman LK, Biller BM, Findling JW, et al. The diagnosis of Cushing’s syndrome: an Endocrine Society Clinical Practice guideline. J Clin Endocrinol Metab 2008;93(5):1526-1540.
  • Jimenez C, Cote G, Arnold A, Gagel RF. Review: Should patients with apparently sporadic pheochromocytomas or paragangliomas be screened for hereditary syndromes? J Clin Endocrinol Metab 2006;91(8):2851-2858.

Neuroendocrine Tumors

  • National Comprehensive Cancer Network. Neuroendocrine tumors. www.nccn.org
  • Brandi ML, Gagel RF, Angeli A, et al. Consensus guidelines for diagnosis and therapy of MEN Type 1 and Type 2. J Clin Endocrinol Metab 2001;86(12):5658-5671.
  • Vinik AI, Woltering EA, Warner RR, et al. NANETS consensus guidelines for the diagnosis of neuroendocrine tumor. Pancreas 2010;39(6):713-734.
  • Kulke MH, Anthony LB, Bushnell DL, et al. NANETS treatment guidelines: Well-differentiated neuroendocrine tumors of the stomach and pancreas. Pancreas 2010;39(6):735-752.
  • Chen H, Sippel RS, O’Dorisio S, et al. The North American Neuroendocrine Tumor Society Consensus Guideline for the diagnosis and management of neuroendocrine tumors. Pancreas 2010;39:775-783.