The University of Pittsburgh Department of Neurological Surgery has several CAST (Committee on Advanced Subspecialty Training) approved fellowships. To apply for any of the fellowships, submit the following information to the contacts listed for the below fellowships.
- Three Letters of Reference
- Program Letter of Good Standing
- USMLE/COMPLEX scores
- Completion of ACGME Neurological Surgery Residency
Endoscopic and Open Skull Base Surgery
The skull base fellowship is primarily focused on endoscopic and open skull base work surgery. Paul Gardner, MD, Cranial Base Surgery Center co-director, and Georgios Zenonos, MD—associate director for the center—perform approximately 30-50 cases a month. About half of these cases are endoscopic endonasal surgeries and are performed in conjunction with their otolaryngology colleagues, Carl Snyderman, MD—who is co-director of the center—and Eric Wang, MD, director of education for the center. The remaining cases are various open skull base cases, including lateral skull base approaches with neurotology, vascular, and brain tumor procedures, minimally invasive transorbital approaches and some general cranial surgery.
In addition, the fellow will have an active role in the center's weekly outpatient clinic and will be responsible for organizing the weekly Multidisciplinary Skull Base Planning Conference where interesting and new cases are presented.
Fellows are expected to engage in scholarly activity through clinical and/or laboratory research. The Cranial Base Surgery Center has multiple avenues for the pursuit of these projects. A comprehensive research registry of skull base patients is available to address clinical questions. A dedicated clinical research manager assists in the development and execution of prospective trials affecting the management and quality of life of skull base patients.
The Surgical Neuroanatomy Laboratory can be utilized to develop novel surgical corridors and reconstructive techniques. This lab, under the direction of Dr. Gardner, includes three high-definition endoscopic stations with complete instrumentation. Fellows are expected to utilize this outstanding resource to prepare for complex cases, improve surgical skills and develop independent anatomical research projects.
Finally, ongoing collaborations with basic science researchers within the University of Pittsburgh can be expanded to address translational research questions.
For more information and to apply, please contact Mary Jo Tutchko at 412-647-8186.
Fellows are selected competitively based on their planned pursuit of an academic medicine practice focused on this neurosurgical subspecialty. Fellows participate in all patient care activities of our center, including:
- evaluation and management decision making,
- participation procedures designed to increase learning in the field, and
- post-operative care.
Fellow will understand the key concepts involved in patient candidacy and selection for a variety of contemporary spinal procedures related to degenerative, trauma, deformity and oncologic spinal pathology.
Fellow will become adept and performing said procedures in an autonomous fashion by Fellowship completion.
Fellow will utilize and master the outcomes database registry and EMR to perform retrospective analysis in addition to prospective studies with the aim to publish said results in peer reviewed journals.
Fellow will attend all teaching conferences and provide at least one lecture at neurosurgical grand rounds on subject of the Fellow’s choosing with mentor permission and guidance.
In the Intensive Care Units, patient care team members include CCM fellows, medical students, interns, anesthesia and surgical residents, and CCM faculty. The CCM faculty members and primary service faculty members are recognized as concurrent attending physicians in the ICU. There is one collaborative team that develops a single treatment plan based on current evidence based guidelines and local consensus based protocols. All team members, including the CCM fellows, are permitted to perform any patient care activity agreed upon and intervene as indicated in emergencies or when the patient’s condition warrants deviation from the treatment plan developed in the morning. Deviations from the designated plan must be discussed with the CCM attending. Most critically ill patients will have several consulting physicians in addition to an attending physician, thus making coordination of patient care extremely important. This can be achieved by conferring with them when they arrive in the area for rounds, and rapidly notifying the attending if their patient’s condition deteriorates.
The CCM attending has ultimate responsibility for all medical decisions regarding ICU patients and is responsible for providing oversight and supervision of all care provided by fellows. Critical care attendings are to be involved in all critical decisions in medical care and must be contacted for significant changes in patient status. All procedures in the ICUs are to be supervised by an ICU attending physician except in unusual, emergency situations. Procedure logs will be maintained.
As the fellows progress through the program, they are expected to take on more of a leadership role in the ICU, leading rounds and making decisions regarding patient care. This culminates in the junior attending rotation, during which faculty allow the fellow significant autonomy and provide feedback on leadership and decision-making skills.
Our Pediatric Fellowship video on YouTube highlights the training experience in Pediatric Neurosurgery at UPMC Children’s Hospital of Pittsburgh, focusing on the overall training philosophy of graded responsibility over the course of the training year. The diversity of cases, covering the full gamut of Pediatric Neurosurgery, the collegiality of the group and institutional collaborators, and the cutting-edge technology available for prospective fellows make this an ideal place to train.
Stereotactic Radiosurgery & Functional
For more than thirty years surgeons working at the UPMC Department of Neurological Surgery and its Center for Image Guided Neurosurgery have performed pioneering minimally invasive brain surgery for patients with tumors, vascular malformations, movement disorders, and epilepsy. In keeping with the goal of minimally invasive surgery, various technologies have facilitated care of patients with these often complex clinical problems. For example, in 1981 the first United States dedicated CT scanner was placed in the operating room at UPMC Presbyterian Hospital, now supplemented with multiple clinical and research 1.5 - 3 T MRI technologies. We often use magnetoencephalography (MEG) to map critical brain function regions in advance of both lesional brain surgery and epilepsy cases. In addition, the program performs approximately 300 functional and epilepsy surgery procedures, including temporal and extratemporal resections, hemispherectomies, invasive monitoring (SEEG and subdural grids), vagus nerve stimulators, and deep brain stimulation for abnormal movement disorders, epilepsy and psychiatric disorders. Our clinical neurophysiology center has multiple MD and PhD level specialists who participate in all operations where monitoring is used.
Individuals who are selected to obtain this subspecialty certification in epilepsy, stereotactic functional, and radiosurgery are promised an enormous experience based on the current patient load at our center and the national and international reputation of our program. The Center for Image-Guided Neurosurgery at UPMC was cited as the most prominent academic publishing organization in stereotactic surgery in the world. On an annual basis, we publish on average 25 peer-reviewed articles. Overall more than 650 peer reviewed articles, >250 book chapters, and 12 books have been published related to the work and studies done at this center. Fellows selected for this program are expected to participate in educational activities that improve clinical skill acquisition, prepare outcomes research, and publish in the clinical or basic science research arena.
Fellows participate in all patient care activities at our center, including:
- evaluation and management leading to decision making,
- participation in procedures designed to increase learning in the field, and
- pre and post-operative care.
The annual patient population referred to our center exceeds 1,000 patients with conditions that include brain tumors, movement disorders, chronic pain conditions, arteriovenous malformations, other vascular anomalies, spinal tumors, and medical intractable epilepsy. In addition to training in current functional neurosurgical procedures for movement disorders using deep brain stimulation, fellows participate in our annual case experience of >650 patients who undergo Gamma Knife brain surgery and >100 cases who may undergo linear accelerator spine radiosurgery under the direction of Peter Gerszten, MD.
Based on individual applicant’s backgrounds, recommendations, and career goals we have developed two tracks for this fellowship program. Successful applicants will enter one of these two tracks depending on their planned post fellowship employment interests’ opportunities:
- Track 1, Stereotactic Radiosurgery core (70%), with additional exposure to Functional Neurosurgery and Epilepsy Surgery (30%)
- Track 2, Functional Neurosurgery and Epilepsy core (70%), with additional exposure to Radiosurgery (30%)