The Neurosurgery Residency
WFUBMC House Officer Programs – General Information
The neurosurgical residency training program of Wake Forest University Baptist Medical Center offers an experience appropriate for both the academic and the general practice of neurological surgery.
All patients are located in one modern medical center, and both private and service patients form a unified service. A complete spectrum of neurosurgical diseases can be studied and generous operating experience is offered to residents at all stages of training.
The American Board of Neurological Surgery has authorized the Neurosurgery Program to match two residents per year. The PGY-1 year is now an integral part of the neurosurgery experience with up to 6 months dedicated to neurosurgery and its related subspecialties. Further details regarding rotations during each year can be found below in the clinical rotations outline.
We will graduate two chief residents in 2010 for the first time in the program’s history. They will each complete the required seventh year in a fellowship of their choice. The chief year is completed in the sixth year and the seventh year is set aside for additional training depending on clinical or research interests. The addition of more residents affords more flexibility for elective rotations or research time depending on each resident’s preference.
Clinical training is highlighted with teaching conference weekly, journal club monthly and weekly teaching rounds. Each house officer completes a laboratory course in microneurosurgery and a review coarse for the written board exam. Funded opportunities to attend national meetings are readily available when presenting research. Every Tuesday afternoon a neurosurgical clinic is held in which resident physicians participate in all aspects of outpatient evaluation and management. Wednesday mornings feature open case discussion with Dr. David L. Kelly, Jr. M.D., Wake Forest University’s Neurosurgery Chair Emeritus.
A close relationship is maintained between the Department of Neurosurgery and the Departments or Sections of Neuropathology, Pediatrics, Neurology, Neuroradiology, and Oncology. Combined conferences are held on Tuesdays in Neuropathology and Neuroradiology.
Prospective resident applicants are interviewed by the entire faculty and resident staff. Emphasis is placed upon the interview process, and prospective candidates are carefully evaluated and selected. The current resident cohort is comprised of individuals from many different backgrounds with a variety of clinical and academic interests.
The opportunity to work with a committed faculty and well-qualified, cohesive resident staff creates a challenging and rewarding experience for the neurosurgical resident. Three neurosurgical nurse clinicians are employed to assist the residents and staff with ward duties. In addition, there are five physician extenders who specialize in outpatient care to enhance the resident experience.
Clinical Rotation Outline
PGY-1 (Intern)
- 3 months of Neurosurgery
- 3 months of Clinical Neurology
- 1 month each of:
- Neuro-Ophthalmology
- Neuro-Critical Care
- Otolaryngology
- 3 months of General Surgery rotations
- Written Neurosurgical Board Exam taken for self-assessment annually
PGY-2 (Junior Resident)
- 12 months dedicated to Neurosurgery Service
- Responsible for day to day management and care of service inpatients
- In-house call currently 1:7
- Opportunity for operative experience with senior residents
PGY-3 & PGY-4 (Senior Resident)
- 3 month blocks of Neurosurgery Service and Elective Rotations
- Responsible for management of inpatient consults and follow-ups
- Primary coverage of operating rooms
- 3 month blocks of Elective Rotations:
- Neuropathology
- Neuroradiology
- Interventional Neuroradiology
- Gamma Knife Radiosurgery
- Written Neurosurgical Board Exam taken for credit PGY-4 year
- In-house call currently 1:7
PGY-5 (Research Resident)
- 12 months of dedicated/flexible research time
- Clinical and/or basic science research encouraged
- Responsible for organization of Journal Clubs and quarterly Cadaver Labs
- Back-up call of PGY-2 resident from home
PGY-6 (Chief Resident)
- Responsible for day to day management of inpatient clinical service
- Run weekly Tuesday afternoon Chief Resident’s Clinic
- Evaluation/management/operative care/follow-up of personal patients
- Organization of weekly Tuesday AM academic conference
- Additional 12 months of focused neurosurgical training
- Options include:
- Subspecialty fellowships (on- or off-campus)
- Additional research experience
- Clinical transition to practice year
- Recent Graduates experiences:
- Dan Couture (2006) – Pediatric Fellowship (Utah)
- Paul Kim (2007) – Spine Fellowship (Cleveland Clinic)
- Alex Powers (2008) – Pediatric Fellowship (Washington University)
- Stephen Scibelli (2009) – Spine Fellowship (Cedars Sinai-LA)
- John Eickman (2010) – Spine Fellowship (Wake Forest)
- Andy Stevens (2010) – Spine Fellowship (TBA)
Clinical Training Overview
Extraordinary experience with spine surgery is provided, with fellowship-level opportunity to learn instrumentation and fusion techniques. Operations for tumor including; skull-base tumors, arteriovenous malformations, aneurysms, seizures, and hydrocephalus are numerous and provide a wide range of exposure to different techniques. In addition, procedures for the alleviation of the pain of carpal tunnel syndrome and tic douloureux, and the motor symptoms of Parkinson's disease, dystonia, and essential tremor are performed regularly. The treatment of trauma patients provides a wide range of exposure to closed head injury and the control of intracranial hypertension. This combination ensures that graduates of the Wake Forest Neurosurgery Residency Program receive the most well rounded clinical training possible.
Image guided Neurosurgery is state-of-the-art. The Medical Center has an extremely active Gamma Knife Program. This is one of the few programs in the country to have both a Gamma Knife and a linear accerlator based (LINAC-Scalpel) radiosurgery program. Wake Forest has one of only two Gamma Knife units in North Carolina and is the closest academic Gamma Knife Center to approximately 20 million people. Multiple image guidance and stereotactic platforms are available for use in the operating rooms.
The resident rotating on neuroradiology is instructed by ten full-time neuroradiologists and has a broad exposure to all neuroradiological procedures, including the latest techniques in interventional neuroradiology. The latest CT, CT-Angiography, MRI (1.5 and 3 Tesla), PET, PET- CT, ultrasound, and other imaging scanners are available. Multiple MRI scanners, including one dedicated entirely to research, are at the physician’s disposal. Two neuropathologists supervise individual performance and conference preparation. The productive relationship with upwards of thirty full-time neurology faculty enables exchange of both information and patients encompassing a wide range of neurologic disorders.
Research
Opportunities for clinical research in the subspecialties of Neurosurgery are abundant. Wake Forest Neurosurgery is a leading institution in national trials in a number of areas including: cerebrovascular neurosurgery, spinal instrumentation, and neuro-oncology. It is one of sixteen members of the National Cancer Institute's NABTT (New Approaches to Brain Tumor Therapy) Consortium which conducts phase I and phase II trials of promising new agents for brain tumors. Wake Forest University’s Comprehensive Cancer Center is one of only sixty-five NCI-designated Comprehensive Cancer Centers in the United States.
Elective time spent in the neurosurgical laboratory is strongly encouraged, as is a career in academic neurosurgery. Waldemar Debinski, M.D., Ph.D. is a member of the Department of Neurosurgery and also functions as director of Wake Forest University’s Comprehensive Cancer Center Brain Tumor Center of Excellence. Wake Forest University is home to the only Brain Tumor Center of Excellence in Western North Carolina. Collaboration with accomplished colleagues in Wake Forest University School of Medicine's excellent basic science departments is also encouraged and results in additional academic productivity.
Residents have a number of projects to complete during their training, and they are expected to publish and present their research at national and regional meetings. The Department maintains a resident library with future plans for expansion of this invaluable resource.
Application Process
Resident applications will be accepted through ERAS (Electronic Residency Application Service) and resident positions are allocated through the NRMP (National Resident Match Program). The application deadline is November 1, 2009. Applications received after this date will not be considered.
For more information about Wake Forest's Neurosurgery residency program, please contact the program director's office:
Margaret Herring
Residency Program Coordinator
(336) 716-0143
mherring@wfubmc.edu
John A. Wilson, M.D.
Residency Program Director
Department of Neurosurgery
Wake Forest University School of Medicine
Medical Center Boulevard
Winston-Salem, NC 27157-1029
(336) 716-4081
facsimile: (336) 716-3065