Functional & Stereotactic Fellowship
The Functional and Stereotactic Fellowship of the University of Cincinnati Department of Neurosurgery is a newly established fellowship funded in part by the Davis Phinney Foundation, of which the University of Cincinnati is named as a center of excellence in research and clinical treatment of Parkinson’s disease. The fellowship focuses attention on the training of neurosurgeons in the care of patients with medically intractable movement disorders and pain. The training duration is 12 months, with the opportunity to extend the training an additional 6-12 months in exceptional situations upon a mutual agreement between the director and fellow in order to expand or conclude specific clinical or basic science research projects. Therefore, the clinical curriculum is specific to the first and usually only 12 months of fellowship. This fellowship is available to neurosurgeons that have completed their residency training and would like to pursue specialized training in this area. Neurosurgeons with a goal of pursuing an academic career are preferred.
Educational goals
The fellowship will consist of a primary clinical and concurrent laboratory assignment. The clinical role of the fellow will be the direction and overview of care of all patients on the Functional service. This is a busy service divided between the University Hospital and Good Samaritan Hospitals. The main patient focus will be on movement disorders, specifically, Parkinson’s disease, essential tremors, generalized dystonia and focal dystonias. Medically intractable pain management will also be emphasized with surgical treatment of failed back syndrome, neuropathic pain as well as facial pain syndromes. Newer psychiatric indication for surgery will also be explored and will include major depression that is medically intractable. Surgical techniques will focus on precision stereotactic methods including framebased as well as frameless techniques, stimulator and device implantation as well as imaging techniques will be stressed during the fellowship. The fellow will evaluate patients in the outpatient setting; participate in decision-making, surgery, and peri-operative hospital care in collaboration with Dr.Mandybur, Director of the Stereotactic and Functional Service, and the chief residents. The fellow will lead the functional team, and help organize and run a monthly interdisciplinary movement disorders conference as well as a weekly planning meeting, participate in resident education and assist in all operative cases. By the completion of the training, the fellow is expected to develop a broad knowledge of the variety of neurological conditions that are amenable to functional surgical intervention, understand the issues involved in treatment decision making, be facile with all major surgical techniques in stereotactic and functional neurosurgery and develop an expertise in post-operative treatment and adjuvant treatment decision making.
Activities in the laboratory will include a teaching role in the on-going series of stereotactic and functional lectures and symposia offered to a national and international audience. The laboratory rotation will include independent cadaveric dissection for the purpose of education and for development of new neurosurgical techniques. The fellow will work closely with Dr. Keller from the Division of Research as well as Drs. Mandybur, Revilla, Espay, Seroogy and other members of the Movement disorders clinic. It is expected that at least two publications will be completed during the fellowship.
Unique characteristics of the Stereotactic and Functional fellowship:
- Regional referral source for complicated movement disorders treatment.
- A strong and cohesive movement disorders clinic consisting of Neurologists, Neuroscientists, Neurosurgeons and nursing.
- Active multi-disciplinary movement disorders teams.
- Regional referral source for complicated medically intractable pain management
- Basic science laboratories that range from MRI imaging to motion analysis laboratories
- Expanding basic science collaboration with Neuroscientists on stem cell and growth factor research.
- A Stereotactic and Functional service that is performing clinical investigational studies.
- An editorial office with medical editing, illustration, and photographic services.
Duties and Responsibilities
The Functional Fellow will participate as an active member of the functional service. He/she will:
Patient Clinical Care Requirements
- Demonstrate the highest level of patient care skills, problem solving skills and technical skills
- Become proficient in the complete management of neurosurgical patients with complex pain issues and movement disorders.
- Demonstrate a high level of multi-tasking for administrative, academic, and clinical endeavors
- Manage and administrate the stereotactic and functional neurosurgical team in conjunction with residents and associated medical services.
Skills Requirements
- The Fellow is expected to be familiar with various surgical approaches and techniques for movement disorders and pain.
- The Fellow is expected to be familiar with medical issues and how to manage them.
Medical Knowledge
- Demonstrate ability to teach effectively
- Manage and lead the movement disorders conference
- Assist program director in overseeing personal, academic and clinical growth and development of junior residents
- Participate actively and lead conferences in a manner that demonstrates a high level of global awareness regarding clinical neurosurgery, applied research, an understanding of the literature, neurosurgical education and program building
Practice-Based Learning and Improvement
- Manage and administrate the quality improvement program for the neurosurgical service
- Demonstrate application of evidence-based medical practice
- Demonstrate knowledge of current neurosurgical literature
- Apply knowledge to clinical practice
Interpersonal and Communication Skills
- Demonstrate a high level of interpersonal communication skills within the neurosurgical team as well as with patients and their families.
- Manage the efficient and effective flow of information between the neurosurgical team and attendings
Professionalism
- Demonstrate a high level of professionalism at all times
- Develop, nurture, and demonstrate high level leadership skills
Systems-Based Practice
- Demonstrate understanding of legal issues in neurosurgery
- Demonstrate a high level of understanding regarding practice types, medical economics and medical politics
- Incorporate evidenced-based methodologies on an ongoing basis to the clinical practice of neurosurgery
- Practice cost-effective neurosurgery
Evaluation Process
The Fellow will be evaluated semiannually by the Director of the Stereotactic and Functional Fellowship program and members of the neurosurgical faculty team participating in the care of patients on the functional service.
Teaching Staff
George Mandybur MD, Director, Division of Stereotactic and Functional Neurosurgery
John M. Tew, MD, Medical Director, The Neuroscience Institute
Mario Zuccarello, MD, Director, Division of Cerebrovascular Surgery
Jeffrey T. Keller, PhD, Director, Division of Education
Philip Theodosopoulos, MD, Director, Division of Skull Base Surgery
Charles Kuntz, IV, MD
Andrew J. Ringer, MD
Ronald E. Warnick, MD
Hwa-shain Yeh, MD
Contact
University of Cincinnati College of Medicine
Department of Neurosurgery
231 Albert Sabin Way
PO Box 670515
phone 513-558-5387
fax 513-558-4878
Director: George Mandybur, MD, FACS
Alternate Program Contact: Jeffrey T. Keller, PhD
