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Curriculum

Clinical training

The training for Mayo Clinic’s Cerebrovascular, Endovascular and Skull Base Fellowship consists of 29 months of clinical training, complemented by didactic and research experience. 

Rotation schedule

This three-year fellowship provides exposure to cranial base and vascular neurosurgery as well as neurointerventional (endovascular) surgery. To best integrate the clinical care, procedural skills, and research skills, the following schedule will be followed:

  • Clinic: One day per week
  • Operating room: Two days per week
  • Interventional suite: One day per week
  • Research and administrative time: One day per week

Rotation schedule by year

RotationPGY-8PGY-9PGY-10
Endovascular 6 months 8 months 6 months
Vascular Cranial Base 4 months 2 months 4 months
Research 2 months 2 months 2 months

Rotation description

A minimum of 18 months of training will be spent in a clinical cerebrovascular, endovascular and skull base (CES) experience under the mentorship of faculty. This period of time will provide the trainee with an organized comprehensive and supervised education experience in the field of CES. This will include a holistic integrative approach to patient care, diagnostic modalities, the performance of surgical procedures, and the integration of non-operative and surgical therapies into clinical patient management.

Call frequency

The fellow will take Q2 call with no in-house call.

Goals and Objectives

  • Receive broad exposure to clinical evaluation and appropriate patient selection for operative and non-operative management in both the inpatient and outpatient settings.
  • Expanded and cultivated knowledge and skills developed during residency in the diagnosis, treatment, and management of cerebrovascular and skull base diseases.
  • Actively participate in the operative management of a wide range of cerebrovascular conditions including both extracranial and intracranial vascular diseases and abnormalities, skull base pathologies, complex intra-axial tumors, and critical care management of the complex neurosurgical patient.
  • Take part in clinical, anatomic, and neuroscience research as an integral component of the educational experience.
  • Gain training and experience in the:
    • Signs and symptoms of disorders amenable to diagnosis and treatment by advanced microsurgical, endovascular, endoscopic, and skull base techniques;
    • Pathophysiology and natural history of neurovascular and neuro-oncological disorders;
    • Indications for and contraindications to vascular and skull base surgical procedures;
    • Clinical and technical aspects of neurovascular and skull base surgical procedures;
    • Medical and surgical alternatives;
    • Preoperative and postoperative management of neurovascular and skull base surgical patients;
    • Neurointensive care management;
    • Fundamentals of imaging physics and radiation biology; and,
    • Interpretation of neuroangiographic studies and advanced neuroimaging pertinent to the practice.

Research training

The wealth of surgical material at Mayo Clinic offers abundant opportunities for research projects. Mayo Clinic researchers collaborate with large active clinical and research groups in several subspecialty areas.

Fellows are required to invest time in research and professional articles. When assigned to research, the surgical fellow: 

  • Presents research findings at interdepartmental and interdisciplinary conferences.
  • Contributes to the education of medical students, residents and other health care providers.

Didactics

The fellowship program will have regular dedicated teaching conferences with participation of the fellow and the associated faculty. Participation in conferences of other affiliated disciplines such as ENT skull base, NeuroOncology (brain tumor), and vascular neurology conferences is expected.

The fellow will participate in all standing neurosurgery conferences including M&M, case review conference, and vascular and cranial base conferences. The fellow will also participate in neuroscience grand rounds, and neuroscience MERIT conferences.

Teaching opportunities                                                                                              

Opportunities are available to teach rotating residents and medical students.

Case logs

The fellowship program director will maintain accurate case logs of all CES cases operated annually within the institution and the subspecialty experience of the fellow.

The fellow will maintain an accurate prospective case log of his/her operative cases throughout the fellowship which documents all operative cases and the level of responsibility in the case (assistant versus primary surgeon).

Clinical experience and education

Clinical experience and education and work conditions for subspecialty fellows will be consistent with ACGME institutional and program requirements for residency training in neurological surgery

Evaluation

To ensure you acquire adequate knowledge and develop the appropriate technical skills to meet program expectations, performance is monitored during the Cerebrovascular, Endovascular and Skull Base Fellowship.

You are formally evaluated by supervising faculty members after each clinical rotation and meet with the program director on a semi-annual basis to review your performance. In addition, you regularly evaluate the faculty to confirm that your education needs are being met.