Clinical training

The one-year Peripheral Nerve Surgery Fellowship is divided between the core training (six months) and elective rotations (six months). At the beginning of the fellowship, you are expected to complete a one-week microvascular training course.

During the clinical portion of your training, you participate in three rotations. During these rotations, you are joined by a Mayo neurosurgery resident. You are integrated into the multidisciplinary approach to patient care of peripheral nerve disorders and their complex reconstructive needs.

For the elective portion of the training, you can select additional two-month rotations with the program director, with other neurosurgery staff (in other subspecialty areas), or orthopedics services, or on research (clinical or basic science). Previous fellows have opted for rotations in spine surgery or have done additional training to learn specific techniques such as sympathectomies, complex wrist surgery, and reconstructive surgery, or interpretation of MRI, ultrasound, or EMG.

Rotation schedule

An example rotation schedule:

Didactic training

Clinical conferences, seminars, small discussion groups, journal clubs and one-on-one instruction are all an integral part of the Mayo educational experience.

There are five one-hour conferences each week at Mayo Clinic Hospital, Saint Marys Campus. You are required to attend conferences related to peripheral nerve surgery and encouraged to attend other conferences as relevant to your career aspirations and background.

Specific neurosurgical conferences include:

• Core neurosurgical curriculum and didactic lectures
• Preoperative conferences
• Anatomy lab dissection
• Interactive discussion
• Role modeling by faculty
• Self-directed inquiry learning
• Oral case presentation and discussion
• Peer-group discussion
• Journal club
• Teaching rounds
• Morbidity and mortality conferences

Additional conferences

There are multiple departmental and subspecialty conferences held daily throughout Mayo Clinic that are open to neurosurgical residents and peripheral nerve fellows. Other conferences that may be of direct relevance to peripheral nerve fellows include those on topics such as hand surgery or neurology (EMG lab, peripheral nerve and radiology, including MRI and ultrasound).

Research training

You have opportunities to pursue clinical or basic science research projects with one or more mentors. This group includes staff neurosurgeons, orthopedic surgeons, general surgeons, neurologists, radiologists, and basic scientists.

It is required that all fellows submit or publish one manuscript a year. When these are accepted for presentation, there is a policy that allows fellows to present their work at national meetings. The average fellow publishes between six and 12 papers in the year and presents at several meetings.

Teaching opportunities

Fellows have many opportunities to teach other learners and faculty. These teaching opportunities may include formal or informal presentations at Mayo or national conferences, in the operating room, or the anatomy laboratory. Fellows are charged to perform dissections with residents as part of a review course for their board examination.

To recognize the fellow for teaching, he or she will be proposed for an appropriate academic appointment (instructor or assistant professor) in the Mayo Clinic College of Medicine and Science.

Basic science laboratories

Neurosurgery Regenerative Laboratory

This group engages in advanced research in regenerative neuroscience from the molecular to cell biological and integrative levels. Specific topics under investigation include molecular analysis of receptors and signal transduction mechanisms; axon guidance, target recognition and regeneration; formation and plasticity of synapses; control of neural cell fate; development of neural networks; and mechanisms controlling vascular development and regeneration.

The lab offers an integrated approach to training in modern neurobiology, utilizing molecular, biochemical and cell biological techniques as well as advanced optical imaging. Members of the lab have the opportunity to work closely with the spinal cord injury research team at Mayo Clinic.

Multidisciplinary Neural Regeneration Laboratory

This laboratory effort focuses on developing synthetic polymeric scaffolds and controlled delivery of bioactive molecules for peripheral nerve and spinal cord repair and regeneration. This National Institutes of Health-funded research endeavor combines strong collaborative efforts of neurosurgeons, neuroscientists, orthopedists, tissue engineers and cellular neurobiologists, and polymer chemists. The goal of this project is to introduce and commercialize biodegradable conduits for clinical use.

Evaluation

Fellows receive quarterly evaluations by the faculty and support staff and a formal evaluation at the conclusion of the fellowship. Fellows, like neurosurgery residents, have the opportunity to provide feedback regarding the fellowship program and its faculty.