Spinal Disorders Fellowship
APPLY & Program Information
The Department of Neurological Surgery, part of the Vickie and Jack Farber Institute for Neuroscience at Jefferson, is pleased to offer a one-year, SNS/CAST-approved fellowship in Spine and Peripheral Nerve Surgery. The Division of Spine and Peripheral Nerve Surgery is one of the pillars of the Department of Neurosurgery with seven faculty members specializing in complex disorders of the spine and peripheral nervous system.
The Department of Neurosurgery collaborates closely with the orthopedic spine surgeons of the nationally-acclaimed Rothman Orthopaedics. There is a joint morning case conference held every weekday and joint operative cases occur almost daily.
We consider our fellowship a “finishing school” for surgeons often exposed to spine surgery in their residencies. Fellows can expect to be exposed to a broad diversity of pathology and a variety of management techniques with escalating levels of autonomy. Moreover, equal emphasis is applied to clinic and the OR with the conviction that good clinical decision-making and indications are central to achieving good outcomes. Fellows spend most of their time at the main campus though some exposure to community care facilitates skills in practice development and management.
To apply to the Spine and Peripheral Nerve Surgery Fellowship Program, please send CV to Michelle Hoffman.
About the Service
Jefferson is home to one of the busiest spine services in the country. In addition to a busy elective service, Jefferson is both a Level I trauma center and part of the Delaware Valley Regional Spinal Cord Injury Center (DVRSCI). The DVRSCI is one of just fourteen federally-designated SCI centers and the only one serving greater Philadelphia; it is the longest running such SCI center in the country.
On a typical weekday there will be four-six neurosurgical spine ORs running with two-two cases each. Fellows typically spend two or three days per week in the operating room and will get exposure to both open and MIS treatment of degenerative disease, trauma, deformity, tumor, infection and intradural and peripheral nerve pathologies. A variety of anterior, lateral and posterior approaches are used routinely.
Outpatient management is one of the hardest parts of spine surgery and probably the biggest deficit that most residents have coming out of residency. Successful outcomes depend centrally on solid indications and decision-making.
Fellows typically spend one-two days per week in clinic with an assigned faculty member. This permits the discussion of cases, indications and management options that is central to development of outpatient management skills.
They spend time both in the clinic at the main campus downtown and also in a variety of Jefferson neurosurgery clinics in the Philadelphia region.
At any given time the neurosurgical spine service consists of two spine fellows, one chief resident, two-three senior resident, two-three junior residents, one intern and a variable number of sub-interns and third-year medical students. In addition the neurosurgery service employs several nurse practitioners who facilitate the day-to-day care of inpatients on the service.
Fellows are expected to demonstrate engagement and ownership of inpatients, particularly the patients they operated on. To provide optimal care, all patients in an ICU are co-managed by the neuro-critical care service. Patients on a stepdown unit or telemetry unit, including the Comprehensive Spine Unit, are co-managed by a team of neurosurgery-dedicated hospitalists and nurse practitioners.
Often times, operative spine trauma cases and other complex spine cases are performed jointly by the neurosurgery and orthopedic spine surgery services. During these cases our fellows are exposed to the surgical techniques and nuances of the orthopedic faculty. On some occasions, our fellows have opted to use some of their academic days to work with orthopedic faculty in the operating room.
In the operating room, fellows will often work with junior and senior residents closely to cultivate teaching skills.
The neurosurgical and orthopedic spine surgery services rotate alternate weeks covering “primary” and “secondary” spine call. Fellows will typically be on backup call during weeks/weekends in which neurosurgery is covering primary call and have the option to come in for interesting operative cases that present overnight or during the weekend. They have no first-call responsibilities. Fellows typically participate in morning rounds with the on-call attending and residents one weekend a month.
Most of our fellows have been extremely productive academically in their time at Jefferson. One day per week is dedicated as an academic day. The fellows work closely with the residents on the spine service and residents in our program interested in spine careers to generate journal articles, abstracts, podium presentations and posters.
The orthopedic and neurosurgical spine services have a daily multi-disciplinary conference in which cases presenting to the hospital overnight and other complex cases are discussed. This conference, referred to as “bone board”, is a highly unstructured and interactive conference in which management options are discussed and refined In addition, we have a weekly “indications conference” specifically for faculty, fellows, residents and medical students on the neurosurgical spine service. This is a conference in which typically one case selected by a fellow is discussed in greater detail to review indications, management options and decision-making.
This is designed to be an informal conference in which the faculty discuss how they “think about this patient" and how they arrive at a surgical strategy. Finally, fellows will frequently attend a weekly neurosurgical case conference, grand rounds, M&M, etc. Finally, fellows will frequently attend a weekly neurosurgical case conference, grand rounds, M&M, etc.
Fellows are encouraged to submit abstracts to spine conferences. Travel expenses are covered for those meetings in which the fellow is presenting.
Three to four industry-sponsored cadaver labs are typically organized per year in which faculty work closely with the two fellows and a small handful of residents to review surgical techniques of particular interest to the fellows. These are either hosted at the nearby company cadaver lab or at Jefferson.
Fellows have the option of completing a rotation at Shriners Hospital of Philadelphia. The rotation typically consists of one operative day and one clinic day per week for three months though there is flexibility in this arrangement. This opportunity provides exposure to decision-making and management in the field of pediatric spinal deformity.
Jefferson has a broad clinical footprint throughout the region and frequently provides call coverage at a number of community hospitals. Board-eligible fellows have the option to get credentialed at these hospitals to provide call coverage from home and generate extra income. Fellows are not obligated to provide this coverage.
All candidates applying to the spinal section of the Department of Neurological Surgery must, as a requirement for application, meet all ABMS Specialty Board-related eligibility prerequisites required to enter training in the related specialty program at Jefferson.
Further, all candidates must satisfy the requirements of the State of Pennsylvania Board of Medical Licensure for appointment at the specific level of training for which the position is offered.
In addition, applicants must meet one of the following qualifications to be eligible to apply for the fellowship training program:
- Graduates of medical schools in the United States and Canada accredited by the LCME;
- Graduates of osteopathic medicine in the United States accredited by the AOA;
- Graduates of medical schools outside the United States who meet one of the following qualifications:
- Have received a currently valid certificate from the ECFMG
- Have a full and unrestricted license to practice medicine in a U.S. licensing jurisdiction.
- Graduates of medical schools outside the United States who have completed a Fifth Pathway program provided by an LCME-accredited medical school.
Applicants must also have completed a residency in neurological surgery at an ACGME-approved program in the United States. All prerequisite prior training must be successfully completed prior to beginning a fellowship in the Department of Neurological Surgery.
Most fellows are encouraged to begin their fellowships on August 1 and end on July 31 of their corresponding year. Exceptions have been made depending on circumstances (typically to start July 1 and end June 30) and will be considered. Fellows have two weeks of vacation per year.
Spinal Disorders Fellowship
Resident Applicants are encouraged to submit applications two years before their intended fellowship year although earlier submissions will be accepted. Candidates will be invited for interview approximately 18 months prior to their expected start-date and final selection of fellows will be made approximately 12-15 months prior to the start-date. Flexibility will be exercised depending on position availability and funding increases.
Fellowship applicants must submit the following documents for consideration:
- Current Curriculum Vitae
- Three letters of recommendation
- A Personal statement of approximately 500-1000 words describing career goals and motivators for pursuing a fellowship in spine and peripheral nerve surgery
All applications are initially reviewed by the fellowship directors, Srinivas Prasad, MD, MS and James S. Harrop, MD. The decision to offer an interview to an applicant is made by the Fellowship Director based upon the following criteria: academic credentials, ability, aptitude, communication skills, three letters of recommendation, and personal qualities such as motivation, honesty and integrity. Jefferson will not engage in or tolerate unlawful discrimination (including any form of unlawful harassment) on account of a person’s sex, age, race, color, religion, creed, sexual preference or orientation, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.
If you have questions about the program, please contact either:
Applications may be submitted in electronic or paper format. Please submit applications to both the program director and the fellowship director.