Goals & objectives of the fellowship
The overall goal of establishing RNZ fellowship is for the fellows to:
- Develop a broad knowledge base and gain extensive clinical experience in the management of wide of range of adult spine surgery and neurosurgery diagnoses.
- Become Experts in the surgical managements of patients with spine and neurosurgery diseases
- Become proficient in evidence-based approach to management of spine and neurosurgery patients
- Become proficient with latest best practices for Safety in Spine surgery by optimizing patient neurological safety with risk stratification and application predictive calculators
- Become familiar with image-guided interventional spine pain management procedures and safely use it in clinical practice with diagnostic and therapeutic applications
- Become Experts in the teaching of the principles of management of spinal and neurosurgery disorders to their colleagues and medical students.
- Participate in spinal and neurosurgery clinical research while improving research skills and furthering the development of the current body of knowledge concerning management of spinal disorders and neurosurgery.
Clinical training activities
1. Clinic and Surgical Exposures
Our Spine Fellows will be exposed to hundreds of spine surgical cases and hundreds of clinic patients with a broad spectrum of spine pathologies. The RNZ Fellowship program seeks to provide all Fellows with wide-ranging experience and thorough training in the diagnosis and treatment of the full spectrum of spine-related problems and disorders. To that end, the academic, clinical, and operative goals of the fellowship will include:
- Emphasis on proper patient evaluation, including physical and neurologic examination, diagnostic workup, image application, and treatment alternatives (both operative and non-operative).
- Regular and broad outpatient experience in the various spine clinics.
- Didactic lectures and case presentations delivered by both Attendings and Fellows (individually or together) for weekly and monthly conferences. This may include attendance of virtual conferences through linkage with American training programs.
- Six months of focused training on the basics of spine surgery (first half of fellowship). As their knowledge and experience grow, Fellows perform increasingly more complex aspects of spinal surgery, including but not limited to lumbar discectomy, lumbar pedicle screw insertion, and anterior cervical discectomy and fusion (including plating procedures).
- Six months of training achieving a more advanced understanding of the indications and outcomes of all spinal procedures (second half of fellowship). Fellows’ surgical experience will continually enlarge to encompass more complex spine procedures for the treatment of degenerative disc disease, deformity/scoliosis, and infection. Procedures include but are not limited to revision spine surgery, anterior and posterior spine surgery, minimally invasive techniques, and more complex spinal deformity surgery.
2. Educational Resources Available to the Fellows
A. Neurosurgery Teaching Faculty
- Canadian, USA, UK, and Nigeria trained Neurosurgeons with extensive experience in managing patients with spinal and neurosurgery disorders.
- Experienced in modern and complex spine surgery, including minimally invasive and endoscopic spine surgery, less invasive approaches to brain tumors and intracranial bleeds, neuroendovascular treatment of spinal and brain pathologies as well as peripheral nerve surgeries.
- Experienced in working with the latest diagnostic equipment such as CT, MRI, X-rays, IR Suite/Cath lab, and state-of-the-art theatre equipment and instruments.
- Established links to international departments of neurosurgery (e.g., Ochsner Health System/Tulane University; University of North Carolina, etc.), with opportunities to join clinical rounds virtually—neuroradiology, neuropathology, case discussion conferences, etc., and externships at these international departments.
B. Patient Load, Mix, and Procedures
RNZ Neuroscience will avail the Junior Fellows opportunities to be exposed to a whole spectrum of spine disorders ranging from degenerative spine diseases, spine infections, spine trauma, and spinal tumors, to spinal deformity. Our Surgeons are fellowship-trained in spinal pathologies and are board-certified Neurosurgeons. We utilize state-of-the-art surgical techniques, including image- guided microsurgery, and we apply minimally invasive techniques to reduce the morbidity of surgical procedures. Neurosurgery cases include brain tumors, trauma, and neurovascular pathologies. Currently, we perform about 200 neurosurgery and spine cases annually, and we expect to see a significant increase in the volume due to plans to hire more staff and our planned expansion to other hospitals in Lagos and Abuja.
C. Academic Events
- Weekly case discussion conferences.
- Weekly virtual conferences- e-spine conferences, e-neurosurgery grand rounds, e-neuroradiology conference.
- Monthly journal club.
- Bi-weekly lecture series.
- Access to e-library with subscriptions to Neurosurgery and Spine journals
- Research training and publications—Fellows will have access to clinical research opportunities. They will be expected to choose 1–2 research projects at the beginning of their fellowship, which must lead to the publication of at least one manuscript. They will also be required to present at least one abstract at a conference during the fellowship.
- Senior Fellows will participate in selected courses
3. Clinical Responsibilities of Junior Fellows and Their Supervision
Fellows function independently under the direct supervision of the Attending Neurosurgeon.
- On-call Responsibilities: The Spine Fellows equally share on-call responsibilities. Weekend call is shared between the Post-graduate Fellows (Senior Fellows) supported by the Pre-residency Fellows (Junior Fellows). While Junior Fellows may take first call (depending on service manpower demand), the Senior Fellows only take backup calls. The Senior Fellows are assigned weekly (Monday–Friday) calls for backup of the hospital service. Senior Fellows are expected to share coverage of
morning rounds on weekends on a rotational basis. - Clinic Coverage: Fellows may be able to have their own independent clinic under the supervision of the Attending Neurosurgeon. Complex cases are discussed with the Attending during each clinic. Attending Physicians should be available to cover all clinics. Fellows’ responsibilities for the patient include preoperative, operative, and postoperative care.
- Operating Room: The weekly schedule for the operative cases is discussed on Friday of the preceding week. The day prior to surgery, Fellows may discuss the cases on which they will be assisting the Attending Physician. Discussion includes the indication and the operative plan. If patients are inpatients, they should be interviewed and examined by the Fellow if possible.
- Case Log: All Fellows will be required to maintain a log of operative procedures. The Program Director reviews the case logs monthly and at Fellows’ semi-annual evaluations.
- Supervision: Every patient, whether seen in an outpatient clinic, treated in ambulatory surgery, or admitted to the hospital, is assigned an Attending Physician. This physician, the Attending of Record, is ultimately responsible for all care provided to the patient. It is the responsibility of the Fellow to ensure that the care plan developed for each patient is reviewed and approved by the Attending of Record. Likewise, any modification of the plan or significant change in patient
status is reviewed by the Attending of Record.
Hospital initial consults are initially evaluated by the Pre-residency Fellows (Junior Fellow) on-call, who then consults the post-residency Fellow (Senior Fellow) on- call. The Attending Physician is available for consultation to the Fellows as necessary. In the clinic, Senior Fellows may cover the Junior Fellows. Each clinic case is thoroughly discussed and planned with the Attending Physician.
Attending Physicians allow the Fellow to operate at their level of ability. Operative experience by the Fellow is at the discretion of the Attending Physician. This typically is limited at the beginning of the fellowship and increases as experience and skill increase and the Attending Physician becomes more comfortable with the Fellow’s overall competence.
A Fellow should endeavor to be present for surgical cases. When the Attending Physician determines that the Fellow has achieved a sufficient level of competence on the service, the Senior Fellow and the Junior Fellow should perform service cases (if coverage of other cases permits) under the direct supervision of the Attending.
Eligibility of candidates and applications
Applicants must
- Possess an MD or MBBS degree.
- Completed neurosurgery residency in an accredited program in Nigeria or any other Sub-Saharan African country.
- He or she must possess a full Nigerian medical license and have passed all required post-residency examinations.
- The candidate must also be interested and committed to expanding his/her expertise in Spine Surgery.
- Present a personal statement related to interest in Spine Surgery.
- 2–3 letters of reference relevant to a career in Spine Surgery.
Fill the application form
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