The Neurosurgical Peripheral Nerve Fellowship in the Department of Neurosurgery at Washington University School of Medicine is a CAST-accredited one-year intensive fellowship in the surgical and medical management of peripheral nerve disorders. This is a combined fellowship led by Wilson Ray, MD, with the additional expertise of orthopedic hand surgeon Martin Boyer, MD. Additional faculty include: pediatric neurosurgeon T.S. Park, MD, orthopedic hand surgeon David Brogan, MD, and orthopedic hand surgeon Christopher Dy, MD.
Our fellowship for 1 year is divided between core training of 6 months during the clinic portion; the fellow will participate in 3-month long rotations. The fellow will spend time with both neurosurgeons and orthopedic hand surgeons to develop well-rounded and comprehensive management skills both in and out of the operating room. The fellow will be integrated into the multidisciplinary approach to patient management and surgical care of peripheral nerve disorders. During the elective component, the fellow can complete 2 additional 3-month clinical rotations like the ones described above. Additional rotations are with the program director and other neurosurgery and orthopedic faculty, or in a peripheral nerve basic science laboratory. Fellows interested in complex spine operations will have the opportunity to spend 3 – 6 months doing complex spinal deformity and minimally invasive spine procedures. The rotation schedule can be tailored to the individual interests of the incoming fellow.
Call will be taken from home, and there is no required hand or reconstruction call that is required of the peripheral nerve fellow. The peripheral fellow will be expected to be available or in rare instances a peripheral nerve urgent case needs to be completed.
Didactic training conference, seminars, journal clubs, cadaver courses, and one-on-one instruction are an important part both residency and fellowship education at Washington University in St. Louis. The peripheral nerve fellow will be expected to participate in this didactic training as well as to serve in a role of teaching more junior residents. There are 2 one-hour conferences each week and 1 monthly conference that would include neurosurgery and orthopedic conferences. The fellow when available will be required to attend these conferences when on the appropriate service. The monthly multi-disciplinary peripheral nerve conference is a didactic case based conference where presentation of upcoming or recently completed cases are presented by the faculty. This occurs on the first Tuesday of the month from 6:15 a.m. to 7 a.m. The neurosurgery case clinical conference is weekly and it is from 5 to 6 p.m. This a case-based presentation conference of cranial, spinal and peripheral nerve cases for both fellows and residents. On Wednesday, we have grand rounds from 7 to 8 a.m. Additional didactics that are available, but not required, are the core curriculum didactic lectures, preoperative conferences, journal club, and M&M conferences. There are occasions where the fellow will be asked to lead the resident conference and teaching of the junior residents.
There will be research training or research opportunities. The fellow will be able to complete basic science research projects with research mentors during the fellowship. The fellow will meet with Dr. Ray to devise a plan for clinical and research endeavors and discuss opportunities for research in the various basic science labs. Potential mentors from both neurosurgery and orthopedic surgery, as well as basic science departments, will be reviewed with the fellow at that time. The fellow is expected to work with Washington University medical students and neurosurgery residents on these projects.
Washington University enjoys a wide range of clinical pathologies from both common-place carpal tunnel release to more unusual large brachial plexus reconstructions with nerve transfers and nerve grafting procedures. The fellow will have ample opportunity to participate in both inpatient and outpatient management of various pathologies, seeing this from multiple viewpoints of both orthopedic and neurosurgical strategies. At the conclusion of the fellowship, the fellow will have mastered patient selection in regard to surgery operative decision-making and the technical details of microsurgery and taking care of all peripheral nerve pathologies.
Eligibility Criteria and Contact
Applicants must be trainees in or graduates of an ACGME-approved neurosurgery residency training program and be able to meet the criteria for an unrestricted Missouri medical license. A personal visit to our department and an interview are required. Interested applicants should apply by sending a cover letter and curriculum vitae.