NEUROLOGICAL SURGERY TRAINING PROGRAM

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NEUROLOGICAL SURGERY TRAINING PROGRAMUniversity of Miami - Jackson Memorial Medical CenterRoberto C. Heros, M.D.,Co-Chairman & Program DirectorBarth A. Green, M.D.,ChairmanProgram OverviewThe neurosurgical training program at the University of Miami/Jackson MemorialMedical Center provides an encompassing clinical experience, rich research opportunities andthe dedication of its faculty to resident education. As the only university medical center inSouth Florida, we directly serve a three county referral area of 4.5 million people. We alsoreceive complicated neurosurgical referrals from around the U.S., Latin America theCaribbean and Europe. Our greatest source of pride is the quality and major contributionsof our residents and fellows to our neurosurgical team.Spine ServiceDr. Barth Green, Dr. Allan Levi, Dr. JamesGuest and Dr. Steven Vanni focus on spinalcord injury and spinal surgery. These dedicated neurospine surgeons have one of thebusiest complex spinal surgery practices inthe country, and also have active basic science laboratories looking at spinal cord regeneration. Dr. Green, as the President of theMiami Project, directs the applied researchprograms of The Miami Project to Cure Paralysis, including clinical neurophysiology, bioengineering and reproductive physiology. Dr.Levi also maintains a busy peripheral nervepractice, which includes a significant numberof complex brachial plexus surgeries.President of the AANS, the Academy of Neurological Surgeons and was this year’s CNS’sHonored Guest. Clinically, he concentrates incerebrovascular and skull base surgery. Dr.Jacques Morcos is highly skilled in both complex cerebrovascular surgery and the management of skull base tumors. He directsthe microsurgical and skull base laboratorywith Dr. Ernesto Coscarella. Dr. Alois Zauneris the Director of Endovascular Neurosurgeryand performs all interventional and diagnostic neuroangiography, as well as open microvascular surgery.Cranial ServiceDr. Roberto Heros joined the department in1995 as Co-Chairman and Director of the Residency Training Program.He has been very active in national leadership positions and is pastNSD 1

Radiosurgery ProgramPediatric Neurosurgery ProgramDr. Howard Landy directs programs in neuro-oncology and Gamma Knife surgery. Active clinical and laboratory studies relate toradiobiology of gliomas and convection chemotherapy. Many of our surgeons, includingDrs. Morcos, Jagid and Ragheb, are skilledin Gamma Knife and Cyber Knife to providecomprehensive care in the treatment of tumors and vascular malformations.Drs. John Ragheb, Glenn Morrison, Greg Olavarria, Sanjiv Bhatia and David Sandbergmanage our busy Pediatric NeurosurgicalService. The broad scope of their practiceincludes brain tumors, developmental disorders, pediatric spine and vascular, pediatrictrauma and critical care, and a nationallyrecognized multidisciplinary epilepsy service. The Pediatric Service covers both Jackson Memorial Children’s Hospital and MiamiChildren’s Hospital.Head Trauma ServiceDr. Philip Villanueva directs the Neurotrauma Service, in collaboration withtheCo-Director,Dr.JonathanJagid, at Ryder Trauma Center.They areactively involved in management of our 24bed neurosurgical intensive care unit and perform both basic science and clinical research inhypothermia and the metabolic effects oftraumatic brain injury.Functional Surgery ProgramDr. Jonathan Jagid directs the functionalprogram, including deep brain stimulationand stereotactic surgery. He has an activeclinical and research program in Parkinson’sdisease and other movement disorders. Drs.Ragheb and Bhatia maintain an adult epilepsy practice in addition to their pediatricpractice.NSD 2Neuro-Intensive Care ProgramDr. Stephen Olvey, Director of the Neurosurgical ICU, is a recognized expert in criticalcare management of neurological injuries.He is internationally respected as a pioneerin motor-injury sports medicine. Dr. Landy isalso actively involved in neuro-intensive care.

The Miami Project to Cure ParalysisThe Miami Project, directed by Dr. Dalton Dietrich, is a comprehensive scientific researchprogram focused on spinal cord injury. Thecutting edge research conducted at the LoisPope Life Center, encompasses every aspectof neuroscience, from molecular and cellularbiology to tissue transplantation and regeneration to physiology and functional studies which are then translated into the clinical arena. A multidisciplinary team of basicscientists and clinicians work together in aunique, integrated environment under theauspices of the Department of NeurologicalSurgery. Our Program presently ranks thirdin the nation in NIH funding.An internationally recognized neuroscientistand Vice-Chairman for Research, Dr. DaltonDietrich serves as a liaison between the clinicaland research faculty of the Department, assisting each resident in planning and implementingtheir 1 or 2 year research program. The MiamiProject is a center of neuroscience excellenceand an important resource for the neurosurgicalresident.NSD 3

Clinical FacilitiesThe neurosurgical training program beganin 1959 as a division of the Department ofSurgery, and became an autonomous Department in 1971. The adult neurosurgical service at Jackson Memorial Hospital issituated on the seventh, eighth and ninthfloors of the West Wing of the hospital. Theseventh and ninth floors are each 36-bedpatient care units . The eighth floor is the 24bed Neurosurgical Intensive Care Unit, whichprovides all aspects of critical care Management. Pediatric patients are housed on thefifth and sixth floors and the Neonatal andPediatric Intensive Care Units of Jackson’sChildren’s Hospital and at Miami Children’sHospital. There are more than 3,800 majorneurosurgical procedures performed by theservice each year.The NSICU, directed by Dr. Olvey, provides the resident with in-depth trainingin all aspects of critical care medicine. Thefivenew dedicated neurosurgical operating rooms provide support for all modern neurosurgical techniques. The RyderTrauma Center contains separate dedicatedoperating rooms used for acute head injuries.The Gamma Knife Institute is a state-of-theart stereotactic radiosurgery facility and anaffiliated Cyber Knife facility is located nearby. In addition, a new state-of-the-art microsurgical skull base laboratory, led by Dr. Morcos,NSD 4is shared with the Department of Otolaryngology. The neurosurgery laboratory providesresidents with the opportunity to practice microsurgical techniques, such as micro-anastomosis, in experimental animals.Jackson Memorial Hospital (JMH) is one of thelargest and currently the busiest hospital inthe United States. JMH, Veterans Administration Hospital, University of Miami Hospitaland Clinic, Sylvester Comprehensive CancerCenter, and Bascom Palmer Eye Institute arewithin a two-block area in the center of theCity of Miami. The Miami Children’s Hospital is 20 minutes away and complements theresident’s pediatric experience.The Neurosurgical Program’s broad patientpopulation provides residents with exposureto an extraordinary range of neurosurgicaldiseases and injuries. The clinical facultyrepresents all major areas of neurosurgicalexpertise and is highly committed to maintaining a world-class training program. SouthFlorida offers excellent quality of living anda wealth of recreational and cultural opportunities.

Residency RotationsTworesidentsarechoseneachyear for this training program, designed to provide preparation for acareer in academic neurosurgery. Residentsmatched in neurosurgery are automaticallyaccepted for a PGY-1 position; divided into6 months of general surgery, 3 months of neurointensive care and 3 months of neurology. Thisis followed by six years of neurosurgicaltraining (PGY-2 through PGY-7).The first two years of neurosurgical training (PGY-2 and PGY-3) consist of 3 monthblocks in the following subspecialties: cranial, spine, neurotrauma, pediatrics, neuroendovascular and the VA Hospital.The PGY-4 and PGY-5 years consist of at leastone year of supervised research with the aid of afaculty mentor. In the fifth year, the resident hasthe option of continuing in an approved research project or achieving special clinicalcompetence through a one-year in-residency “fellowship” in an area of the resident’schoosing such as spine, neuroendovascularor neurotrauma.The PGY-6 year is spent receiving intensivesurgical training on the Spine and Cranial services. The PGY-7 year is the chief residencyat Jackson. The Chief Residents organize theoperating schedule and spend six months asChief of the Cranial Surgery Service and sixmonths as Chief of the Spinal Surgery ServiceConferencesBoard Examination RequirementsAll Residents are required to take the AmericanBoard of Neurological Surgery writtenexamination annually. Satisfactory progressmust be shown before the resident advances tothe next level of training. The examination mustbe passed for credit prior to the chief residency. We also hold “mock” oral boards to help allour residents prepare for when they taketheir examinations.NSD 5

ConferencesHubert Rosomoff Research DayNeurological Surgery Grand Rounds areheldweekly and include topics in theConferencesfields of neurology, neuro-oncology, epilepsy, neuro-ophthalmology, neuroradiology, neuro-otology, neuro-endocrinologyand neuropathology. Journal Club and Morbidity & Mortality Conference are incorporated into the Grand Rounds schedule.We also invite nationally and internationallydistinguished visiting professors to speak intheir specific area of expertise. Dr. Heros conducts a service report and teaching conferencethree times a week and Dr. Levi runs a weekly joint spine conference with the orthopedicspine service. Chief Residents hold a weeklyresident conference aimed at preparation forwritten boards.This annual event includes presentations oforiginal research by the residents, fellows,and clinical faculty, as well as visiting professors. The day is named in honor of the longcareer in clinical research of Dr. Rosomoff,the department’s retired Chairman Emeritus.NSD 6Neurosurgery OlympicsEvery year we participate in Neurosurgery“Olympic Events”, which are organized for allour residents, fellows and clinical faculty. Wecompete with the University of Florida for statebragging rights. The event promotes fitness,fun and comradery.

FELLOWSHIP PROGRAMS IN NEUROLOGICAL SURGERYSpine SurgeryNeuroendovascularFellowship positions are available which provide extensive exposure to all facets of modern spinal surgery. Experience is gained intrauma, degenerative and vascular disease,and tumor surgery utilizing state-of-theart techniques in instrumentation, microsurgery, and neurophysiologic monitoring.Fellows work primarily with Drs. Green, Leviand Vanni, and also have regular interaction with the rest of the faculty. Extensiveresearch oppor-tunities are available.The goal of the fellowship is to train Neurosurgeons, Neurologists and Radiologists tobecome fully trained in Neurointerventionalprocedures over a period of 2 years. Approximately 900 cases per year are performed atJMH out of which, 350 are major interventional procedures. The fellow works mainlywith Dr. Zauner but will also have regular interaction with the rest of the Neurosurgery,Neurology and Radiology staff. Extensive research opportunities are available.Pediatric NeurosurgeryPediatric Neurosurgery FellowshipThis is a one year clinical fellowship working with the joint Division of Pediatric Neurosurgery of the Miami Children’s Hospital andJackson Memorial Hospital, which is available only to neurosurgeons that have completed general neurosurgery training. Thefellow will work with the five full-time pediatric neurosurgery faculty on the over 700hundred pediatric surgical cases annually.There are opportunities for basic as well asclinical research during the fellowship as wellas an extensive conference schedule.Cerebrovascular and Skull Base SurgeryNeurosurgical Intensive Care UnitThe 24-bed Neurological Intensive Care Unitcares for the entire spectrum of neurosurgical disease and has a staff of intensivistsdirecting patient management. Positions androtations may be available to physicians during or after neurosurgical residency training.Extensive research opportunities are available.This fellowship program provides exposureto an aggressive surgical service treatingthe entire gamut of cerebrovascular diseaseand a wide spectrum of skull base tumors.The fellow works mainly with Drs. Heros andMorcos but also have regular interaction withthe rest of the attending staff. The skull baseanatomy and the microsurgical laboratoriesare available to the fellows and clinical research initiatives are encouraged.NSD 7

University of Miami - Jackson Memorial Medical CenterNeurosurgical FacultyFull-time Clinical FacultyBarth A. Green, M.D.Roberto C. Heros, M.D.Sanjiv Bhatia, M.D.Jonathan R. Jagid, M.D.James D. Guest,M.D.,Ph.D.Howard J. Landy, M.D.Allan D. Levi, M.D., Ph.D.Jacques J.Morcos, M.D.Glenn Morrison, M.D.Greg Olavarria, M.D.Stephen E. Olvey, M.D.John Ragheb, M.D.David Sandberg, M.D.Steven Vanni, D.O., D.C.Phillip A. Villanueva, M.D.Alois Zauner, M.D.Full-time Research FacultyW. Dalton Dietrich, Ph.D.Mary Bartlett Bunge, Ph.D.John R. Bethea, Ph.D.John Bixby, Ph.D.NancyBrackett, Ph.D.Mary J. Eaton, Ph.D.Ernesto Coscarella, M.D.NSD 8Ian Hentall, Ph.D.Mark Nash, Ph.D.Brian R. Noga, Ph.D.Jacqueline Sagen, Ph.D.Christine K. Thomas,Ph.D.Pantelis Tsoulfas, M.D.Eva Wiedersrtrom,-Noga, DDS, Ph.D.Patrick M. Wood, Ph.D.Damien D. Pearse, Ph.D.Vance Lemmon, Ph.D.Barbara Grimpe, Ph.D.Helen M. Bramlett, Ph.D.Daniel Liebl, Ph.D.For application requirements,please contact Ingrid Menendez,Residency & Education Manager viaTel./Fax (305) 243-6751 or iami.eduDepartment of Neurological Surgeryc/o Ingrid Menendez, 2nd FloorLois Pope LIFE Center1095 N.W. 14th TerraceMiami, FL 33136

Neurological Surgery Grand Rounds are held weekly and include topics in the fields of neurology, neuro-oncology, epi-lepsy, neuro-ophthalmology, neuroradiol-ogy, neuro-otology, neuro-endocrinology and neuropathology. Journal Club and Mor-bidity & Mortality Conference are incor

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