Junior resident growing interested in peds spine. Ideally would like to make this a part of a future peds practice.
1) From what I have seen, typically dominated by ortho. Is this just a training issue? (Ortho typically does peds spine fellowships?) Can neuro get in on the fun with fellowship or is this a political issue?
2) Is compensation more peds or more spine?
3) Possible to do this alongside peds or is it its own thing?
Any other guidance welcome.
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Neuro can definitely break into that world. Best option is to apply for a fellowship in it (often it is possible to do some of this infolded). Philly Shriner's is a great option, but you need to apply early so I would reach out for their timeline. There are others that are either NSG specific or at least open to neurosurgery, so I would look at neurosurgeons in the field and inquire about their training (or look at their bios for hints).
More spine in terms of per case, but volume is still peds
You can do it alongside peds. Or you can do adult/peds scoli, if concerned about question #2. Hard to be pure anything in peds.
What fellowship do you need to do? Will any complex spine do or are there specific ones to help you break in? Looked at the Shriner one, just seemed to be part of a complex spine fellowship that allowed some sort of customization. I imagine they are competitive since it’s fairly niche — is this like the comp. vasc/skull base that essentially are locked in during PGY-4 year?
Thanks for the info, am planning on finding a mentor but trying to figure out who to contact/what direction to take this.
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You need a pediatric deformity fellowship. Adult deformity is very different as it is primarily a sagittal balance issue with max hardware. In contrast peds is mostly coronal and rotational and the hardware tends to be much more conservative in amount. You also will need to learn about the non-operative management of scoliosis such as bracing and casting. If all you want to do is a few microdiscs and the occasional spine trauma then obviously you don't need it, but scoliosis is the major market for spine in peds. Many of them are locked in early, though I don't know if that in itself is a metric of competitiveness.
Consider doing an orthopedic spine fellowship (has to be a post-graduate/ PGY8 fellowship) in an institution that provides both adult and pediatric deformity experience. It goes through the SF match, so you will be applying during your early PGY6 year. The good thing about it is that even the most competitive fellowships can't be locked in years in advance because it is a match violation (at least not officially locked). There are programs that offer adult and pediatric training, sometimes by the same faculty (which I find impressive, and is what I want to do for my career), or separate faculty (adult-only or pediatric-only). The programs that offer adult and pediatrics include: Columbia, WashU, UC Davis, Penn/Shriner's, San Diego Spine.
From my experience going through the SF match, they value neurosurgery applicants because they know we bring a lot of experience and they don't have to teach us most of the basics, and can just focus on the complex parts of the cases.
What’s the general gist of enfolded vs PGY8 fellowship? Seems most academic centers don’t respect enfolded in terms of career trajectory due to lack of operative experience at the level, but seems like you could really accelerate along the trajectory if your institution actually taught you to operate in PGY2-4.
Postgrad fellowships are "preferred" for the exact reason you mentioned. Some programs have their research/elective years as early as PGY 2 or 3 so obviously you can't say you did a fellowship as a junior resident. Now, this is not mandatory. So it all depends where you wanna end up. I know attendings who did enfolded fellowships and now have academic jobs, but in general most big names and academic centers prefer post grad.
I believe Oklahoma with Andrew Jea may offer a peds neurosurgery fellowship with a specific focus on deformity, so you may be able to do it all in one year (as opposed to doing peds fellowship and then also a spine fellowship).
Columbia also offers an Avanced Pediatric Spine Deformity Fellowship. You need a previous peds fellowship or spine fellowship.
Now, remember, if you don't do peds neurosurgery fellowship, you can't be board eligible for peds.
