Enfolded Spine Fellowship

[Guest]

(06-14-2018, 02:03 PM)Guest Wrote: Anyone know of any programs that offer an enfolded spine fellowship? The only one I've come across is Louisville so far. All the others want someone that has completed residency training.

Pitt, Barrow, Cleveland Clinic. I think one of the recent Hopkins grads had completed one too.

[Guest]

A post grad spine fellowship is not necessary, even for academic positions, just look at the spine faculty at any academic institution for examples. It can make you more competitive in terms of CV and connections, but if you already have a strong CV lack of fellowship won't hold you back.

[Guest]

(06-15-2018, 09:03 AM)Guest Wrote: This is in no way a dig at the specialty, but spine is not like skull base, I.e., by the time you are a pgy 5-6 you should have the skills to do reasonably complex spine with some measure of independence. Thus, unless you want to do massive deformity corrections, an enfolded spine fellowship should prepare you adequately for life after residency, particularly if you're going into privately practice. Warranted or not, this is why people snicker at post-grad spine fellowships, because it shouldn't be necessary.

Couldn't you say the same thing for any subspecialty?   during residency shouldn't we all be able "to do reasonably complex" cases?  "Particularly if you're going into private practice" you won't be doing "like skull base".

[Guest]

(06-16-2018, 09:42 AM)TGuest Wrote:

(06-16-2018, 07:43 AM)Guest Wrote:

(06-15-2018, 09:03 AM)Guest Wrote: This is in no way a dig at the specialty, but spine is not like skull base, I.e., by the time you are a pgy 5-6 you should have the skills to do reasonably complex spine with some measure of independence. Thus, unless you want to do massive deformity corrections, an enfolded spine fellowship should prepare you adequately for life after residency, particularly if you're going into privately practice. Warranted or not, this is why people snicker at post-grad spine fellowships, because it shouldn't be necessary.

Good luck getting an academic spine position without a postgraduate fellowship. Some programs a skull base fellowship isn’t required either. But those guys aren’t graduating and taking top level academic jobs.

You're an idiot anyway if you want an academic spine job.  Half the pay for the same work.  Spine is spine  it's not that hard.

Ok. Make sure your mentors know you have this mentality and hold out hope they don’t have the same. You might not like spine, but no reason to put down someone’s career choice because they like research and teaching.

[Guest]

(06-19-2018, 07:29 AM)Guest Wrote:

(06-15-2018, 09:03 AM)Guest Wrote: This is in no way a dig at the specialty, but spine is not like skull base, I.e., by the time you are a pgy 5-6 you should have the skills to do reasonably complex spine with some measure of independence. Thus, unless you want to do massive deformity corrections, an enfolded spine fellowship should prepare you adequately for life after residency, particularly if you're going into privately practice. Warranted or not, this is why people snicker at post-grad spine fellowships, because it shouldn't be necessary.

Couldn't you say the same thing for any subspecialty?   during residency shouldn't we all be able "to do reasonably complex" cases?  "Particularly if you're going into private practice" you won't be doing "like skull base".

I think it has more to do with numbers, e.g., everyone and their mother (literally) has degenerative spine disease, so any reasonable academic medical center should provide you with the skills to treat and manage the spine when you're out practicing in the community. Compare that to brain tumors or aneurysms, where even though referrals are typically concentrated to the big name academic medical centers, as a resident it's pretty rare to be knocking out multiple GBMs in a week.

[Guest]

Spine is a rapidly evolving field. Yes, after residency you will be able to do bread and butter plus some complex spine. However, there is a huge range of skill sets in spine that fellowship will expand, e.g. XLIFs, ALIFs, OLIFs, endoscopic, adult deformity, pediatric deformity, and advances in spinal-oncology. Just like for skull base in residency you may learn OZs, retrosigs, and far-laterals but you need fellowship to expand your tool sets into the vast number of skull base approaches.

[Guest]

On all of my subI’s I didn’t see a single god damn ACDF on the schedule.

[Guest]

(01-11-2019, 10:52 PM)Guest Wrote: On all of my subI’s I didn’t see a single god damn ACDF on the schedule.

If you rotated at big-name academic powerhouses you probably didn't. In any metropolitan area of decent size, the "bread and butter" neurosurgery cases are already snapped up by the private practice guys. A 2-level ACDF pays equal or better to an aneurysm clipping; you wouldn't want to take on the risk of doing that case when you can knock out multiple spine cases in a day and they all go home and send you a fruit basket when their back pain gets better.

Any decent residency will teach you to do an ACDF. A lot of them will send you to a satellite hospital or a VA to learn that kind of thing, but it'll happen.

[Guest]

That's impressive that you can cure someone's back pain well enough with a two level ACDF to get a fruit basket.

[Guest]

Spine is a rapidly evolving field. Yes, after residency you will be able to do bread and butter plus some complex spine. However, there is a huge range of skill sets in spine that fellowship will expand, e.g. XLIFs, ALIFs, OLIFs, endoscopic, adult deformity, pediatric deformity, and advances in spinal-oncology. Just like for skull base in residency you may learn OZs, retrosigs, and far-laterals but you need fellowship to expand your tool sets into the vast number of skull base approaches.