Curriculum | GNI Neuro APP Fellowship

Module 1: Neurosurgery Foundations (Bootcamp)

Neuroanatomy & Neurophysiology: Identify key structures and their functions; explain CSF dynamics, intracranial pressure, and cerebral blood flow; apply knowledge to clinical cases.
Cranial Pathologies: understand traumatic brain injuries, intracranial hemorrhages, hydrocephalus, brain tumors, and Chiari malformation.
Vascular Pathologies: understand aneurysms, AVMs, carotid stenosis, stroke, headache syndromes
Spinal Pathologies: understand degenerative disc disease, herniated discs, stenosis, spondylolisthesis, spinal cord tumors, fractures, and spinal injuries; understand ASIA impairment grading and treatment options.
Functional Neurosurgery: understand movement disorders, pain syndromes, uses of deep brain stimulation (DBS), vagus nerve stimulation, and other surgical options.

Assigned readings from Greenburg’s Handbook of Neurosurgery
Lectures and online videos
Interactive workshops: hands-on sessions using 3D models for neuroanatomy, sessions with medical sales representatives to discuss bone flaps, coils, stents, spine hardware, etc.

Demonstrate technical proficiency with surgical assisting techniques, including retracting, suturing, and hemostasis.
Describe the steps involved in common neurosurgical procedures, including laminectomy, craniotomy, and ventriculoperitoneal (VP) shunt placement, and apply this knowledge during procedural assistance.
Demonstrate aseptic techniques and the use of neurosurgical instruments and equipment.

Demonstrate a thorough neurological examination.
Identify and manage common perioperative complications, such as surgical site infections, wound dehiscence, cerebrospinal fluid leaks
Analyze and compose a plan for neurosurgical consults and relay findings to the surgeon on-call.
Prepare presentations of assigned patients to discuss during rounds.
Place orders for patients, including imaging, medications, and consults.
Write a concise and organized patient note including history & physicals, consults, progress notes, and discharge instructions.

Case reviews: weekly review of common perioperative complications and management
Skills demonstrations: lumbar puncture, EVD placement, ICP monitoring, central and arterial lines.
Weekly Greenburg readings

Weekly case presentations to program leads.
Competency log with supervisor notes on LP, EVD placement, ICP monitoring, central and arterial lines.
Log will indicate whether the fellow watched, assisted, or performed the activity while being monitored.

Conduct focused histories and physicals for new and follow-up patients.
Apply knowledge on neurosurgical foundations to provide patient education on diagnoses, pre-operative guidance, and post-operative expectations.
Demonstrate independence in conducting post-operative appointments and wound checks, identifying any complications, and initiating appropriate management when necessary.
Operate and adjust VP shunts (Certas, Strata, Hakim) safely and accurately.
Utilize the electronic health record (EHR) efficiently to document patient encounters, ensuring accurate coding and billing practices in alignment with clinical and regulatory standards.

Hands-on patient interactions: supervised clinical assessments, initially shadowing and then taking the lead on patient encounters.
Participating in patient support groups.
Observing multidisciplinary boards (tumor, spine, neuroradiology).
Attending APP journal club meetings.

Competency log with supervisor notes on shunt adjustment, wound care, documentation.
Log will indicate whether the fellow watched, assisted, or performed the activity while being monitored.
Chart review: weekly audits for documentation accuracy and clarity.
Patient feedback: collection of patient surveys to assess satisfaction.

Collaborate with GNI Research Director to contribute to ongoing research projects by analyzing data, developing protocols, or writing manuscripts based on project needs.
Facilitate a journal club discussion by critically evaluating and presenting a research article in a specific area of interest, fostering peer engagement and knowledge exchange.
Continue to engage in clinical duties in chosen clinical setting (opportunity to specialize in pediatric, spine, vascular, tumor, etc.)
Integrate clinical duties by engaging in clinical or administrative projects as discussed with mentor.
Demonstrate clinical proficiency by continuing patient care responsibilities and enhancing hands-on skills through targeted practice and application as needed.

Attend research training sessions.
Attend and present in journal club sessions.
Clinical observations and workshops as needed.
Participate in elective-related conferences, tumor boards, and case reviews relevant to selected area.

Measures: