2025 Proffered Presentations
S386: THE WEILL CORNELL SKULL BASE AND MICRONEUROSURGERY SKILLS-BASED NEUROSURGERY FELLOWSHIP EXPERIENCE: A 20-YEAR RETROSPECTIVE
Travis Atchley1; Alexander Evins2; Laura Baeza - Antón2; Philip Stieg2; Antonio Bernardo2; 1University of Alabama at Birmingham Health System; 2Weill Cornell Medicine
Background: In 2011, the state-of-the-art Weill Cornell Neurosurgical Innovations and Training Center was established, becoming the new dedicated home for the Weill Cornell Fellowship in Skull Base and Microneurosurgery, which was founded in 2004. This skills- and laboratory-based fellowship provides structured, proficiency-based instruction in complex skull base anatomy, approaches, and techniques in a non-patient-based setting.
Methods: The fellowship program, which lasts 6 to 12 months, is tuition-free and open to surgeons worldwide, from senior residents to mid-career surgeons. The program consists of an initial 3 months of training in skull base surgical anatomy, followed by 3 to 9 months of training in skull base surgical approaches and techniques. All training is closely supervised and administered by experienced faculty and follows a standardized sequential dissection curriculum covering the entirety of the skull base. Concurrent research opportunities are available starting in the fourth month, with junior resident teaching incorporated as appropriate after the fourth month. In order to assess the impact and efficacy of this fellowship program, all former fellows were asked to complete a detailed anonymous survey reflecting on their experience and its impact on their surgical abilities and careers.
Results: As of July 2024, 186 fellows from 42 countries have completed the fellowship program, with 117 completing the survey at the time of writing. Alumni responses were quantified and indicated a significant 60% increase in their assessment of their overall neurosurgical skills, abilities, and armamentarium following the fellowship (P < 0.0001; Figure 1). A 57% overall increase in specific surgical skills was similarly found post-fellowship, with the greatest improvements seen in creating a mental map of the skull base (+81%), skull base techniques (+75%), and, notably, complications management (+70%) (P < 0.0001 for all values; Figures 2 and 3). Overall confidence as a neurosurgeon increased by 50% following the fellowship. Additionally, there was strong agreement among alumni that the fellowship expanded their skills and abilities, positively impacted their careers, was fundamental to their neurosurgery training, and made them better neurosurgeons (Figure 4). In all, 96.5% of respondents were mostly or completely satisfied with the program, and 98.2% would recommend it to other neurosurgeons.
Conclusions: The lab-based Weill Cornell Fellowship in Skull Base and Microneurosurgery has had a profound and positive impact on its alumni, significantly enhancing their surgical skills and career trajectories. The significant degree of increases in perceived skills and abilities gained following the fellowship are especially notable given the fellowship’s limited duration and indicate that this model of focused training could serve as a global benchmark for skills-based neurosurgical training.
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