Clinical and Subspecialties Rotations

Residents have the opportunity to practice in a variety of settings including our outpatient clinic and skull base and microsurgical laboratory in addition to a variety of subspeciality rotations. This helps support growth in clinical judgment and decision-making, as well as the development of surgical skills. 

Serving a population of more than 2-million people the majority of training takes place at Wake Forest Baptist Medical Center which includes:

Download our Neurosurgery Residency Program Subspecialties Rotations Overview and Highlights Guide for full descriptions (PDF).

Subspecialties

Functional Neurosurgery

Residents are involved in the care, planning, and surgery of patients undergoing functional Neurosurgical procedures throughout the whole of their residency.

Deep Brain Stimulation

  • The Movement Disorders Center at Wake Forest Baptist Health has one of the most experienced DBS teams in the nation, as well as ranking in the top 3 busiest DBS programs nationally
  • In 1997, The Wake Forest team was among the first centers in the nation to perform DBS surgery

Epilepsy

  • Epileptogenic mapping in dedicated Epilepsy Monitoring Unit in coordination with Epilepsy Neurology Team in order to tailor focused resections
  • Wake Forest has been at the forefront of Laser Interstitial ThermoTherapy. Both Neuroblate and AutoLITT are used at our institution to ablate epileptogenic foci
  • First in the Southeastern U.S. to use MRI guided Laser Interstitial ThermoTherapy for the ablation and treatment of unresectable brain tumors, and one of 5 programs in the nation to participate in clinical trials.

Gamma Knife® Radiosurgery

Wake Forest Baptist Medical Center has the 4th most active Gamma Knife Radiosurgery center in the U.S. with one of the most experienced Gamma Knife treatment teams

  • 479 cases performed in 2015-2016 Academic year
  • Gamma Knife Radiosurgery has been performed at Wake Forest since 1999 and we are one of the few medical centers funded by the National Cancer Institute to conduct brain tumor research.
  • Senior residents have a three-month Gamma Knife rotation combined with outpatient attending clinic

Pediatric Neurosurgery

Wake Forest Neurosurgery residents participate in the planning, management, and operations of all pediatric patients at the Brenner Children’s Hospital throughout the whole of their residency rendering them able to care for the full range of pediatric neurosurgical pathology. The Pediatric Neurosurgery program features:

  • Two full-time fellowship trained Pediatric Neurosurgeons
  • Level I Pediatric Trauma Center
  • Full Pediatric facilities on campus including a Neonatal ICU
  • Active pediatric scoliosis referral center
  • Opportunities for Pediatric Neurosurgery Medical Missions

Peripheral Nerve

  • High volume of Carpal Tunnel Release, Ulnar Nerve decompression, peroneal nerve decompression
  • Partnership with plastic surgery and orthopedic surgery for senior level peripheral nerve experience

Spine

Wake Forest Neurosurgery residents are trained in the full scope of operative and nonoperative spine management throughout their residency. Throughout its history, Wake Forest has been a pioneer in both complex and minimally invasive spine surgery thereby offering its residents fellowship level training in new fusion techniques and scoliotic deformity corrections during their residency training period.

  • Faculty includes nationally and internationally recognized leaders in minimally invasive spine surgery along with complex deformity correction
  • Dedicated Spine Center featuring a multidisciplinary approach to patient care including surgeons, pain specialists, and therapy resources
  • Our faculty hold 13 U.S. and 11 European patents for the development of interbody fusion devices and operations
  • State-of-the-art surgical technique using image guidance and robotic assistance

Neurosurgical Oncology

Wake Forest Neurosurgery residents experience and have full access to the entire range of oncological management and research opportunities. As part of the NCI designated Brain Tumor Center of Excellence within the newly built Comprehensive Cancer Center tower, our residents are exposed to the full spectrum of Neurosurgical cranial and spinal oncological pathology. 

  • Top Cancer Center in the State
  • Multi-disciplinary team includes Neurosurgeons, dedicated Neuro-Oncologists, and dedicated team of Neuro-Radiation Oncologists
  • Brain Tumor Tissue Bank Collection-available for resident research
  • One of 20 sites participating in a phase II randomized vaccine trial for GBM

Vascular Neurosurgery

Wake Forest Neurosurgery residents participate in the management and clinical decision making of all vascular patients and have direct, hands-on experience in both open microsurgical as well as neurointerventional treatment modalities. 

  • Extensive opportunities in both open and endovascular planning, treatment, and post-operation/procedural care throughout residency
  • PGY 3 and PGY5 level dedicated 3 month cerebrovascular/endovacular rotations for more focused experience in the care of vascular patients
  • Joint Commission designated Comprehensive Stroke Center with AHA recognition for outstanding door to needle times and an incredible IV tPA rate of 64%
  • Telestroke Exceptional Achievement award, which increases our neurovascular catchment area
  • #1 in lowest stroke and craniotomy mortality in the UHC network
  • Endovascular and open surgical management of Carotid disease with recognized experts in the field in conjunction with Stroke Neurologists

Trauma

Wake Forest Neurosurgery residents and faculty manage the total spectrum of operative and non-operative cranial and spinal trauma management at a Level 1 pediatric and adult trauma center.

  • Specialization in both blunt and penetrating trauma
  • J. Paul Sticht Center on Aging and Rehabilitation: state-of-the-art rehabilitation facility on campus featuring a 12-bed dedicated Brain Injury Unit that provides a secure therapeutic environment allowing patients to move freely throughout the unit

Call Schedule

PGY 1-4 residents have in-house call four to five times per month.

  • PGY-1 residents take overnight in-house call with a PGY-4 resident providing direct supervision and clinical education
  • PGY-5 to -7 residents take home call
  • A food stipend is provided for on-call residents
  • Spine call is split with the orthopedic spine service two weeks at a time

Conferences and Didactics

Clinical training is augmented with:

  • Weekly didactic operative grand rounds
  • Weekly resident continuity clinic
  • Monthly journal club
  • Monthly conferences in:
    • Neurovascular
    • Neurooncology
    • Neuroradiology
    • Neuropathology
    • Neurointensive care
  • Monthly morbidity and mortality conference
  • Monthly spinal and cranial cadaveric dissection courses in:
    • Surgical skull base approaches
    • Microneurosurgery
    • Neural and vascular microsurgical anastomoses
  • Yearly two-day cranial and spine cadaveric courses
  • Semi-annual visiting professorships in cranial and spinal neurosurgery

The department funds attendance at one national neurosurgical conference during the Post-Graduate Year (PGY)-2 or -3 years.