Spine Center Fellowship
DHMC offers a one-year fellowship at the Spine Center. Fellows are given the opportunity to assume increasing responsibilities in each of the following patient care settings: Outpatient, In-patient, Operative, and Emergency. The fellow serves as the chief of the Spine Service. The fellow is supervised by four full-time attendings on a day-to-day basis and the fellow in turn supervises the residents on the service who are at the PGY-II and PGY-IV levels of training.
It is recognized that those entering a fellowship year/program have already completed full residency training in Orthopaedic and/or Neurosurgery. As such, they should be able to attend to patients in a variety of settings that the practice of Orthopaedics/Neurosurgery demands/requires, i.e. the Emergency Room, the in-patient hospital, patient care areas, outpatient clinic and office care, and operative or surgical care management.
The fellow is mentored and supervised, and their performance followed with increasing responsibility allowed in decision-making and in the performance of specific procedures throughout the fellowship year. On a rotating basis, the faculty or staff will provide on-call coverage to the Emergency Center for in-patient hospital consultation. The faculty is available for discussions with the fellow regarding all problems that may arise.
Early in the course of the fellowship year, the staff are in attendance for the examinations of patients presenting to the Emergency Center for decision making relative to treatment plans and for the conduction of special tests and treatment techniques. The specific techniques include the application of skull tongs, halo apparatus and traction, the reduction of fractures and dislocations, and the preparation of patients for surgical management.
As confidence and competence in such areas are demonstrated by the fellow in training, increasing latitude in freedom and responsibilities are allowed, yet always with the advice and/or participation of the faculty available. We are confident that, by the completion of the fellowship year, our trained fellows are able to manage virtually any problem presented to them and are ready to take on the experience of the future in their chosen specialty.
In the operative or surgical situation, the attending staff will first demonstrate surgical exposures and techniques with fellows serving as an assistant. As time proceeds and their understanding of techniques and skills improves, specific portions of procedures such as exposure and wound closure are first allowed. As greater ability is demonstrated, more significant and major portions at each procedure are allowed and, finally, as proficiency and skill is further demonstrated, the entire procedure for planning to completion is performed by the fellow with the assistance of the residents.
A faculty member is with the fellow throughout each entire case and serves as advisor and assistant. As required in the emergency room, clinic settings, and operative suite, residents and/or fellows are given progressive responsibility with attending staff always available. It continues to be our firm belief that this team approach of faculty and fellow working together serves the patient's and fellow's education most optimally.
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