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, a total of 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; [Fig. 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; [Figs. 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 ([Fig. 4]). In all, 96.5% of respondents were mostly or completely satisfied with the program,
and 98.2% would recommend it to other neurosurgeons.
Fig. 1:
Fig. 2
Fig. 3
Fig. 4
Conclusion: 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.
