The program has been in effect since July 1, 2003. Since the inception of the program, five individuals have completed the fellowship. The duration of the program is two years (ACGME approved program for one year). Applications to the Endovascular Surgical Neuroradiology fellowship program are accepted from candidates who have successfully completed Neurosurgery residencies, as well as Neuroradiology and Vascular Neurology Fellowships; however each requires a preparatory year, which is tailored to their particular background and needs.
In the case of the neurosurgical trainees, a preparatory year is offered with the general goal of expanding their exposure to diagnostic neuroradiology, and neuroangiography in particular. This will include didactic courses in basic radiation safety, radiation physics, digital image quality, angiographic technique, contrast agents, cerebrovascular anatomy and variants, and angiographic diagnosis. Additionally, Cleveland Clinic’s Neuroradiology section and Department of Neurosurgery are fully digital/networked, allowing for nearly real time access to all current and prior cross sectional imaging studies. This provides for a uniquely efficient teaching environment in which correlative findings on diagnostic imaging studies can be reviewed and discussed in the context of diagnoses, clinical decision-making and therapeutics.
In the case of the neuroradiology trainees, a preparatory year is offered with the general goal of expanding their exposure to diagnostic neuroangiography, and in particular broadening their exposure to clinical neurosurgery (including clinical signs/symptoms, natural history, treatment planning, physiological monitoring, intracranial pressure/ pathophysiology, pharmacology and neuro intensive care management). Objectives for the first/preparatory year include:
- Patient Care – demonstrate ability to perform and interpret diagnostic neuroangiography
- Demonstrate command of imaging and clinical diagnosis of (endo) vascular disorders
- Demonstrate competency in directing ward care of endovascular cases
Interpretation of diagnostic and interventional procedures are double read by senior staff throughout the first year. All interpretations are performed based on digital images on workstations distributed throughout the Imaging Institute using voice recognition software to expedite reporting to the referring services. Images are stored centrally on a large digital archive, providing ready access to nearly all of the digital imaging dating back to 1994. Procedures are initially performed by the staff for teaching purposes. Subsequently, the trainee performs the procedures under direct supervision and then assumes more independence once competence is demonstrated. During the second year of Interventional Neuroradiology the Senior Staff will have the responsibility of the primary operator and the trainee serves as first assistant.
Endovascular Neurosurgery fellows and residents are responsible for reviewing diagnostic CT’s and MR’s. Diagnostic angiograms are shared between the first year neuroradiology fellow and the cerebrovascular fellows. During the second year, the fellow assumes a more proactive role, thereby performing interventional procedures. Dictations are also shared during the fellowship and are distributed by the staff.
Endovascular Neurosurgery fellows are expected to participate in clinical conferences, regular daily patient management in conjunction with the Departments of Neurology, Neurosurgery, Neuropathology, Otolaryngology, Ophthalmology, General Medicine and Pediatric subspecialties. The fellow is also expected to participate in the didactic and patient management conferences which are held with the Divisions of Neurology, Neurosurgery, Neuropathology, Otolaryngology and Ophthalmology on a regular basis. All clinical conferences are open to fellows; they are actively encouraged to attend all conferences but are required to attend weekly CV case conferences, weekly neurosurgery patient management, and monthly endovascular M&M as well as journal club.
The fellow is expected to prepare a single one-hour didactic conference during the first year and to prepare two such conferences during the second year. Otherwise, the trainee’s only teaching responsibilities are the one-to-one teaching of residents and medical students during the daily reading sessions. They also work with the residents on the Neuroradiology rotations to acquire interesting cases for the weekly case conference in which they are the primary presenter. One staff member is also present at each conference to aid in the discussions.
Endovascular Neurosurgery staff are actively involved in research and the neuroradiology fellow is strongly encouraged but not required, to participate in basic and/or clinical research during the two years. Each trainee will be given one half day per week to pursue research efforts. They will also be strongly encouraged to present research in national meetings and to prepare manuscripts for publication during these two years.
Each trainee is evaluated by each neuroradiology staff member on a monthly basis and all forms are forwarded to the neuroradiology program director for review. Combined six-month evaluations are submitted to the Graduate Medical Office at CCF and are reviewed with the trainee on a semi-annual basis. When specific problems arise, they are addressed as needed.
How to Apply
Please direct any questions and/or complete the online GME application form and send with current curriculum vitae, medical school transcripts and 2-3 letters of reference to:
Thomas Masaryk, MD, FACR
Section of Neuroradiology
Cleveland Clinic Imaging Institute
9500 Euclid Ave.– P34
Cleveland, Ohio 44195
Linda M. Dagys
Section of Endovascular Surgical Neuroradiology
Cleveland Clinic Imaging Institute
9500 Euclid Ave.– L-10
Cleveland, Ohio 44195
Subsequent required interviews will be granted on a first come, first serve basis.
Please take a moment to review a listing of all the requirements that must be met to train at Cleveland Clinic as well as the non-smoking policy.