Fellowships

Cleveland Clinic’s Center for Spine Health offers a unique opportunity to receive spine medicine graduate training through our fellowship program. At Cleveland Clinic, you’ll have the chance to work with some of the country’s best spine medicine physicians, rheumatologists, neurologists, neurosurgeons and orthopaedists.

Our orthopaedic surgery, rheumatology and neuroscience programs are consistently ranked among the top 10 in the nation and No. 1 in Ohio by U.S.News & World Report’s annual “America’s Best Hospitals” survey. Cleveland Clinic itself is ranked one of America’s top hospitals.

Our fellows are trained comprehensively – we focus not only on procedural techniques, but also on spine wellness, surgical evaluations, imagery interpretation, pharmacologic therapies and more. You also will have the opportunity to select from multiple electives, including sports, radiology, metabolic bone disease, chronic pain management and integrative medicine.

Cleveland Clinic’s large patient population means you’ll be exposed to a diverse range of spinal disorders, providing you with a solid educational experience that you won’t find elsewhere.

Objectives of the Fellowship

The goal of the Cleveland Clinic fellowship in Spine Medicine is to train broadly competent, non-operative specialists in the evaluation and management of the full spectrum of spine disorders. The unique integration of non-operative and surgical specialists within the Center for Spine Health provides fellows the opportunity to develop outstanding clinical skills grounded in an evidence based framework. Scholarly activity is encouraged and expected. Fellows are active participants in clinical research and writing, and there is much flexibility to pursue elective interests.

Program Details

Rotation:
Spine Medicine fellows rotate through medical spine clinics, surgical spine clinics and an interventional pain management clinic, as well as a variety of electives and research experiences. Approximately 40 percent of the fellow’s time is spent in medical clinics, 30 percent in interventional training, 10 percent in surgical clinics and 20 percent in elective and academic activities.

Curriculum:
Our fellowship will offer you the opportunity to study all aspects of spine medicine care.

Spine Medicine

• Learn the clinical skills necessary for evaluation and management of a wide range of cervical, thoracic and lumbar spine disorders
• Learn what role diagnostic imaging, electromyography, laboratory studies and diagnostic injection play in the evaluation of patients with spinal disorders
• Gain experience in the interpretation of imaging studies, including MRI, CT, CT myelography and radiography
• Gain experience in the use of therapeutic injections (e.g., trigger point and bursae injections and the use of fluoroscopy)
• Learn the appropriate role of psychiatric pain management in the management of spinal pain
• Gain experience in the use of the wide array of pharmacologic therapies employed in spine management, including analgesics, muscle relaxants, anticonvulsants, corticosteroids and anti-inflammatory agents
• Become familiar with the full range of active and passive physical therapy modalities available for spinal disorders
• Be exposed to spinal manipulation techniques (manual medicine) and their role in the management of spinal disorders
• Be exposed to acupuncture or a useful modality in the management of spinal pain and associated symptoms

Pain Management

• Gain experience in basic interventional pain management, including epidural steroid injections, trigger point injections, sacroiliac injection, piriformis injection, facet radiofrequency ablation and hip injection
• Become familiar with the full range of procedural treatments for managing spinal pain, including indications, contraindications and potential complications of such treatments

Spine Surgery

• Learn the indications for appropriate surgical intervention (surgical decision making)
• Become familiar with the range of surgical options available for patients with a wide array of spinal disorders
• Become familiar with the indications for referral to spine surgeons

Research/Elective

• Develop and complete a clinical research project, working with your faculty adviser
• Author or co-author at least one paper during the fellowship, to be published in an indexed medical journal

Conferences:
A weekly spine medicine conference includes case conferences, didactic lectures or a journal club. Interdisciplinary conferences (tumor conference, spine biomechanics course) also are available for interested fellows.

Requirements:
Applicants for the fellowship must have completed an accredited residency in physical medicine and rehabilitation, internal medicine, family medicine or subspecialty training in a medical specialty (e.g. rheumatology). All fellows must obtain an Ohio training medical license prior to beginning the fellowship.

Credentialing Standards:
The fellowship’s credentialing standards cover medical assessment and management, including clinical skills, spinal anatomy, infections, pediatric spinal disorders and therapeutics, and interventional spine care, including facet joint injections, medial branch blocks, radiofrequency ablation, lumbar epidural steroid injections, sacroiliac joint blocks and clinical pharmacology.

• Daniel Mazanec, MD, Associate Director, Center for Spine Health
• Edward Benzel, MD, Department Chair, Neurological Surgery
• Edwin Capulong, MD
• Russell DeMicco, DO
• Augusto Hsia Jr., MD
• Tagreed Khalaf, MD
• Anantha Reddy, MD
• Judith Scheman, PhD
• Richard Schlenk, MD
• Santhosh Thomas, DO, MBA, Associate Medical Director, Center for Spine Health
• Fredrick Wilson, DO
• Adrian Zachary, DO, MPH

Application Process

Download our spine medicine fellowship application. Once completed, fax a copy of the application, three letters of recommendation and your CV to Daniel Mazanec, MD at 216.445.9679

If you have any questions regarding the fellowship or the application process, please contact:

Daniel Mazanec, MD
Associate Director
Cleveland Clinic Center for Spine Health
Co-Director, Spine Medicine Fellowship
9500 Euclid Avenue/S40
Cleveland, Ohio 44195
216.444.6191

Russell DeMicco, DO
Co-Director
Spine Medicine Fellowship
9500 Euclid Avenue/S40
Cleveland, Ohio 44195
216.444.0229

Santhosh Thomas, DO, MBA
Co-Director
Spine Medicine Fellowship
9500 Euclid Avenue/WL40
Cleveland, Ohio 44195
440.899.5516

• Visit the Graduate Medical Education Website

Welcome to the Spine Surgery Fellowship at Cleveland Clinic. Our fellowship is a combined Orthopaedic and Neurological Surgery experience that is one year in length, with an option to do an additional year of research for select candidates.

Our philosophy is simple. We strive to recruit the top candidates and then provide the absolute best clinical and surgical education nationally. As a “hybrid” program comprised of four fellowship-trained Orthopaedic Surgeons and five fellowship-trained Neurosurgeons, each fellow will gain ample exposure to a wide range of spinal pathologies ranging from degenerative diseases, infections, intra- and extra-dural tumors, deformity, and trauma. In general, the surgical techniques employed by Orthopaedic and Neurological surgeons vary, and as a Fellow in this program you will become proficient with all techniques, including microsurgery and minimally invasive surgery. A primary goal of our fellowship is to graduate fellows with a highly refined clinical acumen and surgical skill set that will allow them to most effectively treat any type of spinal malady. Approximately 2000 spine surgeries are done annually at Cleveland Clinic providing an excellent opportunity to excel in spinal surgery both technically and clinically.

Our yearly curriculum includes a very thorough series of didactic sessions provided by Staff and guest lecturers, fellow-directed case presentations, biomechanical and controversy conferences, in addition to monthly grand rounds lectures and journal clubs. The curriculum was designed to provide a strong evidence-based foundation on all topics pertinent to spine surgery.

Collectively, the Spine Surgery Staff surgeons have published over 500 articles in the peer-reviewed medical literature, over 400 book chapters and over 30 books in the field of spine surgery and related topics. All of the staff at Cleveland Clinic are involved nationally and internationally in teaching, and are members on numerous academic committees. This underscores our philosophy, enthusiasm and commitment to education as well as the breadth of experience among our staff. As a requirement in our Fellowship each fellow must complete at least one project prior to graduation. There are a multitude of areas of research available to our fellows, including basic science, pre-clinical, clinical, and biomechanical. We believe this is a valuable educational experience, and certainly a strength of this program.

Thank you for your interest the Spine Surgery Fellowship Program at Cleveland Clinic.

The Cleveland Clinic Spine Surgery Fellowship is focused on educating our fellows in a unique academic setting that encourages extensive training in the diagnosis and management of adult spinal disorders. There is emphasis placed on degenerative cervical, thoracic and lumbar disease, spinal deformity, intradural and extradural spinal tumors, spinal trauma, spinal infections, congenital spinal abnormalities, and complex reconstruction/revision cervical and lumbar pathology.

The fellows will gain adequate experience with a multitude of surgical techniques including image guidance, minimally invasive surgery and microsurgery. The primary goal of our fellowship is focused on training the highest quality orthopaedic and neurosurgeons on a personal and professional level in order to prepare them for private or academic practice. Our spine surgery fellowship is a combined orthopaedic and neurosurgical experience that is one year in length with an option to do an additional year of research for selected candidates.

U.S.News and World Report consistently ranks our orthopaedic and neurosurgery programs among the top ten in the nation and number one in the state of Ohio. Both clinical and surgical experience is drawn from the nearly 2000 major spinal procedures performed by our fellowship trained orthopaedic and neurosurgeons each year. Our faculty actively participates in the fellows’ education, helping to provide a high level of proficiency in a variety of surgical techniques and approaches designed to effectively treat any type of spinal condition.

Our clinical education program is comprised of didactic lectures given by staff, conferences, faculty interaction and ambulatory clinics which focus on the evaluation, diagnosis, operative and non-operative decision making, along with results and complications for all spinal treatments.

Fellows are required to participate in core curriculum education throughout the length of the program, which entails weekly conferences occurring every Friday. Topics include general spine indications, core curriculum, controversies in spine care, and biomechanics.

In addition to weekly conferences, there are monthly journal club meetings, fellow organized grand rounds, and visiting professor lectures on various topics four times per academic year. Our weekly conferences consist of presentations directed by our spine fellows with faculty input relating to various spinal pathology and surgical treatment options. Our journal clubs are organized every month, with attendance by both faculty and fellows. Articles for journal club are selected by the presenting fellow, with discussion of content, methods, results and conclusions of each article presented amongst the group. Fellows are also encouraged to participate in the education and clinical teaching of residents in and out of the operating room throughout the year.

Research plays a vital role in our spine surgery fellowship. Fellows will have the opportunity to engage in clinical research with the intent to publish peer-reviewed articles under the direction of our faculty. Fellows will be expected to apply the principles of spinal research, with strong focus on the use of evidence-based medicine in their surgical decision making. Fellows will have access to our spine research lab at Lutheran Hospital which is minutes away from our main campus. Some of our research interests include biomechanics, biologics, spine kinematics, and spinal cord injury and clinical research. Each fellow will be required to complete and present one research project at the end of the year as part of their requirement for program graduation. These projects will be prepared for submission prior to completion of the fellowship and are expected to be submitted for publication.

Over 1900 spine surgeries are performed annually by the Staff Spine surgeons involved in the Cleveland Clinic Fellowship, and this volume affords a wide variety and breadth of surgical training for our fellows. Approximately 60% are non-fusion procedures, and the remainder involve some kind of fusion surgery. Of the total surgeries performed, about 30% involve the cervical spine, 60% involve the lumbar spine, and the remainder are thoracic surgeries.

There are a wide variety of cases with which our fellows are involved ranging from the less to the most complex. As a tertiary care center, the spine surgeons at Cleveland Clinic treat the most complex spinal pathology, including revision surgery, spinal deformity of many etiologies, primary spinal column tumors and metastatic disease, infections, as well as intra- and extra-dural tumors. While Cleveland Clinic is not a trauma center, we do evaluate and treat a variety of traumatic spine injuries and we believe this offers a substantial exposure to this cohort of patients for the fellows.

Our primary goal as a fellowship program is to deliver a broad, balanced, evidence-based exposure to the various surgical techniques used today in spine surgery. Integral to optimizing the surgical treatment of any patient is a need to understand the pathology, historical treatments and outcomes, and to develop sound and efficacious surgical skills. We firmly believe that by the end of the fellowship each fellow will be comfortable and very capable of treating any surgical spine issue, and will have had ample exposure to some of the more contemporary techniques including minimally invasive surgery, image guidance and microsurgery.

View a gallery of images from our program. (Click each image for a larger view.)

John H. Shin, MD
Neurological Surgeon
2009-11 (Research/Clinical)
Harvard Medical School
Massachusetts General Hospital
Boston, MA
“The fellowship did an excellent job of preparing me for an academic career in spine. The combination of orthopedic and neurosurgical spine training is invaluable and is what really made the fellowship a rich environment for learning. The didactics, including lectures and case presentations, were comprehensive and provided ample opportunity for discussion and debate. For anyone wishing to pursue spine as a subspecialty, I would recommend this fellowship without any hesitation or reservation. The numerous opportunities for research made this a very productive time.”

Elijah Hothem, MD
Orthopaedic Surgeon
2010-11 (Research/Clinical)
Ohio State University
Columbus, OH
“The spine fellowship at Cleveland Clinic is a unique training experience. The combination of orthopedic and neurosurgical training sets you apart from the conventionally trained crowd. You are treated as a colleague and friend by the attendings. The educational didactics were excellent and by the end of the year I had a well read, evidence based, and objective approach to treatment of the spine.”

Fernando Techy, MD
Orthopaedic Surgeon
2010-11
University of Illinois
College of Medicine at Chicago
Chicago, IL
“Overall it has been simply great. All attendings were always very patient and took their time to let us operate. Clinics were also great. Attendings took their time to discuss cases, go over indications and so on. Great clinical experience overall (from cervical to lumbar, to intradural pathology, to deformity).

The experience operating with Neurosurgeons and Orthosurgeons was very interesting to me. In the end I came to a conclusion that the indications and operations in this day and age are pretty much the same. I guess it does not matter at all what your background is, as long as you are well trained. You can take the lamina out with a drill or a Leksell, as long as you leave the dura in place the patient will be OK.”

Frank Bishop, MD
Neurological Surgeon
2010-11
Northern Rockies Neurosurgical Associates
Kalispell, MT
“Having had a strong spine experience during my neurosurgery residency, I was unsure of the actual value of adding a spine fellowship to my training prior to starting. The year proved to be one of the best of my training experience. I was able to see a diversity of complex cases in clinic and the operating room, which has greatly enhanced my decision-making and technical abilities. Perhaps more importantly, Cleveland Clinic has a group of world-renown spine surgeons, from both neurosurgery and orthopaedic backgrounds, with whom I worked closely and individually, and was therefore able to see and discuss multiple ways of treating spinal disorders. My knowledge and armamentarium increased noticeably during the course of the year. The fellowship has transformed what I am able to do for my practice and patients.”

William F. Lavelle, MD
Orthopaedic Surgeon
2008-9
SUNY Upstate Medical University
Syracuse, NY
“I felt the combined orthopaedic surgery and neurosurgery spine experience helped prepare me for my academic spine surgery career. I am currently Fellowship Director of the spine fellowship at SUNY Upstate Medical Center. My practice is a combined trauma, tumor, deformity and degenerative spine practice at an academic tertiary center. I felt well prepared for practice after my fellowship at Cleveland Clinic.”

Daniel Refai, MD
Neurological Surgeon
2009-10
Washington University in St. Louis School of Medicine
St. Louis, MO
“I enjoyed working with the orthopaedic spine service and doing deformity cases. This was a huge asset. In addition, I definitely expanded my repertoire of skills from having great mentors in both neurosurgery and orthopedics.”

Todd J. Stewart, MD
Orthopaedic Surgeon
2002-03
Washington University in St. Louis School of Medicine
St. Louis, MO
“The Cleveland Clinic Spine Fellowship provides outstanding training in the full breadth of spinal pathologies from routine degenerative cases to complex cervical reconstructions, tumor resections and scoliosis. The opportunity to train under opinion leading surgeons from both neurosurgery and orthopaedics makes this a top fellowship program.”

Daniel Shedid, MD
Neurological Surgeon
2004-2006
Montreal, Quebec, Canada
“I did a combined fellowship of 2 years. After more than 5 years in practice, I can honestly say that I did a tremendous training at Cleveland Clinic. For me as a neurosurgeon, I had an excellent opportunity to work closely with orthopedic surgeons. This has helped me to understand and master all the aspects of the spine as a whole. I can proudly say that my fellowship at Cleveland Clinic made me where I am now as a spine surgeon.”

Robert Talac, M.D, PhD
Orthopaedic Surgeon
2008-2009
Advanced Spine Institute, PLLC
Jackson, TN
“I have been a spine surgery fellow between the years 2008-2009. In my opinion, Cleveland Clinic spine surgery fellowship is one of the top fellowships in the country. The depth of the program provides a unique opportunity to learn how to handle any spine pathology from a simple one to the most complex. The entire program is well balanced. A fellow has enough independence to facilitate his/her transition into the practice. At the same time, s/he has enough support to learn from experienced staff. Should you need any more information about my experience please do not hesitate to contact me.”

S. Scott Lollis, MD
Neurological Surgeon
2009-10
Dartmouth-Hitchcock Medical Center
Lebanon, NH
"The Cleveland Clinic fellowship was a great experience. For me, the principal clinical benefits were in the areas of spinal deformity and tumor surgery. As a neurosurgical resident I had had no exposure to major deformity correction, and while I had certainly done laminectomies for tumors, I was not completely comfortable with the posterolateral approaches for thoracic tumors (costotransversectomy/lateral extracavitary with anterior column reconstruction). The diversity and volume of cases at Cleveland Clinic is exceptional, and this allowed me to develop competence in these two areas."

There is great value in the combined ortho/neuro fellowship, both in terms of learning new operative techniques and in terms of clinical judgment and pre-op decision-making. Because each fellow has a one on one experience with each faculty member, the fellowship offers a breadth of experience that is uncommon.

Lastly, I am really grateful for the friendships that I formed during my year in Cleveland. The fellowship’s greatest strength is that it brings together a large number of great people with a shared interest. Our class had a great time, and I expect these relationships to continue throughout our professional careers.”

Dhruv B. Pateder, MD
Orthopaedic Surgeon
2006-07
Town Center Orthopaedic Assocs.
Reston, VA
“I am very thankful for my spine fellowship experience at Cleveland Clinic. It was a very comprehensive educational and operative experience and instrumental in preparing me for academic/private practice. The interactions with the attendings as well as the other fellows were a very valuable component of this well-rounded fellowship. It was a perfect combination of the orthopaedic and neurosurgical experience as well as "routine" and "big" cases. I honestly believe it is the best fellowship in the country.”

L. Brett Babat, MD
Orthopaedic Surgeon
2001-02
Premier Orthopaedics & Sports Medicine
Nashville, TN
“I was a Cleveland Clinic fellow, class of ’01-’02. I am now in private practice in Nashville, TN. My year in Cleveland was perhaps the most valuable of my entire education. I left there fully confident in my ability to handle the entire range of adult spinal surgery, from simple disc herniations to complex deformity. Furthermore, I had gained enough of an understanding of the degenerative spine to facilitate continued learning and technical advancement. I am convinced my Cleveland Clinic fellowship provided the best possible grounding and experience.”

Richard Schlenk, MD
Neurological Surgeon
2002-03
Director, Neurosurgery Residency Program
Cleveland Clinic
Cleveland, OH
“The fellowship was truly an experience that shaped and molded my clinical and surgical skills. It was a tremendous opportunity to work with both orthopedic and neurosurgeons in a meaningful manner not available in any other fellowship program. It certainly helped prepare me for a career in academics.”

Eric Klineberg, MD
Orthopaedic Surgeon
Assistant Professor
Director, Spine Fellowship Program
Adult & Pediatric Spinal Surgery
University of California, Davis
Sacramento, CA
“The Cleveland Clinic fellowship allowed me to further my understanding of spinal surgery with both Orthopaedics and Neurosurgery. This experience has allowed me to learn from both sides of the fence and take the best of both specialties. I have used this knowledge and now have an academic practice at UC Davis, in which I provide care for complex fracture, tumor, cervical deformity and scoliosis patients. In addition, I now count Cleveland Clinic staff as close friends and we talk often about cases, and collaborate on research projects. I would recommend this fellowship highly.”

Sharad Rajpal, MD
Neurological Surgeon
2009-10
Boulder Neurosurgical Associates
Boulder, CO
“One unique aspect of this program is the breadth of training afforded by the combination of Orthopedic and Neurosurgical specialties. The excellent teaching in both the operative and clinical settings provided me with the tools to help me be successful and confident today in my treatment decisions by analyzing difficult and complex spine problems with perspectives from both specialties.”

Cristian Brotea, MD
Orthopaedic Surgeon
2006-07
Westchester Spine Institute
Specialty Orthopaedics, PLLC
Harrison, NY
"I feel that the Cleveland Clinic Spine Fellowship program provided me with a very thorough, complete experience which prepared me very well for my private practice. It provided me with the tools to approach any type of cervical/thoracic/lumbar case. The program provides the fellows with a wide variety of cases and working on them with residents was particularly rewarding. I found it was particularly insightful to work with neuro- and orthopaedic surgeons and I learned a lot from both specialties."

Christopher Kager, MD
Neurological Surgeon
2000-01
Neuroscience & Spine Associates
Lancaster, PA
“My spine fellowship experience was outstanding. It provided me with comprehensive training in all aspects of spinal surgery. One outstanding feature was the collaboration with both orthopedic and neurosurgery spine specialists, providing an interesting hybrid experience. The facilities at Cleveland Clinic are excellent, in both clinical and research areas, and many opportunities to be involved in research projects in both arenas. The program also maintains a strong collegial feel as well, with great relationships between the fellows and the faculty and residents.”

Saad B. Chaudhary, MD, MBA
Orthopaedic Surgeon
2007-08
Spine Surgeon
Assistant Professor
UMDNJ - New Jersey Medical School
Newark, NJ
“The Cleveland Clinic Spine Surgery Fellowship was outstanding. It was enriching to work closely with experts in spinal surgery from both the Orthopaedic and the Neurosurgical disciplines. I had a tremendous operative experience with the nine faculty members; covering a wide variety of pathology from simple disc herniations and degenerative disease to complex spinal deformity and spinal tumors. I was exposed to both traditional open surgery, and to cutting edge minimally invasive surgical treatments. This fellowship not only equipped me with the tools needed to excel as a private practitioner, but also prepared me for a career in academics. In my opinion, the Spine Surgery Fellowship at Cleveland Clinic is easily in the top 3 best programs in the country.”

• Thomas Mroz, MD, Director, Spine Surgery Fellowship Program
• Edward Benzel, MD, Chairman, Department of Neurological Surgery
• Gordon Bell, MD, Director, Center for Spine Health
• Robert McLain, MD
• Iain Kalfas, MD
• Ajit Krishnaney, MD
• R. Douglas Orr, MD, Chief of Surgery, Lutheran Hospital
• Richard Schlenk, MD, Director, Neurosurgery Residency

Orthopaedic and Neurosurgery applicants to Cleveland Clinic's Center for Spine Health Fellowship follow two different processes.

Orthopaedic Surgeons

All Orthopaedic trained surgeons must apply through the SFMatch. The timeline for the match is as follows:

• July 15, current year: SFMatch begins accepting registration for the Spine Surgery Fellowship Match. Applicants can view the Program Directory once registration is concluded. It is recommended that you check this directory on a regular basis since it is updated by programs year round. Please note the individual deadline dates of each program to which you will apply.
• September 15, current year: SFMatch Central Application Service becomes available to all Spine Surgery Fellowship Programs around the country.
• December 15, current year: Cleveland Clinic Spine Surgery Fellowship Application Deadline date
• January and February, current year: Interviews take place
• April 29, current year: Interview period ends
• May 3, current year: Rank List Submission Deadline
• May 10, current year: Match results are available

Please note: These dates may vary, as will the deadline dates of each individual program.

Neurological Surgeons

Applicants must send their application directly to the Program Coordinator via e-mail or fax.

A personal statement, CV, and three letters of recommendation must accompany the application. Neurosurgery applicants are encouraged to apply before September 30th to be included in the interview day scheduled each year in autumn.

Applications are processed two years in advance and accepted year round.

Candice Cross Coordinator, Spine Surgery Fellowship
Ph: 216.445.9234
Fax: 216.636.2040
E-mail: spinefellowship@ccf.org

International Medical Graduates

To qualify for a Fellowship at the Cleveland Clinic you must be able to obtain a permanent Ohio Medical License. To qualify, International Applicants must have passed the US-MLE Step 3, and must hold an H1 Visa or equivalent. (A J1 Visa will not suffice.)

• To sign up for the US-MLE go to www.usmle.org, or for more information go to SFMatch.