The Elmacı Neurosurgery Institute (ENI) offers an advanced surgical training program for neurosurgeons, neurosurgery residents, and specialists through the Neurosurgery Fellowship Program. This program aims to provide experience in complex neurosurgical cases as an observer and scrub assistant, enhance surgical skills, foster multidisciplinary collaborations, and educate participants on current neurosurgical techniques under the leadership of Prof. İlhan Elmacı, MD.
Objectives and Goals
The primary objective of this fellowship program is to provide advanced training in microsurgery, endoscopic surgery, neuro-oncology, cerebrovascular surgery, spine surgery, and functional neurosurgery. The program focuses on developing surgical skills, surgical decision-making processes, and multidisciplinary patient management.
Program Content
1.Advanced Clinical Case Discussions and Management
Days: Monday, Tuesday, Wednesday, Thursday, Friday
Location & Time: Istanbul Florence Nightingale Hospital, Neurosurgery Department Meeting Room, 08:00
One of the cornerstones of ENI is the discussion of clinical cases within the team. This provides participants with comprehensive training in clinical decision-making and the development of treatment plans through a multidisciplinary approach. During these meetings:
- Case Discussions: Complex daily cases from the neurosurgery department are thoroughly discussed. The medical history, symptoms, diagnostic methods, treatment processes, and outcomes of the cases are shared with participants.
- Surgical Planning: Reviewing imaging studies and determining optimal surgical approaches.
- Post-Operative Outcomes: The clinical conditions of post-operative patients are assessed, and valuable information about the recovery process is provided. And post-operative patient follow-up from a neuroanesthesia perspective.
2.Theoretical Training and Development of Basic Practical Skills
Days: Monday, Tuesday, Wednesday, Thursday, Friday
Location & Time: Istanbul Florence Nightingale Hospital, Inpatient Rooms, 08:30
During daily bedside visits, participants observe clinical practice and acquire theoretical and practical knowledge in post-operative follow-up and patient management, including:
- Post-Operative Examination and Monitoring: Neurological and physical examinations to assess patients’ general condition during post-operative recovery.
- Medical Treatment Processes: In-depth understanding of medical treatment methods for neurosurgical patients.
- Intensive Care Management: Topics include anesthesia and post-anesthesia management, neurological monitoring, and complication management.
- Discharge Planning: Planning for neurosurgical patients’ discharge and post-discharge care.
3.Hands-on Surgical Training and Observation
Days: Monday, Wednesday, Thursday, Friday
Location & Time: Istanbul Florence Nightingale Hospital, -3rd Floor, Operating Room No:1 08:30
Participants observe real-time surgical operations at ENI and participate as observers in each stage of the surgery. These observations help enhance participants’ surgical skills. During these sessions:
- Microsurgical Techniques: All invasive surgical techniques required for microsurgery.
- Endoscopic Neurosurgery: Endoscopic transsphenoidal/endoscopic endonasal skull base surgical techniques (in collaboration with the ENT team).
- Spine Surgery: Advanced instrumentation, stabilization, microsurgical decompression, and microdiscectomy techniques.
- Peripheral Nerve Surgery: Nerve repair techniques.
- Cerebrovascular Surgery: Aneurysm clipping, AVM resections, and bypass techniques.
- Advanced Technology Utilization: Hands-on training in neuronavigation, neuromonitoring, intraoperative ultrasound, endoscopic use, O-Arm CT navigation systems, and Laser Induced Thermal Therapy (LITT) device principles.
- Post-Operative Early Procedures: Information is provided on post-operative anesthesia monitoring, intensive care planning, early neurological examinations, and evaluation of radiological findings during the recovery phase.
4.Principles of Neurosurgical Patient Evaluation
Days: Tuesday, Wednesday, Thursday, Friday
Location & Time: Istanbul Florence Nightingale Hospital and Elmacı Neurosurgery Clinic (schedule based on the program)
Participants observe how neurosurgical patients are evaluated from Prof. Elmacı’s perspective and how accurate treatment plans are developed. This training covers:
- Neurological and Physical Examination Techniques: History taking, complaints, clinical findings, and patient background assessment with a focus on neurological examination techniques and post-operative follow-up.
- Surgical Indication Criteria: Detailed discussions on surgical intervention decisions based on urgency, priority, and necessity, considering symptom severity, progressive diseases, neurosurgical emergencies, and pathological findings in imaging.
- Neuroradiological Imaging Techniques: Introduction to MRI, MR Angiography, CT and CT Angiography, X-rays, and other imaging methods, with training on how to analyze imaging results and evaluate patients accurately.
- Post-Operative Patient Follow-up: Understanding periodic follow-up strategies for post-operative patients.
5.Multidisciplinary Council Participation
Day: Tuesday
Location & Time: Istanbul Florence Nightingale Hospital, 1st Floor, Neuro-Oncology Meeting Room, 07:30
ENI’s multidisciplinary approach offers participants the opportunity to engage with specialists from various fields in case discussions and treatment strategy development. During these multidisciplinary council:
- Case Discussions: Experts from neurosurgery, medical oncology, radiation oncology, radiology, and pathology collaborate on cases.
- Treatment Planning: Treatment options are developed through a multidisciplinary approach. In neuro-oncology councils, treatment processes and pre/post-surgical treatment options are discussed.
6.Literature Review and Academic Development
Day: Thursday
Location & Time: Istanbul Florence Nightingale Hospital, 1st Floor Meeting Room, 08:30
Fellows will participate in weekly article presentations and literature reviews covering:
- Current Neurosurgical Developments: Reviewing significant academic publications.
- Case-Based Literature Analysis: Discussions on evidence-based medical practices.
- Presentation and Academic Development: Fellows will present articles and receive feedback to enhance their academic skills.
7.Research and Academic Contributions
Participation in clinical research projects at ENI with opportunities for publication in peer-reviewed journals.
8.Study Group Participation
Understanding the role and importance of study groups in neurosurgery.
Our Study Groups:
- Neuro-oncology Study Group
- Cerebrovascular Study Group
- Skull Base Surgery Study Group
- Spine Surgery Study Group
- Epilepsy Surgery Study Group
- Radiosurgery Study Group
9.Neuropathological Diagnoses
Understanding the pathological diagnosis processes after surgery and planning necessary additional treatments.
Program Duration and Certification
ENI Neurosurgery Fellowship Program offers various duration options. Fellows who successfully complete the program will receive a training certificate.
Application Process
Applications for the fellowship program are accepted through the ENI website. Applications will be reviewed by Prof. İlhan Elmacı, and suitable candidates will be contacted.