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Neurosurgery

Oxford is a world-renowned neurosurgical centre of both clinical and academic excellence which is proud to be distinguished for providing top quality training for neurosurgeons. Historically, Oxford has been an important institution in the development of the speciality. Many historic figures pivotal in the history of the understanding of the neurological system have practiced in Oxford throughout the years, including Thomas Willis, William Osler, Charles Sherrington and John Fulton. The practice of clinical neurosurgery in Oxford dates back to 1938 with the establishment of expertise in the management of neurological injuries during World War II by Sir Hugh Cairns, and was continued by Pennybacker and his successors.

The Oxford neurosurgical training programme is a top choice for successful applicants at national selection. Trainees are based at the John Radcliffe hospital site of the Oxford University Hospitals NHS Foundation Trust under the supervision of eminent experts in the field. There are currently 11 NTN training posts in Oxford ranging from ST1-ST8, including two Academic Clinical Fellowship posts. The department has strong links with the University of Oxford and a significant number of trainees are supported to undertake higher research degrees (DPhil / MD) during their neurosurgical training.

There are 18 neurosurgical consultants in the unit, including two academic professors, who provide comprehensive training across the breadth and width of neurosurgical practice for both adult and paediatric practice.  The Oxford neurosurgical department prides itself in providing world class care and pioneering techniques in neurosurgical practice, including the well-established deep brain stimulation service, skull base and pituitary service, epilepsy surgery and awake craniotomy for intra-axial brain tumours. The department attracts a significant number of post-CCT level fellows from all over the world in pituitary surgery, skull base surgery, vascular neurosurgery, spinal surgery, paediatric neurosurgery, neuro-oncological and functional neurosurgery. Oxford neurosurgical trainees also have the benefit of training with the renowned Oxford Craniofacial Unit team and the Oxford Functional Neurosurgery and Experimental Neurology (FNEN) group to attain world-class level experience.

Trainees can expect to gain exposure to and training in the following sub-specialty areas:

Skull base and Vascular Neurosurgery:

  • Endoscopic resection of pituitary tumours
  • Acoustic neuromas, meningiomas and other skull base tumours
  • Trigeminal neuralgia surgery
  • Aneurysms, arteriovenous malformations and spinal arteriovenous fistulas

 

Neuro-oncological Neurosurgery:

  • Awake cranial surgery
  • Gliolan assisted resection of malignant brain tumours
  • Endoscopic assisted resection of intra-axial brain tumours
  • Low grade glioma surgery

 

Spinal Neurosurgery:

  • Degenerative spinal disorders
  • Spinal instrumentation
  • Intramedullary and extradural spinal tumours

 

Functional Neurosurgery:

  • Deep brain stimulation
  • Spinal cord stimulation
  • Dorsal root ganglion stimulation
  • Epilepsy surgery

 

Paediatric Neurosurgery:

  • Hydrocephalus
  • Paediatric Brain Tumours
  • Craniofacial disorders
  • Spina bifida and paediatric spinal disorders

 

Training Site

Trainees are based in a single institution, the John Radcliffe hospital, a regional tertiary neurosurgical centre which serves a catchment area for an approximate 2 million population. Certain services including the Craniofacial, the Neurofibromatosis Type 2 and the Functional services are supra-regional and provide quaternary level services. ST1-ST3 level trainees undertake 4 month rotations through the Oxford Neuro-Intensive Care unit, and the Accident and Emergency department, which is an Adult and Children’s Major Trauma Centre. They additionally undertake rotations in neurology, orthopaedics and/or general surgery depending on their specific training requirements, as well as at least one to two years of training within the neurosurgery department itself.

From ST4 onwards, trainees are placed on the higher surgical training ‘registrar’ rota complete with full oncall duties. They rotate through each of the five clinical firms on six month rotations. For each year, they have a dedicated educational supervisor who they meet with six times per year, as well as between 3-4 named clinical supervisors for each placement. 

Day to day clinical training takes place in the setting of dedicated operating lists, outpatient clinics, the inpatient wards and the neuro-intensive care unit. Trainees are expected to attend the multidisciplinary team meetings that occur on a weekly basis for each firm.

 

Teaching:

There is a monthly departmental neurosurgical training morning, which is chaired by a consultant neurosurgeon on a rotational basis, and frequently features training sessions from external invited expert speakers. Over the course of the training programme, the entire curriculum is covered. Additionally Oxford participates in the South West Neurosurgical Supra-regional Training Days, which are held in collaboration with Plymouth, Bristol, Southampton and Cardiff and are held every few months. 

ARCPs:

The Annual Review of Competencies and Progress (ARCP) is currently held in June/July with the venue and exact date confirmed several months in advance.

Evidence is submitted electronically via the ISCP website and is reviewed by the ARCP panel prior to a feedback meeting which trainees attend.

The requirements for sign-off include:

  • Clinical Supervisor (CS) and Assigned Educational Supervisor (AES) reports
  • Completion of Multi-Source Feedback (MSF)
  • Completion of Workplace Based Assessments (WBAs) – Minimum 40 per year
  • Participation in clinical audit
  • Participation in teaching
  • Research presentations and publications
  • Satisfactory surgical logbook

 

Useful Resources:

The Society of British Neurological Surgeons

 

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