The Weill Cornell Fellowship in Skull Base and Microneurosurgery lasts 4 to 12 months, is tuition-free, and is open to surgeons worldwide, from senior residents to practicing neurosurgeons. The fellowship is lab- and skills-based and designed to provide fellows with an exhaustive understanding of surgical approaches to the cranial base. Instruction centers around supervised, independent, and slow, meticulous cadaveric dissection following our core tenets and surgical philosophy. All training is closely supervised and administered by experienced faculty and follows a standardized sequential dissection curriculum covering the entirety of the skull base. The program consists of an initial 3 months of systematic training in skull base surgical anatomy, followed by 3 to 9 months of training in skull base surgical approaches and techniques. Concurrent research opportunities are available starting in the fourth month, with junior resident teaching incorporated as appropriate after the fourth month.
The initial dissection curriculum is divided into two main blocks lasting a total of 3 months, comprised of extradural skull base (7 weeks) and intradural skull base/cisternal (5 weeks). Each block is subdivided into weeks dedicated to specific regions, beginning anteriorly and working posteriorly, wherein fellows identify a series of boney, neurovascular, and soft tissue structures, as well as key surgical landmarks. The first week is devoted to meticulous dissection of the orbit and the careful removal of all periorbital fat, while preserving all intraorbital structures. This gives fellows the opportunity to practice working under the surgical microscope, honing their microdissection skills, and lays the foundation for the expected pace of dissection going forward. From there fellows proceed posteriorly to the superior orbital fissure, middle fossa, cavernous sinus, anterior petrous bone, posterior petrous bone, posterolateral upper cervical region and craniocervical junction, lateral upper cervical region and extracranial jugular foramen, and infratemporal and pterygopalatine fossae.
Following the initial 3-month period of anatomic dissection, the curriculum shifts to technique based instruction for the remainder of the fellowship, where the full scope of skull base surgical approaches, maneuvers, and techniques are performed simulating live surgery, and under close direct faculty supervision. This encompasses anterior, anterolateral, lateral, and posterolateral approaches and their variants and associated maneuvers; combined skull base approaches; endoscopic transsphenoidal approaches; endoscope-assisted skull base techniques; lesion-specific approach selection; and targeting and tailoring of approaches and corridors.
Within the program, the faculty strongly fosters a spirit of constructive collaboration and egalitarianism. Fellows work closely together, collaborating on dissections and research projects, and constructively review dissections in a group setting, as well as manage day-to-day upkeep of the lab. There is no differentiation among fellows based on career seniority and all fellows begin from the same level, following the same systematic curriculum.
