Clinical Training Overview

3441 Cases in academic Year 2015-2016 – 50% cranial, 50% spinal 

OR 2486
IR 4756
Gamma Knife 479

 Wilson OR

1,800 Average Cases Logged by Chief Residents at the completion of their residency

- Wake Forest Baptist Medical Center consists of an 850-bed teaching hospital including the 150 bed Brenner Children’s Hospital,  the Sticht Rehabilitation Center, and the NCI- designated Comprehensive Cancer Center including the Brain Tumor Center of Excellence

- North Carolina Baptist Medical Center is the largest hospital in North Carolina serving a population of over 2 million people from North Carolina, South Carolina, Tennessee, Virginia, and West Virginia

- Wake Forest Medical Center includes: Level 1 Trauma centers for adults and pediatrics, a Joint Commission designated Comprehensive Stroke Center,  Comprehensive Spine Center,  4th busiest Gamma Knife center in the US, and the nation’s 3rd largest Deep Brain Stimulation programs. 

- North Carolina Baptist Medical Center is the largest hospital in North Carolina serving a population of over 2 million people from North Carolina, South Carolina, Tennessee, Virginia, and West Virginia

- These all-encompassing facilities and rich academic environment provides opportunities for residents to receive a well-rounded Neurosurgical training experience incorporating the full depth and breadth of Neurosurgical practice

Clinical Training Specifics

Call schedule:

PGY 1-4 residents have in-house call 4-5 times per month

  • PGY 1 residents take overnight in-house call with a PGY-4 resident providing direct supervision and clinical education
  • PGY 5-7 residents take home call
  • A food stipend is provided for on call residents
  • Spine call is split with the Orthopedic Spine service 2 weeks at a time

Conference and Interdisciplinary Meetings:  

Weekly Neurosurgery didactic clinical conference on Tuesday mornings

  • Topics include a rotating schedule of integrated lectures on Neuroradiology, Neuropathology, and Neurosurgical cases of high educational value
  • Residents deliver grand rounds reviewed by attending faculty to deliver a well-researched, up to date, and thorough presentation that will stimulate academic discussion and further scientific inquiry
  • Monthly Morbidity and Mortality conference
  • Monthly Journal Club with topics related to those presented in Tuesday clinical conference
  • Monthly Neurovascular and Stroke joint conference with Neurology, Neuroradiology, and Neurointerventional Surgery
  • Monthly trauma peer review conference
  • Management of epilepsy patients with the Epilepsy Neurology Team
  • Management of oncological patients at the weekly Neuro-Oncology case conference
  • Management of patients with Parkinson’s disease and other movement disorders in conjunction with the Movement Disorder Neurology team and clinic

Book Fund and Essentials:

In order to support the academic advancement and evolution of our residents’ knowledge base the program supports an annual book fund for all residents

  • $600 per resident per academic year
  • May be applied towards texts, journals, Neurosurgical courses, and Neurosurgical supplies. Other requests will be reviewed by the program director.
  • Loupes are provided and maintained by the department.
  • Monogrammed lab coats and dry cleaning is provided by the department.
  • PGY 4 residents attend the RUNN (Research Update in Neuroscience for Neurosurgeons) course which is funded by the department

Board Examination and National Meetings:  

Wake Forest University Department of Neurosurgery encourages its residents to excel in all aspects of Neurosurgery and the Neurosciences for the benefit of our patients and is pleased to reward such excellence. 

  • Written Neurosurgical boards are taken for practice in the PGY 1-3 years
  • Written Neurosurgical board examination is taken for credit in the PGY 4 year
  • Residents taking the boards for credit are sent to the Chicago Neurosurgery Board Review Course by the program to aid in preparation
  • Residents are required to pass the written board in at least the 80th percentile
  • Residents who pass the written boards for credit in or above the 90th percentile will receive an additional $500 toward their book fund.

Participation in organized neurosurgery through national and recognized regional conferences is highly encouraged. 

  • Funding of a national conference in the PGY 2 or 3 year in order to promote involvement and experience in organized Neurosurgery
  • Thereafter, funding will be provided for travel to approved national/regional conferences at which the resident is giving an oral presentation and the manuscript has been submitted for publication


  • Tuesday afternoon resident operated outpatient clinic
  • All residents may staff operative cases from clinic, based on their level of experience, and perform them with attending support and supervision
  • During elective rotations residents attend the faculty subspecialty clinics
  • Senior residents have a 3 month gamma knife and outpatient clinic rotation in order to hone clinical judgment and decision-making prior to graduation

Skull Base and Microsurgical Laboratory:

 Lab Collage

The daily hands-on experience that residents receive in the operative theater involving surgical technique, operative approaches, and microsurgical practice are all augmented via our Skull Base wet laboratory with the goal of providing an additional realm for residents to develop their surgical skill set for the betterment of the care they provide our patients.

  • Spinal and cranial cadaveric dissection courses take place every 6-8 weeks
  • Course topics include surgical approaches, the practice of microneurosurgery, and neural and vascular microsurgical anastomoses
  • Annual cadaveric spine course including basic and advanced spine surgery techniques with state-of-the-art operative instrumentation and imaging guidance
  • Annual combined Neurosurgery/ENT cadaveric course with emphasis on skull base and endoscopic approaches
  • Semi-annual visiting professorships in cranial and spinal neurosurgery


Functional Neurosurgery

Residents are involved in the care, planning, and surgery of patients undergoing functional Neurosurgical procedures throughout the whole of their residency.

Deep Brain Stimulation 

  • The Movement Disorders Center at Wake Forest Baptist Health has one of the most experienced DBS teams in the nation, as well as ranking in the top 3 busiest DBS programs nationally
  • In 1997, The Wake Forest team was among the first centers in the nation to perform DBS surgery


  • Epileptogenic mapping in dedicated Epilepsy Monitoring Unit in coordination with Epilepsy Neurology Team in order to tailor focused resections
  • Wake Forest has been at the forefront of Laser Interstitial ThermoTherapy. Both Neuroblate and AutoLITT are used at our institution to ablate epileptogenic foci
  • First in the Southeastern U.S. to use MRI guided Laser Interstitial ThermoTherapy for the ablation and treatment of unresectable brain tumors, and one of 5 programs in the nation to participate in clinical trials

Gamma Knife Radiosurgery

Wake Forest Baptist Medical Center has the 4th most active Gamma Knife Radiosurgery center in the U.S. with one of the most experienced Gamma Knife treatment teams

  • 476 cases performed in 2015-2016 Academic year
  • Gamma Knife Radiosurgery has been performed at Wake Forest since 1999 and we are one of the few medical centers funded by the National Cancer Institute to conduct brain tumor research
  • Senior residents have a 3 month Gamma Knife rotation combined with outpatient attending clinic

Pediatric Neurosurgery 

Wake Forest Neurosurgery residents participate in the planning, management, and operations of all pediatric patients at the Brenner Children’s Hospital throughout the whole of their residency rendering them able to care for the full range of pediatric neurosurgical pathology. The Pediatric Neurosurgery program features:

  • 2 full-time fellowship trained Pediatric Neurosurgeons
  • Level I Pediatric Trauma Center
  • Full Pediatric facilities on campus including a Neonatal ICU
  • Active pediatric scoliosis referral center
  • Opportunities for Pediatric Neurosurgery Medical Missions

Peripheral Nerve

  • High volume of Carpal Tunnel Release, Ulnar Nerve decompression, peroneal nerve decompression
  • Partnership with plastic surgery and orthopedic surgery for senior level peripheral nerve experience


Wake Forest Neurosurgery residents are trained in the full scope of operative and nonoperative spine management throughout their residency. Throughout its history, Wake Forest has been a pioneer in both complex and minimally invasive spine surgery thereby offering its residents fellowship level training in new fusion techniques and scoliotic deformity corrections during their residency training period.   

  • Faculty includes nationally and internationally recognized leaders in minimally invasive spine surgery along with complex deformity correction
  • Dedicated Spine Center featuring a multidisciplinary approach to patient care including surgeons, pain specialists, and therapy resources
  • Our faculty hold 13 U.S. and 11 European patents for the development of interbody fusion devices and operations
  • State-of-the-art surgical technique using image guidance and robotic assistance

Neurosurgical Oncology

Wake Forest Neurosurgery residents experience and have full access to the entire range of oncological management and research opportunities. As part of the NCI designated Brain Tumor Center of Excellence within the newly built Comprehensive Cancer Center tower, our residents are exposed to the full spectrum of Neurosurgical cranial and spinal oncological pathology. 

  • #1 Cancer Center in the State
  • Multi-disciplinary team includes Neurosurgeons, dedicated Neuro-Oncologists, and dedicated team of Neuro-Radiation Oncologists
  • Brain Tumor Tissue Bank Collection-available for resident research
  • One of 20 sites participating in a phase II randomized vaccine trial for GBM

Vascular Neurosurgery

Wake Forest Neurosurgery residents participate in the management and clinical decision making of all vascular patients and have direct, hands-on experience in both open microsurgical as well as neurointerventional treatment modalities. 

  • Extensive opportunities in both open and endovascular planning, treatment, and post-operation/procedural care throughout residency
  • PGY 3 and PGY5 level dedicated 3 month cerebrovascular/endovacular rotations for more focused experience in the care of vascular patients
  • Joint Commission designated Comprehensive Stroke Center with AHA recognition for outstanding door to needle times and an incredible IV tPA rate of 64%
  • Telestroke Exceptional Achievement award, which increases our neurovascular catchment area
  • #1 in lowest stroke and craniotomy mortality in the UHC network
  • Endovascular and open surgical management of Carotid disease with recognized experts in the field in conjunction with Stroke Neurologists
  • 2 dedicated Siemens neurointerventional angio suites available 24/7


Wake Forest Neurosurgery residents and faculty manage the total spectrum of operative and non-operative cranial and spinal trauma management at a Level 1 pediatric and adult trauma center. 

  • Specialization in both blunt and penetrating trauma
  • J. Paul Sticht Center on Aging and Rehabilitation: state-of-the-art rehabilitation facility on campus featuring a 12-bed dedicated Brain Injury Unit that provides a secure therapeutic environment allowing patients to move freely throughout the unit


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