The evolution of training in brain stereotactic radiosurgery: a growing part of intracranial neurosurgery.
OBJECTIVE
Stereotactic radiosurgery (SRS) has evolved to become an established, well-studied treatment modality for intracranial pathologies traditionally treated with more invasive neurosurgical management. As the field expands, among neurosurgeons and across multiple disciplines, resident training will become increasingly crucial.


METHODS
In this review, we reflect on 25 years of SRS at the University of Pittsburgh Medical Center and the development of formal training in this area at our institution. We describe the formal resident rotation, fellowship opportunities, and training courses for multidisciplinary physician teams and allied health professionals.


RESULTS
The number of SRS cases performed annually has significantly increased in recent years and indeed surpassed caseloads for certain more traditional surgeries. Residents report high rates of expectation for including SRS in future practice, yet participate in only a small fraction of annual cases. The formal postgraduate year 3 rotation established at the University of Pittsburgh Medical Center provides a way to expose and educate residents in this growing subspecialty within the confines of duty hour regulations. In combination with extended clinical elective opportunities and postresidency fellowships, this rotation prepares residents at our institution for the use of SRS in future clinical practice.


CONCLUSIONS
SRS is a rapidly expanding field that requires a unique skill set and current neurosurgical resident training often does not fully prepare trainees for its use in clinical practice. Focused resident training is necessary to ensure trainees are proficient in this specialty and well equipped to become leaders in the field.
Department of Neurosurgery, New York University Langone Medical Center, New York, NY, USA.
Gillian
G
Harrison
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Ramesh
R
Grandhi
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Edward A
EA
Monaco
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Ajay
A
Niranjan
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address: shapirorb@upmc.edu.
L Dade
LD
Lunsford
D001921:Brain / Q000601:surgery*; D007396:Internship and Residency; D009493:Neurosurgery / Q000193:education*; D016634:Radiosurgery / Q000193:education*; D066231:Surgeons
Education; Gamma Knife radiosurgery; Medical residency; Radiosurgery