The Committee on Advanced Subspecialty Training (CAST), our governing body for all fellowships in the U.S., has instituted certain changes to standardize accreditation of neurosurgical oncology (NO) fellowships. The most notable change has been with enfolded fellowships. Prior to beginning their fellowship, residents must have completed senior level clinical experience. The term “senior level” has been defined to occur after the successful completion of the chief resident year, ideally during PGY7 and not before PGY6.
Other program requirements for fellowship education in NO include the following:
- The standard length of fellowships will be 12 months and an optional year of research is strongly recommended.
- Each fellowship should provide a broad exposure to clinical evaluation and appropriate patient selection for operative and non-operative management in both the inpatient and outpatient settings.
- Each fellow should actively participate in the operative management of a wide range of NO disorders including benign and malignant tumors that affect the brain, skull, skull base, spine, spinal cord and peripheral nerves.
- A broad exposure to modern techniques for stereotactic radiosurgery (SRS) is considered an integral part of the NO fellowship experience and training.
We currently have 15 CAST-approved NO fellowships in the U.S. Each NO fellowship may differ in their focus from program to program, and candidates may have different goals in mind as well. The Tumor Section must continue to provide important guidance to CAST to remain flexible in how we structure these programs while adhering to the requirements set forth.