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Neurosurgery has a long history of mentorship through a trainee’s dedicated time under a more experienced surgeon’s tutelage. Surgical training has long been considered a more advanced form of apprenticeship, mastering a skill under a more experienced practitioner’s guidance. In this tradition, the Sylvester Comprehensive Cancer Center — part of the University of Miami Miller School of Medicine — has launched an International Neuro-oncology Scholars Program (INOSP) that allows neurosurgery trainees to join internationally renowned brain tumor experts in other countries to increase their experience.

The goal is to enhance education and facilitate multi-institutional collaboration. The INOSP program is made possible by a generous gift from a grateful donor family. The plan is to support four traveling rotations each year.

Charles Teo, MD, IFAANS, left, with neurosurgery fellow Daniel Eichberg, MD.

“INOSP represents a unique resource offered to our fellows to visit and learn from world-renowned experts in neurosurgical oncology,” said neurosurgeon Ricardo J. Komotar, MD, FAANS, FACS. He continued, “The goal of the program is to enhance further their neurosurgical training so that they may be able to translate these techniques to our patients. With this international collaboration, we ultimately hope to improve clinical outcomes and enhance surgical education.”

The inaugural recipient of INOSP was neurosurgery fellow Daniel Eichberg, MD, who spent two weeks in Sydney, Australia, learning from highly accomplished neurosurgeons Charles Teo, MD, IFAANS and Michael Sughrue, MD, at Prince of Wales Hospital in Randwick, Australia.

“The opportunity to learn minimally invasive keyhole approaches for complex brain and skull base tumors in one-on-one training sessions from two of the most experienced neurosurgeons in these techniques was a powerful experience and augmented my skillset for cranial neurosurgery,” said Dr. Eichberg.

Dr. Sughrue and Dr. Teo have developed the world’s most advanced technology for mapping the brain’s functional and structural connectivity, which may be markedly abnormal in patients with brain tumors. Providing a better understanding of an individual’s connectome — a map of the brain’s overall connectivity — may critically impact brain tumor surgical outcomes by minimizing postoperative deficits, predicting recovery and maximizing the amount of tumor that can safely be removed during surgery.

Furthermore, this brain mapping technology uses machine learning and artificial intelligence techniques to guide non-invasive transcranial magnetic stimulation (TMS)-based neuro-interventional rehabilitation to improve postoperative brain tumor patients’ strength and speech deficits.

As a result of the international collaboration fostered by INOSP, Sylvester and the University of Miami Department of Neurosurgery will partner with the Sydney team in the Glioma Connectome Project. This endeavor seeks to learn how gliomas cause the brain to reorganize its connectome and initiate a TMS Neuro-interventional Rehabilitation prospective clinical trial.

“Not only are we now able to give our neurosurgical fellows access to additional world-renowned brain tumor experts and each of their unique skills, but we are also seeing that these new international relationships lead to groundbreaking global collaborative research and enhanced clinical trials that will continue to allow us at Sylvester to be able to provide the most advanced and world-class brain tumor treatments possible to our patients,” said program co-director Michael E. Ivan MD, MBS, assistant professor of neurosurgery.

Ashish Shah, MD; Alexis Morell, MD; Ricardo J. Komotar, MD, FAANS, FACS and Christopher A. Sarkiss, MD

Additionally, in 2019, the AANS/CNS Tumor Section, in conjunction with the CNS Foundation, created the International Observership Program, which will allow an Argentinean neurosurgeon to participate as an observer for three months at the University of Miami in the division of surgical neuro-oncology. The rotation focuses on all central nervous system tumors, with participation in clinic, conferences, surgery, and consultations.

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Ricardo J. Komotar, MD, FAANS, FACS
University of Miami Miller School of Medicine
Miami, Fla.

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