Registrar training and clinical fellowships

The Department of Neurosurgery provides a rich educational programme integrated into a busy clinical service. Speciality Trainees (ST) are appointed through national selection and complete a seven year training programme that ensures immersion in every subspeciality of neurosurgery.

In addition to the ST programme we also offer clinical fellowships in a number of sub-specialities, as well as attachments for medical students from the University of Liverpool and other institutions.

Neuro-oncology fellowship

The neuro-oncology service offers a comprehensive patient service for all tumour types. The Department offers a one-year fellowship that is suitable for either a post-CCT trainee or a more junior trainee. Fellows will be exposed to the surgical management all tumour types including low and high grade gliomas, metastases, meningiomas and rarer intraventricular and pineal tumours.  Fellows will experience complete exposure to a range of surgical techniques including awake craniotomy and functional mapping, frame-based stereotactic biopsy, use of Gliadel and fluorescence-guided resection, endoscopic surgery and stereotactic radiosurgery.  An intra-operative MRI is scheduled for installation in 2013. Fellows will be expected to participate and complete a clinical research project as part of the ongoing brain tumour research programme. This post has SAC approval for training.

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Epilepsy, pain and functional neurosurgery

Two fellowships are available for one to two years and are aimed at senior trainees seeking to subspecialise in functional neurosurgery. These posts have SAC approval for training. Fellows will be expected to complete a clinical research project as part of the fellowships.

Epilepsy surgery: A large number of resective surgical operations are undertaken as well as invasive monitoring procedures and vagal nerve and deep brain stimulation. Intra-operative and chronic recordings are routinely carried out using both depth and surface electrodes.  Neurophysiological support for intra operative mapping is regularly undertaken as are awake craniotomies for functional and neurophysiologically guided resections of a variety of lesions beyond lesionectomy for epilepsy.

Chronic pain: A wide range of percutaneous and open surgical procedures are undertaken for chronic pain conditions – the centre is now one of few institutions in the country providing lesional techniques such as DREZ and cordotomy. The Walton Centre has one of the largest neurostimulation programmes in the country including both spinal and intracranial stimulation.  A number of intra-thecal infusion devices are also implanted for spasticity and for chronic pain, both of non-malignant and malignant origin.

Facial pain: - The investigation and management of facial pain including the interventional management of trigeminal neuralgia, notably by microvascular decompression is of particular interest to the department; a stereotactic radiosurgery service is currently being developed for trigeminal neuralgia and foramen ovale techniques are also undertaken.

Movement disorders: - The main conditions treated by deep brain stimulation are Parkinson’s disease, dystonic and tremors such as essential or that related to multiple sclerosis.  A large number of surgical procedures for movement disorders are routinely carried out including deep brain stimulation, microvascular surgery for hemifacial spasm and intrathecal drug delivery for spasticity, and selective dorsal rhizotomy.

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Spinal neurosurgery

The Walton Centre is the lead centre for regional MSCC (metastatic spinal cord compression) and acute spinal cord injuries for the region. Also, the collaborative trauma unit is based at Walton/Aintree and hence large numbers of spinal fractures are referred here.  Six complex spinal surgeons offer a complete exposure to simple and complex spine conditions of all aetiologies.  Opportunity is also available to be exposed to paediatric deformity surgery at Alder Hey. Two spine fellowships are offered and are aimed at senior neurosurgical or orthopaedic trainees (one post has SAC approval for training). Exposure to degenerative spine disease, trauma, spinal instrumentation (open and percutaneous; from occiput to sacrum), MSCC, intradural/intramedullary spinal tumour work and a well organised regional Chiari/syringomyelia service is provided.

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Skull base neurosurgery

A one year fellowship in skull base neurosurgery is available and aimed at senior trainees seeking to gain further experience. Exposure to endoscopic pituitary surgery and minimally invasive skull base surgery will be provided. Fellows will be expected to complete a clinical research project as part of the fellowship. This post has SAC approval for training.

For further details contact: