Did you ever wonder why people sometimes say, “It’s not brain surgery”? That’s because it typically take 15 years of training after high school to become a neurosurgeon. This process is highly selective and grueling. Even after this process, a neurosurgeon is neither board certified nor fellowship trained, and additional right of passage is required to achieve these distinctions.
A graduate from a United States medical school can obtain a state medical license after completing an internship. However, in order to practice any specialty or sub-specialty of medicine, a residency is required. Neurosurgery residencies, which focus on brain and spine care, are the longest of any residency. In addition to residency training, some neurosurgeons choose to complete a fellowship to further gain expertise in a sub-specialty area of interest; and others seek board certification to demonstrate their commitment to their field.
Board certification is tied to the primary specialty, as there is a medical board for each of the specialties. Upon completing a specialized residency, a physician can take the exams and apply for certification by their specialty board.
“For neurosurgery, the process of board certification involves multiple phases, including completion of residency, passing the written board exam, review of one’s surgical case log by board-appointed experts, and passing the oral board exam conducted by leaders in the field,” said Kamal Woods, MD, FAANS the medical director for Kettering Brain & Spine. He is a fellowship-trained, board-certified neurosurgeon who specializes in minimally invasive spine surgery. “If they pass all those criteria, they can then be certified by the American Board of Neurological Surgery.”
Physicians can practice a specialty such as neurosurgery indefinitely without being board certified. A board certification indicates a physician has completed their residency and also has demonstrated to the specialty board they have the competence and experience to be endorsed as a certified specialist.
For physicians, a fellowship is an immersive, hands-on on or two year training program in a subspecialty that provides the physician the opportunity to work alongside national or global thought leaders in their specific area of interest.
“One could choose to subspecialize, for example, in minimally invasive surgery, vascular neurosurgery, or pediatric neurosurgery,” explained Dr. Woods. “These areas are all included in residency, but the fellowship is a way to gain additional expertise beyond the basic requirements.”
Physicians accepted to fellowship training programs are called fellows and are exposed to more complex cases in a highly specialized field. They are mentored by other physicians who have extensive experience and have excelled in their clinical and academic pursuits.
What does it mean to the patient?
Fellowship programs and board certifications show commitment and expertise, but what does it really mean for patients and the level of care provided? “Being fellowship trained, as well as board certified, demonstrates the physician has a commitment to and passion for treating patients in that area of medicine,” said Dr. Woods.
Fellowships are usually performed under the guidance of a physician or surgeon who has demonstrated a level of excellence to that community of specialists. The doctors who participate in fellowships are mentored and taught by some of the most elite physicians in the world.
“One could have various other doctors provide care,” said Dr. Woods. “But you can be confident knowing the fellowship-trained doctor you chose has a deeper understanding of your condition and has spent additional time enhancing their skill set to treat you.” There are far fewer fellowships than residencies.
When looking for a neurosurgeon, you should seek a physician who has gone the extra mile to obtain the training necessary to provide exceptional care. To learn more about Kettering Health Network’s neurosurgery expertise, visit ketteringhealth.org/neuro