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The Department of Neurosurgery at the NCVC attracts the country's best neurosurgeons. In addition to its physicians, many physicians from universities and medical institutions from all over Japan come to the NCVC to pursue resident or specialist training or to perform research. As a specialist training facility recognized by the Japan Neurosurgical Society, the department offers a resident training curriculum to nurture future specialists in neurosurgery. In addition, the department has established a system that provides necessary training in brain tumor treatment, pediatric neurosurgery, and spine and spinal cord surgery. The training programs are confirmed in collaboration with other training and related facilities associated with the NCVC. The specialized training curriculum is designed to train high-level specialists in cerebrovascular diseases who will lead the future of this branch of medicine.

　

1. Cerebrovascular diseases

The Department of Neurology at the NCVC, the key facility for training programs, has performance records that are among the best and most advanced with regard to the treatment of cerebrovascular diseases in Japan. The abundant clinical experience provided by the department, ranging from common diseases to highly refractory illnesses and from acute to chronic cases, allows an in-depth learning of the whole spectrum of specialized medical care, from basics to its application. Trainee physicians can learn firsthand how high-level medicine is practiced in each case as the department's specialists draw up an optimal treatment modality for each case by selecting from among, or combining, open surgery, endovascular treatment, and stereostatic radiosurgery. Trainees can thereby expect to develop the ability to find solutions from a broad perspective.

Close collaboration with neurologists
The key facility enjoys close collaboration with the Department of Neurology, which represents the largest group of specialists in the field at one place in Japan, with a total of over 40 specialists of neurology and cerebrovascular internal medicine. Together, these specialists determine treatment policies and engage in medical care in many cases. Through discussions at weekly joint conferences of neurosurgeons and neurologists, trainees learn to examine diseases from multiple aspects, including an internist perspective, thereby keeping neurosurgeons from always practicing "their own way."Surgeons can also learn internist skills, such as the interpretation of carotid or intracranial ultrasound images.

2. Brain tumor

The treatment of benign intracranial tumors, such as meningiomas, requires high-level microsurgical techniques. Accordingly, trainee physicians receive thorough training in this area to learn how to minimize tissue damage while maximizing treatment effects. Meanwhile, among the current treatment modalities available for brain tumor, patients are being increasingly treated with surgery in combination with gamma knife radiosurgery, if deemed necessary. Therefore, in this training program, neurosurgeons undergo the entire process from conceiving a radiation schedule to delivering treatment. Thus, trainee physicians acquire practical knowledge and skills required for stereostatic radiosurgery.

The treatment of primary malignant tumors in the central nervous system requires not only microsurgery and radiosurgery but also broad knowledge about chemotherapy and brain tumor pathology. For these reasons, a part of the 4-year training period is exclusively reserved for intensive training in this domain, allowing trainee physicians to learn how to handle a diverse range of cases.

The number of cases with brain metastasis of malignant tumors has been increasing due to population aging and prolongation of survival from primary diseases. In this program, trainee physicians can practice gamma knife radiosurgery; referrals of patients with brain metastasis of malignant tumors are expected to the training facilities from many community-based medical institutions.

3. Head trauma

At partner facilities, trainees learn the basics of trauma management usually by observing traffic trauma cases. At the key facility, which handles many cases of head trauma and intracranial hemorrhage with antithrombotic therapy (antiplatelet/anticoagulant therapy) and takes in a wide range of cerebrovascular patients, trainees can expect to build a broad base of knowledge and gain experience in the management and surgical treatment of these specific conditions.

4. Spine and spinal cord diseases

This program takes place in specialized facilities that perform over 600 spine and spinal cord surgical procedures each year. Trainees can thus pursue efficient learning with exposure to many cases in a concentrated manner.

5. Pediatric neurosurgery, functional neurosurgery

Among the associated training facilities is a children's hospital with one of the largest patient populations. In this program, trainees learn about pediatric diseases such as congenital malformation and hydrocephalus in a concentrated manner during a 3-month rotation period. At the key facility, which has a large number of cases of pediatric cerebrovascular diseases, practical training is offered in pediatric craniotomy and perioperative management. Regarding functional neurosurgery, a system is set in place to enable trainees to pursue intensive training at associated facilities, so that they learn both the theoretical and technical aspects of treatment.

Thorough off-the-job training in treatment techniques
Vascular anastomosis training is provided using a system that includes the use of laboratory animals, allowing trainees to acquire high-level microsurgical techniques. For endovascular treatment, a training room equipped with a simulator is provided for effective practice.

Nationwide educational seminars dedicated to surgical and endovascular treatment techniques
For over 15 years since 2001, the Department of Neurosurgery has been hosting a major 3-day educational seminar for neurosurgeons twice a year, with a focus on open surgery and endovascular treatment; the event is titled "Art and Science of Neurovascular Intervention". All physicians undergoing specialist training at the department are required to participate in this seminar and play active roles in learning and discussions. Consequently, while acquiring expert techniques, trainees can expose themselves to diverse practices and opinions, cultivating a broad perspective unconstrained by a particular school of thought.

last updated : 2021/10/01