The Fellows Who Follow

September 01, 2013

Dr. Daniel F. Kelly’s innovative work attracts neurosurgeons from around the world.

Daniel F. Kelly, MD with Wei "Harvey" Hua, MD, PhDThe fellowship programs at the John Wayne Cancer Institute have impacted neurosurgeons and medical communities globally from China to Chile to Nigeria.

As director of the brain tumor center at the Institute and an inter-nationally recognized leader in neurosurgical research and training, Daniel F. Kelly, MD, receives dozens of applications for the clinical and observational fellowship programs every year.

One type of fellowship, the clinical fellowship, is designed for physicians who have already completed their neurosurgical residency. They receive an additional year of training focused on minimally invasive surgery for brain, pituitary and skull base tumors. The program is focused on teaching the latest techniques in endonasal (through the nose) and keyhole (small openings into the skull) approaches, and the overall care of patients with intracranial tumors.

The clinical fellow also participates in research projects and teaching conferences. Five clinical fellows have completed the program since it began in 2008.

Another training program, called the observational fellowship, is for foreign-trained neurosurgeons who want to gain additional experience in minimally invasive keyhole techniques. They typically spend six to 12 months at the Institute and Saint John’s Health Center observing in the operating room and attending neurosurgery clinic where new patients are evaluated.

These fellows have the opportunity to work on some of the biggest challenges in neurosurgery. For example, they participate in brain tumor research projects and learn new surgical dissection techniques in the micro-dissection lab. Led by neurosurgeon Garni Barkhoudarian, MD, the lab is one of the newest developments at the John Wayne Cancer Institute and brain tumor center.

“The average survival for patients with metastatic melanoma tends to be less than a year,” Dr. Kelly states. “There is a great need to improve our ability to understand how the tumors get into the brain and effective treatments to halt their growth.”

Dr. Kelly also oversees the Fudan Neurosurgical Fellowship, established earlier this year after he, Chester Griffiths, MD, and Dave S.B. Hoon, PhD, visited Fudan University in Shanghai, China. The resulting collaboration provides Fudan University neurosurgeons, such as current fellow Wei "Harvey" Hua, MD, PhD, with six to 12 months of study with Dr. Kelly and Dr. Hoon. This collaboration also includes the Institute’s researchers gaining access to Fudan’s extensive brain tumor tissue bank.

“We like the observational fellows to come for six to 12 months so they can gain a sufficient understanding of the indications, technical details and complication avoidance techniques of these newer approaches,” Dr. Kelly explains. “Many neurosurgeons feel they need the extra experience with these advanced procedures before they can go out and do them on their own.”

Currently, there are three obser-vational fellows at the Institute who train for a six-month period of time. They hail from China, Nigeria and Chile. Pablo Villanueva, MD, arrived as a visiting observational fellow in April 2013 and completed his fellowship this fall. Originally from Santiago, Chile, he studied neurosurgery at Pontificia Universidad Católica de Chile before completing a fellowship in pituitary surgery at the University of Melbourne in Australia. He now directs the pituitary tumor program and is an assistant professor at Pontifica Universidad Católica.

“You don’t just come here and do the surgeries and then you go home,” Dr. Villanueva says. “By being exposed to many of these surgeries, you have the chance to learn a lot about minimally invasive surgery and microdissection techniques as well as getting involved in research.From this experience, you eventually get the chance to get involved in writing articles and learn some skills and specific skull base surgical anatomy.”

Beyond the extensive scope of research taking place at the Institute, it’s the dedication and humility of Dr. Kelly that helps make the fellowship program so valuable, he adds.

+ The brain tumor program receives generous support from The Carole Zumbro and George Adler Family, Ruth K. March and Family, Danielle Brown Ross and Ronald Ross, and Jeff and Carole Schwartz.