Spine Fellowship

Spine Fellowship overview

Dr. Hiratzka
Dr. Jayme Hiratzka

We aim to provide our fellows with the clinical and surgical skills to manage all aspects of a modern surgical spine practice. We strongly emphasize decision-making based on the principles of evidence-based medicine. Our fellows gain in-depth knowledge of primary and revision degenerative problems of the cervical and lumbar spine, adult spinal deformities and spinal trauma, including spinal cord injuries. Exposure to minimally invasive techniques and pediatric deformities is also available. Protected time for study and research is assured. Fellows are expected to participate in at least one original research project supervised by an attending spine surgeon, and one review article, book chapter or similar. Fellows also participate in weekly educational conferences with the orthopaedics and neurosurgical residents. No general orthopaedic call is required. Fellows can expect to participate in over 300 surgical cases, including many complex revision procedures. Surgical involvement will increase as the fellow gains maturity, with the goal of operating independently and managing a complex surgical spine caseload by the end of the fellowship.
~ Dr. Jayme Hiratzka, Spine Fellowship Director

Spine Fellowship program details

The Department of Orthopaedics and Rehabilitation at Oregon Health & Science University seeks applicants for 12-month clinical fellowships. Candidates should have completed the equivalent of five years of orthopaedic training in the United States. International applicants must have completed the ECFMG exam.

Interview dates for the 2020-2021 fellowship are:

  • Monday, Jan. 28, 2019
  • Monday, Feb. 4, 2019
  • Monday, Feb. 11, 2019
  • Monday, Feb. 25, 2019

How to apply

Please apply through Spine Fellowship Match.

Vivek Natarajan, M.D.

Vivek Natarajan, M.D.

Vivek graduated from the OHSU orthopaedic residency in 2015. He completed a pediatric orthopaedic fellowship which included a substantial volume of pediatric and adolescent spine cases. He practiced general pediatric orthopaedics for 2 years before deciding that he wanted to focus more on spine. Being familiar with the OHSU spine program, he chose to return for the fellowship to gain a broad and well-rounded background in adult spinal surgery. He intends to develop a practice that encompasses the full spectrum of adult and pediatric spine.

Thuy M. Nguyen, D.O.

Thuy M. Nguyen, D.O.

I grew up in Missouri and attended medical school at Kansas City University. Thereafter, I completed a neurosurgery residency at Beaumont Hospital in Detroit. I chose this fellowship for a multitude of reasons but the biggest reasons included the attendings. I felt the attendings were very receptive to academics and discussions and demonstrated a very easygoing and collegial attitude. OHSU is the only academic/university level 1 trauma center in the Pacific Northwest, and as a graduate of a neurosurgery program I wanted to be in a fellowship that would allow me to see the worst of the worst cases. As a tertiary referral center I knew I would see everything from simple degenerative cases to complex deformity in addition to revision cases.

Incoming fellows 2019-2020

Vikram Sampath, MD - Augusta University, Augusta, GA

Tyson Travis, DO - OPTI-West/Valley Hospital Medicine Center, Las Vegas, NV

Incoming fellows 2020-2021

Michael Wheeler, M.D. - John Peter Smith Hospital, Fort Worth, TX

Stephen Hoge, M.D. - Louisiana State University-Shreveport

Previous fellows

2017-2018     Aaron Kunkle, DO

2017-2018     Chandrakanth Boddu, MD

2016-2017     Wesam Nasrallah, MD

2015-2016     Christopher Kong, MD

2015-2016     Ngoc-Lam Nguyen, MD

2014-2015     Renuka Kuruvalli, MD

2014-2015     Sourabh Mukherjee, MD

2013-2014     Satoshi Kawaguchi, MD

2012-2013     Max Berdichevsky, MD

2012-2013     Marc El Najjar, MD

2011-2012     Ahmed Mohamed, MD

2011-2012     Paolo Punsalan, MD

2010-2011     David Ferachi, MD

2010-2011     Brian Jones, DO

2009-2010     Kurtus Dafford, MD

2008-2009     Geoffrey Kaung, MD

2005-2006     Alex Ching, MD

As an extension of the faculty, fellows are responsible for participating in patient care, including operative care, inpatient care, call and clinics. Fellows are also responsible for resident education, and are required to participate in weekly basic scientific and clinical conferences, as well as clinical or basic research. The goal of the fellowship is to produce a well-rounded spine surgeon who can provide a valuable contribution to the medical community. The main priorities are: 1) surgery and patient care; 2) research and education.

Operative care

During the clinical year the fellows are the primary assistants to the attending physician during surgery. The fellows do not operate independently except as directed to do so by the attending physician. Cases include primary and revision degenerative problems of the cervical and lumbar spine, adult spinal deformity, spinal trauma including spinal cord injury patients, and fracture and tumor patients.

Inpatient care

The spine service is run by three full-time attending orthopaedic spine surgeons, with fellows functioning as junior consultants. Fellows are responsible for supervision of two orthopaedic residents assigned to the spine service (PGY-1 and PGY-4).  Fellows and residents are responsible for ensuring adequate communication with the attending physician(s). While the primary responsibility for inpatient work rounds is carried by the residents, fellows are responsible for knowledge of and involvement with patient care on an ongoing basis.

Call

Spine call is divided equally between the orthopaedic and neurosurgical services. Call is taken in one-week blocks that begin on Mondays at 6 a.m. Fellows are responsible for devising a call schedule that ensures that there is a fellow covering each on-call block. The spine team PGY-4 also participates in the spine call schedule, taking up to two days of call in any week.

Clinic

Fellows are expected to be at all clinic sessions with the attending physician(s) as dictated by the trainee schedule. Fellows will become proficient in the diagnosis of clinical disorders of the spine, the pathogenesis of these disorders, the operative and nonoperative treatment modalities available for managing these disorders, and the results and complications of such treatment. This learning environment provides a unique opportunity to develop clinical judgment that will ultimately lead to the ability to function independently as the primary surgeon.

Conferences

Fellows are expected to attend and participate in the following weekly scheduled conferences at OHSU:

  • Grand Rounds/M&M -- Presentation of service M&M summary will be done by the PGY-1 or PGY-4. Presentation of individual cases will either be by the senior resident or the fellows, depending on faculty assignment.
  • Spine lecture series -- Fellows will alternate presenting 30-minute didactic lectures with the neurosurgery residents. Each fellow thus presents approximately one didactic lecture every other month. The PGY-4 on service will also present once during their rotation.
  • Spine indications conference -- Fellows and residents will present operative elective cases for the upcoming week. Fellows are responsible for presenting or guiding the residents in presenting concise patient histories, including relevant radiographs.

Fellows are permitted to attend one approved course or national meeting during the fellowship year, with a $1500 travel stipend provided by the department. To ensure adequate coverage of the service, fellows to should plan to attend different meetings. Additional meetings may be approved on a case-by-case basis if the fellow has original research to present.

All fellows are expected to participate in at least one original research project, supervised by an attending spine surgeon, and one review article, book chapter or similar. Opportunities for both in-house and external grant funding exist for collaboration in valid clinical or basic science research projects. An epidemiologist and outside statistical consultant are available for research project design and analysis. In addition, two full-time research assistants support the spine service. Fellows are encouraged to begin their research project early, in order to prepare abstracts for submission by March or early April. The goal is to have a peer-review publication submitted by the end of the fellowship year.

Timeline for milestones is as follows:

  • Review of research opportunities complete by Sept. 1
  • Presentation of written research proposal with critique by faculty by Dec. 1
  • Submission of first draft of the paper to faculty advisor(s) by March 1

Authorship: Fellows will be given first authorship on papers if they complete a nearly final draft prior to the conclusion of the fellowship. However, if the attending physician has to substantially complete the paper, or a major rewrite is needed, the fellows will forgo the privilege of first authorship.

Presentation: Costs for travel and registration to any North American meeting at which the fellows are presenting original research will be covered by the spine education fund. Abstract authorship and presentation will be handled as for paper authorship.

Orthopaedic spine team

Orthopaedics Spine Team
Dr. Jayme Hiratzka, Dr. Clifford Lin and Dr. Jung Yoo