Fellowship at Home: A Model for Expanding Neurosurgical Capacity in Low- and Middle-Income Countries
{"BACKGROUND":[0],"AND":[1],"OBJECTIVES:":[2],"Short-term":[3],"global":[4],"neurosurgical":[5,262],"missions":[6],"and":[7,55,70,73,108,111,116,156,266,275,295],"off-site":[8],"fellowships":[9],"rarely":[10],"achieve":[11],"durable":[12],"independence":[13],"in":[14,77,186,264],"low-resource":[15],"settings.":[16],"Sustainable":[17],"capacity":[18,54,263],"building":[19],"requires":[20,145],"longitudinal,":[21],"locally":[22,42],"embedded":[23,43,276],"training":[24],"that":[25,259],"integrates":[26],"technical":[27],"skill":[28],"with":[29,59,191,220],"system":[30],"development.":[31],"The":[32,92,98,253],"objective":[33],"of":[34,106,113,149,175,200,279,285],"this":[35,280],"study":[36],"was":[37,94,127],"to":[38,79,182,188,207,211,231],"evaluate":[39],"whether":[40],"a":[41,64,81,86,131,239,247],"\\"Fellowship":[44,89],"at":[45,90,255],"Home\\"":[46],"model":[47,87,257],"could":[48],"establish":[49],"sustainable":[50],"independent":[51,189],"cerebrovascular":[52,83],"surgical":[53],"identify":[56],"factors":[57],"associated":[58],"success.":[60],"METHODS:":[61],"We":[62],"established":[63],"longitudinal":[65,290],"partnership":[66,281],"(2022-present)":[67],"between":[68],"Brigham":[69],"Women's":[71],"Hospital":[72,74],"de":[75],"Itauguá":[76],"Paraguay":[78],"develop":[80],"comprehensive":[82],"program":[84,99],"through":[85,272],"termed":[88],"Home.\\"":[91],"goal":[93],"independent,":[95],"safe":[96,143],"practice.":[97],"combines":[100],"iterative":[101],"in-country":[102],"microsurgical":[103],"training,":[104],"development":[105],"neuroanesthesia":[107],"neurocritical":[109],"care,":[110],"implementation":[112],"standardized":[114],"operative":[115,154,297],"perioperative":[117],"systems,":[118],"reinforced":[119],"by":[120,196,234],"continuous":[121],"virtual":[122],"mentorship.":[123],"A":[124],"defining":[125],"strategy":[126],"deliberate":[128],"focus":[129],"on":[130,238],"single":[132,240],"high-complexity":[133],"\\"anchor":[134,242],"pathology.\\"":[135],"Brain":[136],"arteriovenous":[137,165],"malformations":[138],"were":[139,169,178,203],"selected":[140],"because":[141],"their":[142],"treatment":[144],"the":[146,197,217],"full":[147],"integration":[148],"advanced":[150],"anesthesia,":[151],"microsurgery,":[152],"imaging,":[153],"technology,":[155],"critical":[157],"care.":[158],"RESULTS:":[159],"Over":[160],"3":[161],"years,":[162],"18":[163],"brain":[164],"malformation":[166],"(bAVM)":[167],"resections":[168],"performed":[170],"collaboratively":[171],"without":[172],"preoperative":[173],"embolization,":[174],"which":[176,201,299],"13":[177],"Spetzler-Martin":[179,204],"grade":[180,205],"II":[181],"IV.":[183,208],"This":[184],"resulted":[185],"transition":[187],"practice,":[190],"14":[192],"bAVMs":[193],"subsequently":[194],"resected":[195],"local":[198,218,288],"neurosurgeon,":[199],"4":[202],"III":[206],"Systems":[209],"built":[210],"support":[212],"bAVM":[213],"care":[214],"translated":[215],"across":[216],"program,":[219],"aneurysm":[221],"clipping":[222],"volume":[223],"increasing":[224],"from":[225],"<60":[226],"cases":[227,233],"annually":[228],"before":[229],"2022":[230],">100":[232],"2025.":[235],"CONCLUSION:":[236],"Focusing":[237],"complex":[241],"pathology\\"":[243],"can":[244,269],"serve":[245],"as":[246],"catalyst":[248],"for":[249],"system-wide":[250],"capability":[251],"building.":[252],"Fellowship":[254],"Home":[256],"demonstrates":[258],"durable,":[260],"high-level":[261],"low-":[265],"middle-income":[267],"countries":[268],"be":[270],"achieved":[271],"continuity,":[273],"co-ownership,":[274],"training.":[277],"Analysis":[278],"identified":[282],"recurring":[283],"determinants":[284],"success,":[286],"including":[287],"leadership,":[289],"mentorship,":[291],"multidisciplinary":[292],"systems":[293],"development,":[294],"progressive":[296],"autonomy,":[298],"may":[300],"inform":[301],"future":[302],"capacity-building":[303],"initiatives.":[304]}
Authors
- Nirav J. Patel (ORCID: https://orcid.org/0000-0003-1725-3293)
- Lucia Rivera‐Lara (ORCID: https://orcid.org/0000-0002-9053-2283)
- R. Moser
- Linda Liverani
- Silvia D. Vaca
- Roberto Labin
- Pablo Maidana
- Jose Kuzli
Institutions
- Brigham and Women's Hospital (US)
- Harvard University (US)
- University of Massachusetts Chan Medical School (US)
- Hospital Nacional Cayetano Heredia (PE)
- Stanford Health Care (US)
- Stanford University (US)
Publication Details
- Journal
- Neurosurgery
- Published
- 2026-09-18
- DOI
- https://doi.org/10.1227/neu.0000000000004216
- Primary Topic
- Global Health and Surgery
- Type
- article
- Field-Weighted Citation Impact
- 0.00