The University of New Mexico, School of Medicine is seeking a dynamic leader to serve as Chair of the Department of Neurosurgery at the UNM Health Sciences Center. The Chair will provide strategic leadership and direction for all aspects of the Department of Neurosurgery’s involvement in the University as well as in the state and region.
The Neurosurgery Department was established in 2005 as a stand-alone department and plays a critical role in the health of the State of New Mexico, as it is the single largest neurosurgical practice in the state. Dr. Howard Yonas as the first chair has built a multidisciplinary clinical faculty consisting of 7 neurosurgeons, 3 neurocritical care specialists, 3 physiatrists, a pain focused neurologist and an interventional trained neuroradiologist. The faculty is supported by 5 nurse practitioners. The faculty has expertise in all of the major subspecialty areas in Neurosurgery including Trauma, Neurovascular, Spine, Skull Base, Neuro/oncology, and Pediatric Neurosurgery and Oncology. The department also currently houses Neurocritical Care, the interdisciplinary Pain Consultation and Treatment Center, and the Physical Medicine and Rehabilitation (PM&R) Division, which is in preparation for becoming an independent department of UNM SOM. In many of these areas, faculty at the HSC represents the only resource in the state for subspecialty-trained experts. The department has a broad practice in multiple sites, with a significant research effort and a large telemedicine program.
Departments Mission Statement
Our patients will receive the finest integrated care for Neurosurgical Health Problems, which will include: Counseling pertinent to the disease or injury, Treatment, Therapy, and finally, any Surgery which may be required consistent with the highest medical standards
UNM Neurosurgery: People
Current clinical faculty includes 7 neurosurgeons, 1 interventional neuroradiologist, 3 neurocritical care intensivists, 4 physiatrists, and a pain neurologist. One neurosurgery faculty position is vacant and is an active recruitment effort. Two neurosurgeons have advanced vascular and endovascular training, and together with a Neuroradiologist form the Neuro Interventional Team for UNMH. There are 4.3 FTE research faculty. Advanced practice providers supporting the department number at 11, along with a physical therapist. There are 11 administrative support staff, and 7 clinical research support staff. The ACCESS program contributes a nurse educator and program manager to the team. Multiple staff and faculty in the department have significant tenure, a tribute to the dynamic and rewarding environment and the department’s significant accomplishments
UNM Neurosurgery: Education
The ACGME accredited Neurosurgery residency program offers a dynamic, rigorous and fulfilling training experience, and emphasizes both clinical and research skills. There are currently 11 residents involved in a 7 year program. University Hospital (UNMH), the state’s only Level 1 trauma center, is the main training site. The 24-bed modern Neurosciences Intensive Care Unit at UNMH is co-managed by Neurosurgery, permitting our residents to get significantly more hands-on training in trauma and critical care. The program also offers a Society of Neurological Surgeons-approved enfolded fellowship in critical care for PGY-2 residents that will enhance their training upon graduation in a field that has a shortage of trained doctors.
Our program emphasizes both clinical skills and the development of important research expertise and/or a specialty concentration in areas such as critical care, cerebrovascular care, pediatric neurosurgery, or spine care. All residents are required to work with clinical and research faculty on at least one major basic and/or translational research project that is presented and judged at the annual Neurosurgery Research Day. The department also provides research staff to assist residents with their IRB submissions, grant submissions and applicable maintenance of required paperwork. The residency program requires residents to have one quality and/or patient safety project per year. Having adopted the Next Accreditation System instituted by the ACGME, our program meets these new requirements.
A pre-residency program exists within the Neurosurgery Department (3 positions) as well as in partnership with Emergency Medicine and Surgery (an additional 3 positions). This program improves coverage of intensive care and subacute care units at UNMH while also providing an opportunity for medical students to obtain valuable experience while awaiting a program match. Several pre-residents have gone on to accept residency positions at UNMSOM, including Neurosurgery.
UNM Neurosurgery: Facilities and Programs
UNMH is the state’s only academic medical center. The 554-bed hospital manages over 93,000 emergency visits, 7,000 trauma cases, 18,000 surgeries, and over 491,000 visits, with an annual budget just under $2 billion. The Department of Neurosurgery has a strong financial arrangement with UNMH that rewards the department for growth and performance improvement. This is a critical component of support for the department. UNM Neurosurgery is an integral part of the push to move UNMH from Joint Commission Primary Stroke Center status to Comprehensive Stroke Center accreditation within the next 1-2 years. The Neurosurgery Department has significant block time in the main OR, which comprised of 16 operating rooms. The interventional radiology lab comprises 4 advanced IR suites and houses much of the department’s endovascular service. UNM Neurosurgery is the primary provider of interventional procedures at UNMH. In 2008, UNMH expanded by building the Bill and Barbara Richardson (BBRP) pavilion, which houses 6 OR suites that are primarily for pediatrics. Another 6 operating rooms exist at the Outpatient Surgery and Imaging Services facility two blocks from UNMH. The BBRP also houses the 24 bed Neurological Intensive Care unit that is co-managed through partnerships between Neurosurgery, Emergency Medicine, Surgery, and Neurology. We are currently in the planning stages for a new surgical tower adjacent to the current BBRP.
The UNMH Clinical Neurosciences Center is the only comprehensive neurology, neurosurgery, and pain management center in the state. This facility houses the Neurosurgery Clinic as well as the Pain Consultation and Treatment Center (Pain Center). Both clinics are managed by UNMH, with significant direction from the department. The Pain Center is an interdisciplinary clinic that includes faculty from Neurosurgery, Anesthesia, Psychiatry, Psychology, Family Medicine, and Neurology. A Pain Management Fellowship is directed by the Anesthesiology Department. Both clinics combined register over 7,000 visits a year. Faculty members also play central roles within Project ECHO, a national and international telemedicine educational program based at UNM.
The Sandoval Regional Medical Center (SRMC) is a 60-bed facility in Rio Rancho, and has six OR suites. A small neurosurgery and PM&R clinic is housed in the attached medical office building, and the department operates the Anthony Yeung Center for Minimally Invasive Spine Surgery out of SRMC. UNM is one of only a handful of academic centers engaged in the development of advanced endoscopic minimally-invasive surgical techniques for treatment of spinal disorders.
Other entities under the UNM Health Systems umbrella include the UNM Carrie Tingley Hospital, which offers the widest range of pediatric rehabilitation services in the state, the UNM Comprehensive Cancer Center, where 60 percent of adults and nearly every child with cancer in New Mexico receive care; the UNM Psychiatric Center and the UNM Children’s Psychiatric Center, which provide the full spectrum of behavioral health care. The UNM Medical Group supports more than 1,100 practitioners in over 150 specialties in outpatient clinics.
In 2017, UNM formed a joint venture with Lovelace Health System to operate the Lovelace/UNM Rehabilitation Hospital (LUNMRH), a 62-bed inpatient and outpatient rehabilitation facility. The Department of Neurosurgery, largely through the PM&R Division, is engaged in the creation of a PM&R residency at this site, as well as creating an interventional PM&R clinic focused on spine, musculoskeletal pain, and functional restoration services. The PM&R residency, slated to begin July 2019, will eventually comprise 15 residents with rotations at LUNMRH, the Raymond G. Murphy VA Medical Center, and UNM Carrie Tingley Children’s Hospital. The PMR division is in the process of application to become an independent department.
The UNM Access to Critical Cerebral Emergency Support Services (ACCESS) Telemedicine program is administered through the Neurosurgery Department. Through ACCESS, emergency room physicians and hospitalists across the state are able to consult with Neurosurgeons and Neurologists. ACCESS has markedly enhanced treatment of stroke and other neurological conditions in rural communities, and has radically altered patient transfer patterns, avoiding well over $100 million in transportation charges alone since inception in 2015. Begun as a CMS innovations grant, ACCESS is a sustainable and growing service that currently provides just over 200 consults a month, generating approximately $125,000 a month in professional services revenue.
For fiscal year 2019, the Neurosurgery Department has just over a $12 million budget.
UNM Neurosurgery: Research
Clinical and basic science research is a central element of the Department with most of the faculty actively engaged in either clinical or basic science research. There are presently 4.3 FTE of research faculty, with a PhD clinical research manager and 3 research coordinators, enabling robust national trial support and investigator-initiated studies. Key research projects include clinical investigations into spreading depolarization, multi-modal neurocritical care monitoring, and basic science studies of acute brain injury. Current grants and contract budgets total $3 million.
In 2014, Dr. Yonas received a contract with CMS to develop a unique neuro emergent telemedicine program in rural New Mexico. The 15.2 million dollar funding supported the creation of a state wide program that has impacted the entire state and established UNM Neurosurgery as a major player in New Mexico health care delivery. The unique value of this program is the basis for sustainability despite the end of federal funding.