FNB Spine Surgery Fellowship Programme

1. About the Programme

The Department of Spine Surgery at ISIC Multispeciality Hospital, New Delhi, holds the proud distinction of being the first unit in the country to be recognized by the National Board of Examinations (NBE) for super-specialty fellowship training in Spine Surgery, a milestone achieved in the year 2000. This landmark recognition underscores the department's pioneering role in the development of specialized spine surgery training in India and reflects its enduring commitment to surgical excellence, academic leadership, and patient care.

Over the past two decades, the FNB (Fellow of National Board) Spine Surgery programme at ISIC has trained numerous spine surgeons who are today recognized as leaders in their field, practising across premier institutions in India and internationally. The department continues to set benchmarks in spine surgical outcomes, research output, and fellowship training quality.

The two-year FNB Spine Surgery fellowship is a rigorous, structured super-specialty training programme that is open to both Orthopaedic Surgeons and Neurosurgeons, making it one of the few truly multidisciplinary spine training programmes in the country. Currently, three fellows are selected every year through a nationally competitive process.

3. Admission & Selection Process

Selection to the FNB Spine Surgery fellowship programme is conducted through a rigorous and transparent national process overseen entirely by the National Board of Examinations:

• An All India Entrance Examination is conducted by the NBE annually.The examination tests candidates on spine anatomy, biomechanics, pathology, and clinical decision-making relevant to spine surgery.
• Applications are invited the NBE each year. Candidates should apply through the official NBE portal within the stipulated timeline.
• The programme is open to candidates holding MS (Orthopaedics), DNB (Orthopaedics), MCh (Neurosurgery), or DNB (Neurosurgery) qualifications from NBE-recognized or university-recognized institutions.
• Seat allotment is conducted through a centralized counselling process administered by NBE, based on the candidate's rank in the entrance examination and seat availability at accredited centres.
• All eligibility criteria, application procedures, examination syllabi, and counselling schedules are governed by NBE. Candidates are advised to regularly visit www.natboard.edu.in for the most current information.

4. Fellowship Commitments & Training Structure

The two-year FNB Spine Surgery fellowship at ISIC Multispeciality Hospital is designed to provide fellows with an immersive, high-intensity training experience that encompasses clinical practice, surgical skill development, research, and academic participation. From day one, fellows are integrated as active members of the spine surgery team.

4.1 Clinical Responsibilities

• Fellows actively participate in all Spine Outpatient Clinics, where they are responsible for the initial assessment, clinical evaluation, and diagnostic work-up of new and follow-up patients.
• Fellows assist in the development of individualized management plans for patients with complex spine pathologies, under the direct supervision of consultant spine surgeons.
• On-call responsibilities are assigned to provide fellows with exposure to emergency spine conditions including acute disc herniation, spinal trauma, and cauda equina syndrome.
• Accurate and systematic documentation of all clinical encounters, operative notes, and follow-up records is a mandatory responsibility of all fellows, building habits of meticulous record-keeping essential for clinical practice.
• Fellows are involved in pre-operative planning, intraoperative surgical decision-making, and post-operative management, gaining a holistic understanding of the surgical patient journey.

4.2 Surgical Training

Hands-on surgical training is the cornerstone of the FNB fellowship. Fellows at ISIC benefit from an exceptional surgical volume and case complexity:

• The department performs approximately 2,000 spine surgeries annually, providing fellows with unparalleled exposure to a vast and diverse case mix.
• Surgical procedures range from straightforward decompressions and microdiscectomies to the most complex multi-level deformity corrections, revision surgeries, and minimally invasive spine procedures.
• Both orthopaedic and neurosurgical spine cases are managed, giving fellows a truly comprehensive understanding of the full spectrum of spinal disorders.
• Fellows progress through structured levels of surgical autonomy - from assisting to performing under supervision to operating with senior oversight - as their competence is assessed and confirmed.
• Training encompasses cervical, thoracic, and lumbosacral spine surgery, including disc replacement, spinal instrumentation, interbody fusion, osteotomy, tumour resection, and infection management.
• Exposure to intraoperative neurophysiological monitoring, fluoroscopy-guided and navigation-assisted surgery, and endoscopic/minimally invasive techniques is provided.

5. Scope of Surgical Exposure

The rich and varied clinical material at ISIC Multispeciality Hospital ensures that fellows gain exposure to a comprehensive range of spinal conditions and surgical procedures:

5.1 Degenerative Spine

• Cervical and lumbar disc herniation - microdiscectomy, anterior cervical discectomy and fusion (ACDF), cervical disc replacement
• Lumbar canal stenosis - laminectomy, laminoplasty, decompression with or without fusion
• Spondylolisthesis - posterolateral fusion, TLIF, PLIF, ALIF, XLIF/LLIF
• Cervical myelopathy - anterior and posterior approaches, laminoplasty
• Adjacent segment disease and revision spine surgery

5.2 Spinal Deformity

• Adolescent idiopathic scoliosis (AIS) - posterior spinal fusion with pedicle screw instrumentation
• Adult degenerative scoliosis and sagittal imbalance - complex multi-level corrections, pedicle subtraction osteotomy (PSO), vertebral column resection (VCR)
• Kyphosis - Scheuermann's kyphosis, post-tubercular kyphosis, iatrogenic deformity
• Early onset scoliosis - growing rod techniques and magnetically controlled growing rods (MCGR)

5.3 Spinal Trauma

• Cervical spine injuries - occipito-cervical fixation, C1-C2 stabilization, subaxial cervical fixation
• Thoracolumbar fractures - posterior short and long segment fixation, corpectomy and anterior reconstruction
• Osteoporotic vertebral fractures - vertebroplasty, kyphoplasty, and cement-augmented fixation
• Polytrauma cases with associated neurological deficits

5.4 Spinal Tumours & Infections

• Primary benign and malignant spinal tumours - intralesional excision, en bloc resection, reconstruction
• Metastatic spine disease - palliative decompression, stabilization, and separation surgery
• Spinal tuberculosis - medical and surgical management, anterior debridement and fusion
• Pyogenic and fungal spinal infections

5.5 Minimally Invasive Spine Surgery (MIS)

• Percutaneous pedicle screw fixation, MIS-TLIF
• Endoscopic spine surgery - uniportal and biportal endoscopic discectomy and decompression
• Navigation-assisted and robotic-guided spine procedures
• Outpatient and day-care spine surgery protocols

6. Research, Publications & Academic Achievements

Research is deeply embedded in the culture of the Spine Surgery department at ISIC, and the FNB fellowship provides fellows with exceptional opportunities to contribute to the advancement of spine surgery knowledge. The department has a distinguished track record of high-impact research and international recognition.

6.1 Research Awards & Recognition

The department's research has been honoured with several prestigious international awards:

• ISSLS Prize - 2004, 2010, and 2013: The International Society for the Study of the Lumbar Spine (ISSLS) Prize is among the most coveted awards in global spine research, and ISIC's Department of Spine Surgery is one of very few institutions in the world to have won it multiple times.
• ASSI DePuy Research Awards - 2004 to 2013: Multiple awards from the Association of Spine Surgeons of India (ASSI) in partnership with DePuy recognizing outstanding clinical and translational research.
• Sofamor Danek Award of the ISSLS - 2006: A further recognition from the ISSLS for research of exceptional quality and international significance.

6.2 Fellow Research Commitments

• Each fellow is required to undertake a long-term research project during their two-year tenure, culminating in the submission of a formal Dissertation to the National Board of Examinations. This dissertation must demonstrate scientific rigor, ethical compliance, and meaningful clinical relevance.
• In addition to the dissertation, fellows are encouraged to conduct shorter research projects that can be completed and submitted for presentation at national and international conferences.
• Fellows are guided and supported to publish their research findings in peer-reviewed indexed journals, with editorial mentorship provided by senior faculty.
• The department's rich clinical material of nearly 2,000 surgeries per year provides fertile ground for prospective cohort studies, registry-based research, randomized controlled trials, and systematic reviews.
• Regular research methodology workshops, biostatistics training, and manuscript writing sessions are organized to equip fellows with the skills needed for impactful research.

6.3 Conference Participation

• Fellows are expected and supported to present their research at major national conferences including ASSI (Association of Spine Surgeons of India), IOA (Indian Orthopaedic Association), and Neurospine India.
• Participation in international meetings such as ISSLS, AOSpine, North American Spine Society (NASS), and EuroSpine is actively facilitated for fellows with strong research output.
• The department regularly hosts national spine surgery workshops, cadaveric surgical courses, and visiting professor programmes, in which fellows play an active organizational and academic role.

7. Academic & Teaching Activities

Beyond the operating theatre, the FNB fellowship at ISIC offers a structured and stimulating academic environment:

• Weekly Spine Journal Club: Critical appraisal of landmark and recent publications in spine surgery, fostering evidence-based clinical decision-making.
• Case Conferences: Multi-disciplinary case discussions involving spine surgeons, radiologists, neurologists, oncologists, and rehabilitation specialists for complex cases.
• Grand Rounds: Regular departmental grand rounds where interesting, challenging, and instructive cases are presented and discussed.
• Radiology & Imaging Sessions: Dedicated teaching sessions on the interpretation of spine MRI, CT myelography, CT scans, dynamic radiographs, and EOS imaging.
• Biomechanics & Implant Workshops: Hands-on sessions on spine implant systems, surgical instrumentation, and the biomechanical principles underlying surgical decision-making.
• Guest Lectures by International Faculty: Periodic visits by globally recognized spine surgeons who conduct operative demonstrations, lectures, and interactive workshops.
• Cadaveric Surgical Courses: Fellows participate in hands-on cadaveric courses covering advanced surgical approaches and techniques, conducted at the hospital's anatomy facility.

8. Infrastructure & Facilities

ISIC Multispeciality Hospital provides world-class facilities to support the highest standards of spine surgery and fellowship training:

• Dedicated Spine Operating Theatres with laminar airflow, intraoperative fluoroscopy (C-arm), and 3D cone-beam CT navigation systems.
• Intraoperative Neurophysiological Monitoring (IONM) - continuous SSEP, MEP, and EMG monitoring for complex spine deformity and tumour cases.
• Robotic-Assisted Spine Surgery platform for precision screw placement and minimally invasive procedures.
• High-field 3 Tesla MRI, 128-slice CT scanner, and digital X-ray systems with EOS full-body imaging for comprehensive spine imaging.
• Comprehensive Implant Library including systems from leading global manufacturers for deformity correction, motion preservation, and tumour reconstruction.
• Physiotherapy and Spine Rehabilitation Unit with dedicated spine rehabilitation protocols and gym facilities.
• Digital Medical Library with access to PubMed, Cochrane Library, Ovid, and major spine surgery journals including Spine, European Spine Journal, and The Spine Journal.
• Research Cell with dedicated statistical analysis support, data management infrastructure, and manuscript preparation assistance.
• Skills and Simulation Lab for cadaveric training, implant handling workshops, and endoscopic technique simulation.

9. Faculty & Mentorship

The FNB Spine Surgery fellowship is guided by a team of internationally trained, highly experienced spine surgeons with subspecialty expertise spanning all domains of spine surgery. Faculty members are active contributors to national and international research, hold leadership positions in major spine surgery societies, and regularly participate as faculty at global spine surgery meetings.

Each fellow is assigned a primary faculty mentor who provides individualized academic guidance, research supervision, career counselling, and ongoing performance feedback throughout the two-year training period. The mentorship model ensures that every fellow receives personalized attention and develops a well-rounded surgical and academic identity.

10. Further Information

For complete and current information regarding the FNB Spine Surgery programme - including eligibility criteria, examination dates, application procedures, seat matrix, and counselling schedules - candidates are advised to visit the official website of the National Board of Examinations:

www.natboard.edu.in

For institution-specific enquiries regarding the FNB Spine Surgery fellowship at ISIC Multispeciality Hospital, New Delhi, please contact the Department of Spine Surgery or the Academic department - academics@isichealthcare.org