Neurosurgery resident Matthew Svalina, MD, PhD, met his wife while studying in the dual MD/PhD program at the University of Colorado Anschutz School of Medicine. The program included 4 a.m. cadaver labs and late-night study sessions. The hard work paid off when he and his wife both matched at CU Anschutz for residency training.

Without protected research time, residents who want to pursue research in their early years of residency must find ways to fit it into their busy schedules, either while taking call or during precious sleep hours.

During Svalina’s fourth year, under the direction of a new department chair and surgeon scientist, Peter Fecci, MD, PhD, the residency training program underwent substantial changes in order to provide residents with five individualized training tracks in physician-scientist development, innovation, global health, education, and surgical mastery to cultivate the diverse skills and interests of each resident. For Svalina, the introduction of the physician-scientist track, combined with protected research time for every resident, was a welcome change.

 

A passion for basic science

Svalina’s neurosurgical area of interest is stereotactic and functional neurosurgery, and his research focus is on executive function in the human brain.  

Svalina explains that many neurological conditions cause executive dysfunction — Alzheimer’s, dementia, Parkinson’s disease, as well as other neuropsychiatric disorders. Svalina’s basic science research aims to understand the underlying mechanisms in order to discover better treatment options for these diseases.

“Basic science is just drilling down to how these networks in the frontal lobe function to sustain attention and focus and impulse control,” Svalina says.

When he started residency, Svalina gravitated toward computational neuroscience and human intracranial electrophysiology. Over the past few years, he has worked in this area under the direction of Daniel Kramer, MD, in the NERD-CO Lab.

“I worked with him on some of his intracranial steroEEG recordings and I will be working with him on this exciting work using the Neuropixels probe to elucidate how the dorsolateral prefrontal cortex contributes to executive function,” Svalina says.

There is very little research in these areas due to the limited number of opportunities to record in the human brain. Neuropixel probes allow researchers to record from a much higher number of neurons to get a clearer picture of what is happening in the brain.

“I started doing preliminary research with this probe during my PhD,” Svalina says. “My hope is that we have a more fundamental understanding of how computations are taking place and see how they are altered in health and disease.”

Another area of interest for Svalina is using deep brain stimulation (DBS) for patients with treatment-resistant depression. The CU Anschutz campus has a robust DBS program evaluating DBS to treat a variety of psychiatric conditions, including obsessive compulsive disorder, depression, and schizophrenia.

Science and medicine

When Fecci was announced chair of the Department of Neurosurgery, Svalina was thrilled. “There’s a shared language that MD/PhDs have,” he says. “They speak the language of both science and medicine.”

The physician-scientist track for neurosurgery residents brings innovators and scientists together to train neurosurgeons as scientists and innovators. The goal is to provide enough research support to get residents independent enough to run their own labs.

“The physician-scientist track provides time to do good science — set training goals, writing grants, protected research time, and advance studies while completing clinical training,” Svalina says.

In addition to the changes in the residency training program, Fecci has also recruited 20 new faculty members, including three PhD researchers, with additional faculty recruitment underway.

“Dr. Fecci is expanding the research programs that are associated with our clinical specialties,” Svalina says. “He’s recruiting lots of basic scientists, specifically in neuromodulation and brain tumor, to really shore up these programs.”

Before Fecci’s arrival, Svalina explains that the residency program was traditionally more clinically focused. “The program was more focused on surgery. You can be an excellent surgeon and an excellent scientist,” he says.

Under the direction of Christopher Roark, MD, neurosurgery residency program director, all neurosurgery residents, regardless of their track, are given protected research time outside of their scheduled clinical responsibilities.

“It’s a huge amount of time for surgical residents,” Svalina says. “The department is recruiting strong applicants and candidates who have strong research backgrounds and who want to continue to be innovators in the field.”

In addition to faculty support, residents also have access to research support services including grant management, tailored grant searches, and assistance with research operations including consultancy, regulatory compliance, and assistance with setting up clinical studies from patient recruitment to data management.

“Research year is your fifth year of residency, and you are in the lab full time. You make a lot of good progress,” Svalina says. “Then you come back during your sixth year as chief.”

During the chief year, clinical responsibilities are high, but residents are eligible to receive research funding to provide additional research personnel to continue their research projects. The seventh year of the physician-scientist track allows residents to split their time evenly between the clinic and the lab.

“The physician-scientist track gives you almost two and a half years of dedicated research progress,” Svalina says. “This makes you competitive for research awards and gives you a leg up in your path to independence.”

 

Strong academic neurosurgery program

With the implementation of the residency tracks combined with ongoing recruitment efforts, opportunities for incoming residents are new and novel.

“Fecci is changing the vision of the program,” Svalina says. “We are a top tier program where basic science is going to be a higher priority. The program is starting to look more like my ideal, strong academic program.”

Now in his fifth year, Svalina wants to be productive by applying for grants, publishing academic papers, and refining the vision of his future lab to position himself to apply for research funding when he graduates.

“This is a really exciting time to be a resident here because Dr. Fecci is really interested in creating something that is notable in both the clinical space and the research space.”