The Beginning
The University of Florida (UF) College of Medicine opened in 1956, accepting its first medical school class. In 1958, Shands Hospital admitted its first patient. Sometime shortly thereafter, Edward Woodward, the Chair of the Surgery Department hired UF’s first neurosurgical Chief, Henry Lamar Roberts. Roberts was born in Macon, Georgia on 9/2/1919. After obtaining an MD and PhD, he trained in neurosurgery with Wilder Penfield at the Montreal Neurological Institute (Figure 1). He and Penfield coauthored the neurosurgical classic, “Speech and Brain Mechanisms.”1 He brought expertise in epilepsy surgery and functional neurosurgery to UF. He remained at UF until 1968 when he went into private practice in nearby Ocala.
The real hero of the first neurosurgical decade at the University of Florida was Francisco Garcia-Bengochea, M.D.. He went to medical school in Cuba and did his neurosurgical training at Columbia Presbyterian in New York City, under Byron Stookey, M.D., Lester Mount, M.D. and others. He is actually mentioned in John Gunther’s book, “Death Be Not Proud,”2 in his role caring for Gunther’s young son, Johnny Jr., who died from a glioblastoma. Dr. Garcia became a renowned leader of Cuban neurosurgery with a practice that included many patients from other parts of the Caribbean and South America. When Castro came to power, he and his family left everything behind and came to the United States. He found a neurosurgical position at the University of Kansas with Charles Brackett, M.D.. His brother, an engineer, worked in Gainesville, Florida. This connection led to his moving to the new UF Neurosurgery Division in 1960. Until the arrival of Albert L. Rhoton, Jr., in 1972, Dr. Garcia was the go-to and sometimes the only practicing neurosurgeon at UF. His trainees (starting with Joseph Cauthen, M.D. in 1962 and ending with William A. Friedman, M.D. in 1982) remember him as a superb surgeon and a consummate gentleman.
During the “Roberts-Garcia” era, several other neurosurgeons served short terms on faculty: Robert Brawley, M.D. in 1966 and Joseph Cauthen, M.D. (mentioned above as the first resident) from 1970—1973. The service was focused on general neurosurgery. The residency program began in 1962 and continues to this day (see Table 1 for a complete resident trainee list).
In 1968, Dr. Woodward searched for a new neurosurgical chief. He interviewed Albert L. Rhoton who was then on faculty at the Mayo Clinic but judged him “too young.” He hired Lowell E. (Bud) White, Jr., M.D. White had trained in neurosurgery at the University of Washington. After joining the UW faculty he also served as an Associate Dean of the medical school. His time at UF was short. Dr. Garcia served as Interim Chief. Woodward hired Albert L. Rhoton in 1972 (Figure 2).
Rhoton
Albert Loren Rhoton Jr. trained at Washington University. After residency he joined the Mayo Clinic faculty and, in 1972, was recruited by Ed Woodward to become chief of neurosurgery at the University of Florida. He became the first Chair when departmental status was achieved in 1980. During his tenure as chairman, he landed the first $1 million donation in the history of the University of Florida system. He subsequently obtained funding for 10 endowed chairs for research and education in cerebrovascular, pediatric, spinal, computer-assisted and stereotactic surgery, and microsurgery and neural regeneration. He played a key role in the development of the McKnight Brain Institute, a 6-floor building devoted to neuromedicine, which opened in 1998.
Dr. Rhoton was an outstanding teacher of residents and neurological surgeons. He began a series of microsurgery courses at the University of Florida in 1975 that were attended by more than 1000 neurosurgeons and residents over the ensuing 25 years. He published more than 400 scientific papers and chapters, as well as 3 books. He contributed many full-issue supplements to Neurosurgery, featuring his outstanding neuroanatomical studies, which have truly changed the way that all neurosurgeons perform microsurgery and improved surgical outcomes for countless patients.
During the “Rhoton era,” the number of UF neurosurgical faculty rapidly increased. Ira Denton joined briefly in 1974. Jack Maniscalco, M.D., a UF trainee, was on faculty from 1975-1978. Jin Whang, another trainee, briefly served on faculty. Both Maniscalco and Whang wound up in private practice in Tampa. Maniscalco remained there throughout a distinguished neurosurgical career. Whang eventually returned to Korea where he became a national neurosurgical leader. Joseph Cauthen left in 1973 for private practice in Gainesville, first at Alachua General Hospital and then at the newly opened North Florida Regional Medical center. Cauthen was the recognized leader of the Gainesville private neurosurgical community throughout his career.
See Table 2 for a complete list of UF neurosurgery faculty over time. Figure 3 shows the entire department in 1981. Other faculty during the “Rhoton era”:
- George W. Sypert, M.D. – Sypert trained at the University of Washington and brought deep epilepsy expertise to UF. He joined the faculty in 1974. He had continuous NIH and VA grant funding for well over a decade while pursuing basic spinal cord neurophysiological research with his neuroscience colleague, John Munson, Ph.D. Sypert was one of the first neurosurgeons in the U.S. to embrace and teach spinal instrumentation. He later (1990) pursued a very successful private practice career in Ft. Myers, Florida.
- John K. Vries, M.D. – Vries trained at the Medical College of Virginia under Donald Becker, M.D.. He was UF’s first pediatric neurosurgeon. He later became Chief of Pediatric Neurosurgery at the University of Pittsburgh Children’s Hospital. In his later career, he focused on computational biology.
- Arthur L. Day, M.D. – Day trained at UF and spent several decades on faculty as its premier cerebrovascular neurosurgeon. He left to eventually become Chair of Neurosurgery at the Brigham and Women’s Hospital at Harvard. He later joined the UT Houston faculty. During his very distinguished academic career, he served as President of the Congress of Neurological Surgeons, President of the Society of Neurological Surgeons, and Chairman of the Board of Neurological Surgery. He published over 170 papers and served as Visiting Professor at more than 50 institutions.
- J. Parker Mickle, M.D. – Mickle trained at Brigham and Women’s Hospital and, in 1979, replaced John Vries as UF’s pediatric neurosurgeon. He ran a very busy clinical practice until his retirement from neurosurgery in 2000.
- William A. Friedman, M.D. – trained at UF and joined the faculty in 1982. See details below.
- Paul J. Reier, Ph.D. – Reier obtained his Ph.D. at Case-Western in 1972. He joined UF Neurosurgery in 1984. His research centered the biology of spinal cord injury. He and Richard Fessler, M.D, Ph.D. spearheaded a first in human trial of stem cell transplantation for spinal cord injury. He transferred to the Department of Neuroscience in 1996.
- Steven A. Reid, M.D. – Reid trained at UF and joined the faculty in 1985. In 1990 he left to pursue a successful private practice career in Gainesville.
- Richard G. Fessler, M.D., Ph.D. – Fessler trained at the University of Chicago. He joined UF in 1989. He moved to Rush University in Chicago in 2000. In 2002 he became Chief of Neurosurgery at the University of Chicago. He later moved to Northwestern, then back to Rush. He has made many contributions in the area of minimally invasive spine surgery. He is the author of many books, chapters, and papers and is a sought after national/international speaker.
- John Delashaw, M.D. – Delashaw trained at the University of Virginia. He spent several years on the UF Neurosurgical faculty before moving to the University of Oregon in 1992. He was Chair of Neurosurgery at UC Irvine and at the Swedish Neuroscience Institute in Seattle. He is currently on faculty at Tulane.
- Steven N. Roper, M.D. – Roper trained at UCLA and joined the faculty in 1992. He is the surgical director of the UF Comprehensive Epilepsy program and has performed well over 1000 surgeries for epilepsy. For many years he ran a basic epilepsy research lab which was funded by the NIH and the Epilepsy Foundation of America. He also runs a very busy pituitary surgical practice.
- R. Patrick Jacob, M.D. – Jacob trained at UF. After several years in private practice in Ocala, he returned to UF in 1992. His clinical interests focused on complex spine surgery. He became Chief of Neurosurgery at the Gainesville VA Hospital in 2014 where he continues to serve today. He has been President of the Florida Neurosurgical Society and a member of the Board of Directors of the American Association of Neurological Surgeons.
In 1999, Rhoton stepped down as Chair. He continued an active clinical and research practice until his death in 2016. After a national search, William A. Friedman, MD was appointed (January 1, 1999) the second Chair of UF Neurosurgery (Figure 4).
Friedman
William Alan Friedman trained at UF. In 1982, he joined the faculty of the Department of Neurosurgery, as an Assistant Professor. He received an NIH Teacher Investigator Award which funded research into the basic neurophysiology of spinal cord injuries. In addition, this award supported the development of one of the first intraoperative neurophysiology monitoring laboratories, subsequently used to monitor thousands of neurosurgical and orthopedic surgical cases. Dr. Friedman served as Medical Director of the Intraoperative Neurophysiology Service from 1982-1992.
Friedman brought image guided stereotactic surgery to UF and performed many stereotactic “firsts” in Florida including biopsy, guided craniotomy, brachytherapy, pallidotomy, and deep brain stimulation. In 1986, Dr. Friedman began collaborative work with Frank J. Bova, Ph.D., which led to the development of the University of Florida radiosurgery system. Dr. Friedman is the leader of a multidisciplinary radiosurgery team which has treated over 5000 patients, published more than 150 papers and chapters, produced many international meetings, and educated hundreds of visiting physicians.
Dr. Friedman is the Director of the Preston Wells Center for Brain Tumor Therapy at the University of Florida. During his tenure as Chair of the Department of Neurosurgery he grew the department’s endowed funds to greater than $45 million, much of which is focused on finding a cure for malignant brain tumors. In 2013, these funds were used to recruit Duane Mitchell, M.D., Ph.D. and his team to UF. The translational research team, which has now grown to over 100 members, is focused on first in human brain tumor immunotherapy for malignant brain tumors.
The ”Friedman era” was characterized by dramatic growth of sub-specialized clinical faculty, departmental clinical volume and unprecedented growth in the research aspects of the department (Figures 4-8). New clinical programs included a world class movement disorder surgery center and a renowned endovascular/cerebrovascular surgery group. He led the task
force which brought Level 1 trauma to UF. For five years, Friedman led a UF Neurosurgery group at Orlando Health in Orlando, Florida. He played a major role in convincing the Shands Hospital Board to build the Neuromedicine Hospital which opened in 2018.
Clinical faculty hired during this nearly twenty-year epoch include:
- David W. Pincus, M.D., Ph.D. – Pincus trained at Columbia and did a pediatric neurosurgery fellowship at National Children’s Hospital, Washington, D.C. He joined UF in 1999 as our pediatric neurosurgeon. His interests included all aspects of pediatric neurosurgery as well as complex spine surgery. In 2017, he became Chief of Pediatric Neurosurgery at the Kaiser Permanente Oakland Medical Center.
- Benjamin H. Guiot, M.D. – Guiot trained at the University of Ottawa. He did a complex spine fellowship with Richard Fessler at UF and joined the faculty in 1999. After several years he left to pursue opportunities at several other institutions. He is now in private practice in St. Augustine, FL.
- Robert Mericle, M.D. – Mericle trained at UF. He did an endovascular fellowship under Nicholas Hopkins at SUNY, Buffalo. He joined the UF faculty in 2000 as its first endovascular neurosurgeon. He left in 2004 and is currently in private practice in Nashville.
- James V. Gainer, Jr., M.D. – Gainer first trained in family practice and became a Naval Flight Surgeon (eventually becoming Captain USNR). He retrained in neurosurgery at West Virginia University and established a private practice at Alachua General Hospital in Gainesville, FL. When AGH was acquired by Shands, he joined the UF faculty. He later became Chief of Neurosurgery at the Gainesville VA Hospital (2003). He retired in 2007.
- Stephen B. Lewis, M.D. – Lewis trained in Perth, Australia. He did fellowships in cranial base (with Alan Crockard, London) and vascular neurosurgery (with Arthur Day, UF). He joined the UF faculty in 2002 and ran a busy cerebrovascular service until his return to Perth in 2013 where he is in private practice.
- Jeffrey Henn, M.D. – Henn trained at the Barrow Neurological Institute. He joined UF in 2002. He had a busy clinical practice until his departure for private practice in Ft. Myers in 2004.
- Kelly D. Foote, M.D. – Foote trained at UF. He joined the UF faculty in 2002 where he helped to build a world leading movement disorder center. He and his colleagues currently perform hundreds of deep brain stimulation procedures per year. He also has special training and expertise in radiosurgery. He is the author/coauthor of over 200 papers and chapters, the recipient of numerous awards and research grants. He is a very popular national and international speaker.
- Brian L. Hoh, M.D. – Hoh trained at Massachusetts General Hospital (Harvard) and joined UF in 2006. See details below.
- Gregory J.A. Murad, M.D. – Murad trained at UF and joined the faculty in 2007. He has served as President of the Florida Neurosurgical Society and as a Council of State Neurosurgical Society representative. His clinical interests include general adult neurosurgery and complex spine surgery. He has served as Residency Program Director since 2015.
- J. Richard Lister, M.D. – Lister trained at UF and spent much of his career on faculty at the University of Illinois, Peoria. In 2007 he returned to UF as Associate Chairman, Residency Program Director and Chief of the VA Service. He retired in 2015.
- Erin Dunbar, M.D. – Dunbar trained in medical oncology at UF and did a neuro-oncology fellowship at Johns Hopkins (under Stuart Grossman). She joined UF as its first neuro-oncologist from 2007-2013. She currently practices at Piedmont Hospital in Atlanta.
- J Duffy Mocco, M.D. – Mocco trained at Columbia and did an endovascular fellowship at SUNY, Buffalo. He joined the UF faculty in 2008 as an endovascular expert. While at UF he was a prolific writer and sought-after teacher/mentor. In 2011 he left for Vanderbilt. He is currently on faculty at Mt. Sinai in New York City.
- Daniel J. Hoh, M.D. – Hoh trained at the University of Southern California and did a complex spine fellowship at the Cleveland Clinic (under Edward Benzel). He joined UF in 2011. He is a complex spine surgical expert and is the director of the UF Comprehensive Spine Clinic. He is Treasurer of the Congress of Neurological Surgeons and is on the Executive Board of the Joint Spine Section. He is on the editorial board of Spine and JNS Spine.
- Spiros Blackburn, M.D. – Blackburn trained at Washington University where he also did an endovascular fellowship. He joined UF in 2012 as an endovascular expert. In 2015 he departed for the University of Texas, Houston where he remains.
- Maryam Rahman, M.D. – Rahman trained at UF. She did a surgical neuro-oncology fellowship at Johns Hopkins (under Alfredo Quinones). She returned to UF in 2013. She has served as President of the Florida Neurosurgical Society. Her clinical focus is on advanced surgical techniques for brain tumor surgery. She has an NIH K award which supports her basic research into immunotherapy for brain tumors.
- David Tran, M.D., Ph.D. – Tran received an MD/PhD from the Mayo College of Medicine. He completed internal medicine training and a neuro-oncology fellowship at Washington University, then joined their faculty. In 2015, he joined UF Neurosurgery as Chief of Neuro-Oncology. He is an NIH funded investigator and a leader in precision medicine. He is the principal investigator of many brain tumor clinical trials.
- Ashley Ghiaseddin, M.D. – Ghiaseddin did Neurology residency at the University of Indiana and a neuro-oncology fellowship at Duke. He joined UF Neurosurgery as a neuro-oncologist in 2015. He is the PI on multiple clinical trials.
- W. Christopher Fox, M.D. – Fox trained at the University of Michigan. He did an endovascular fellowship at UF (under Brian Hoh). After time at the Naval Hospital in San Diego and at Columbia in New York, he joined the UF faculty (2015). In 2020 he departed to join the Mayo Clinic in Jacksonville, FL.
- Adam Polifka, M.D. – Polifka trained at the University of Maryland. He did an endovascular fellowship at Thomas Jefferson. He joined UF in 2015. His clinical interests include open and endovascular neurosurgery as well as complex spine surgery.
- Sridharan Gururangan, M.D. – Dr. Gururangan completed his fellowship in peds heme-onc at Memorial Sloan Kettering in 1999. He then joined the Duke Brain Tumor Center. In 2016 he moved to UF Neurosurgery as our pediatric neuro-oncologist. He left in 2021.
- Chandan Reddy, M.D. – Reddy trained at the University of Iowa and did fellowships in movement disorder surgery and peripheral nerve surgery. He was on UF faculty from 2017-2019 before departing for private practice in Orlando.
- Lance S. Governale, M.D. – Governale trained at Brigham and Women’s and did a pediatric neurosurgery fellowship at Boston Children’s Hospital. He joined the faculty at Nationwide Children’s Hospital in Columbus, Ohio. In 2017 he moved to UF as Chief of Pediatric Neurosurgery. He has special expertise in craniosynostosis and tethered spinal cords.
- Jason E. Blatt, M.D. – Blatt trained at the University of North Carolina and did a pediatric neurosurgical fellowship at Children’s Hospital of Pittsburgh. He joined UF as a pediatric neurosurgeon in 2017. He has special interests in epilepsy surgery and endoscopic surgery. He serves as the Quality Director for UF Neurosurgery.
Research Faculty hired include:
- Frank J. Bova, Ph.D. – Bova obtained his Ph.D. in Medical Physics at UF and joined the UF Radiation Oncology department in 1978. Bova and Friedman developed the patented UF radiosurgery system and treated the first patient in 1988. They have treated over 5000 patients to date. Bova joined the UF Neurosurgery department in 1999. He has served as Chair of the UF Faculty Senate. He has been a UF Research Foundation Professor and has received the UF Inventor of the Year award. He is the author of over 200 papers and chapters and has mentored dozens of Ph.D. and Masters students. His laboratory also supports all image guided surgery procedures at UF.
- Dennis Steindler, Ph.D. – Steindler received his Ph.D. at UCSF and did a post-doc fellowship at the Max Plank institute. He joined the UF Neuroscience department where his research focused on stem cell biology. He became Director of the McKnight Brain Institute at UF (2004-2010). He then joined the UF Neurosurgery Department. In 2014 he left to become a Senior Scientist at Tufts University.
- Brent Reynolds, Ph.D. – Reynolds received his Ph.D. from the University of Calgary. He and his mentor discovered the existence of stem cells in the adult nervous system and developed the neurosphere assay. His research career has focused on stem cell biology and nutriceuticals.
- Didier Rajon, Ph.D. – Rajon earned his Ph.D. at UF. He joined UF Neurosurgery in 2005 after a 2-year postdoctoral fellowship with Bova. He supports the Bova laboratory and the image guided surgery program.
- Mu Yang, M.S. – Yang joined UF Neurosurgery after receiving his masters in Computer Sciences in 2002. He supports all aspects of image guided surgery at UF.
- Duane Mitchell, M.D., Ph.D. – Mitchell received his MD and a Ph.D. in immunology at Duke. He then joined their neurosurgical faculty as Associate Director of the Duke Brain Tumor Immunotherapy Program. In 2013, Mitchell joined UF Neurosurgery as Associate Chair for Research, Co-Director of the Preston Wells Center for Brain Tumor Therapy and Director of the UF Brain Tumor Immunotherapy program. He has served as the PI of many first in human immunotherapy treatment protocols for brain tumors. He has built a world leading immunotherapy program with over 100 active participants. He recently became Director of the UF Clinical and Translational Science Institute.
- Elias Sayour, M.D., Ph.D. – Sayour did a pediatric residency at North Shore Long Island, then a heme-onc fellowship at Duke. He also completed a Ph.D. at Duke. He joined the UF Neurosurgery and Pediatrics faculty in 2013. His research focus is mRNA nanoparticle vaccines for malignant brain tumors. He is the PI on a first in human study of this approach. He has multiple NIH and foundation grants.
- Jianping Huang, Ph.D. – Huang earned her medical degree from Harbin University in China and her Ph.D. from the Chinese Academy of Sciences in Beijing. She joined UF neurosurgery in 2013. She is the Director of Clinical Laboratory Operations for the UF Brain Tumor Therapy Program and has NIH funding for her own research focused on CAR-T cells in immunotherapy for brain tumors. She is PI on a first in human clinical trial launching this year.
- Koji Hosaka, Ph.D. – Hosaka received his Ph.D. from Nihon University in Japan. He joined Brian Hoh’s lab in 2010.
- Loic P. Delyrolle, Ph.D. – Delyrolle received his Ph.D. from the University of Montpellier in France. He did postdoctoral fellowships at the University of Queensland and at UF, then joined the Reynolds laboratory. In 2016 he moved to the Mitchell laboratory where his research focuses on stem cell biology in brain tumors.
- Catherine Flores, Ph.D. – Flores received her Ph.D. from Imperial College London and did post-doc work at Duke. She joined the UF faculty in 2013. Her NIH funded research (two R01s) is focused on the use of hematopoietic stem cells to overcome resistance to PD-1 blockade in the treatment of brain tumors. She is PI on a first in human clinical trial using this approach.
- Oleg Yegorov, Ph.D. – He received his Ph.D. from the Academy of Science in Kiev, Ukraine. He completed post-doc training in Canada and at UF. In 2014 he joined the UF faculty where his research is focused the genetic characterization of brain tumors and immune responses.
- Farhad Dastmalchi, D.V.M. – he earned his DVM in Iran. He joined the UF faculty in 2016 as part of the Preston Wells Brain Tumor Center. His research is focused on tumor specific autologous immune cells in the treatment of malignant brain tumors.
- Katherine Candelario, Ph.D. – She received her Ph.D. from the University of New Mexico. She was a post-doc in the Steindler lab. She joined the UF faculty in 2016. His research is focused on adoptive T cell therapy in the treatment of brain cancer.
- Hassan Azar, Ph.D. – Azari received his Ph.D. from Isfahan University in Iran. He did a postdoc at UF (under Brent Reynolds). He joined the UF faculty in 2018. His research is focused on the use of natural products in combination with immunotherapy in the treatment of brain tumors.
Hoh
In 2018, Brian Lim Hoh became the third Chair of the UF Department of Neurosurgery (Figure 5). He earned his BA from Stanford University, his MD with Alpha Omega Alpha honors from Columbia University College of Physicians & Surgeons, and did his neurosurgical residency training and fellowship in interventional neuroradiology at Massachusetts General Hospital. He earned his executive MBA from the Hough Graduate School of Business at the University of Florida Warrington College of Business Administration with Beta Gamma Sigma honors.
Dr. Hoh’s clinical and surgical interests are centered on the microsurgical and endovascular treatment of cerebrovascular diseases and conditions. He is an NIH-funded principal investigator of the biologic mechanisms of cerebral aneurysm formation and rupture, as well as innovative tissue engineering technology to improve the treatment of cerebral aneurysms.
He is also a leader in neurosurgical education at the University of Florida, where he is a past-program director of the neurosurgery residency and past-fellowship director of the endovascular surgical neuroradiology fellowship. He is currently the President of the Congress of Neurological Surgeons.
Clinical faculty hired during the “Hoh era” include:
- Siva Sriharan, M.D. – Sriharan trained at the University of Alberta and did a complex spine fellowship at the Medical College of Wisconsin. He joined UF neurosurgery in 2019 as part of the UF Comprehensive Spine Center.
- Matthew A. Decker, M.D. – Decker trained at UF. He joined the faculty in 2020.
- Justin D. Hilliard, M.D. – Hilliard trained at UF. He did an enfolded movement disorder fellowship with Kelly Foote and spent several years on faculty at the University of Kentucky. He returned to UF in 2020.
- Nohra Chalouhi, M.D. – Chalouhi trained at Jefferson and completed fellowships in endovascular surgery and spinal neurosurgery. He joined UF in 2020.
- Matthew J. Koch, M.D. – Koch trained at Massachusetts General Hospital.. He did separate fellowships in endovascular surgery and open vascular/skull base surgery. He joined UF in 2021.
Dr. Hoh spearheaded the development of the UF Comprehensive Spine Center. He has established an active UF Neurosurgical service at Halifax Hospital in Daytona Beach, Florida. He brought an NIH NINDS R25 Early Research Program grant for Neurology and Neurosurgery to UF. He has facilitated the opening of the new Fixel Center for Neurological Diseases at UF. Most recently, he has become the PI on a $38 million NIH U award. His goals include top five status for our department in US News ranking and NIH funding.
Acknowledgements: Many thanks to alumni, Joseph Cauthen, M.D., Jack Maniscalco, M.D., and J. Richard Lister, M.D. for invaluable help in reconstructing this history.
References
- Penfield W, Robert HL: Speech and Brain Mechanisms. Princeton, NJ: Princeton University Press; 1959.
- Gunther J: Death Be Not Proud. New York, NY. Harper Press, 1949.