Program Curriculum by Year

Each year of the program has a specific focus, with progressively more responsibility for patient management under the direct supervision of the faculty.

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PGY-1

Rotation in Neuro ICU (3 months):

Interns are expected to rotate and round in the Neuro ICU for a 3-month block. During this time, they will be exposed to a Systems-Based Practice approach for taking care of patients critically ill from neurologic disease. This rotation is Monday thru Friday. They will be expected to arrive by 7am to receive sign-out from the Neuro-ICU night float and may be expected to stay until 7pm to give sign-out. On the weekend, interns may be expected to work one day with the Neurosurgery team to be determined by the chief residents.

Rotation in Neurosciences (3 months):

Interns will experience a 3-month long experience in the Neurosciences with rotations in a variety of specialties including Anesthesia, Stroke Neurology, Neuro-Ophthalmology, Neuro Interventional, Neuro Radiology, and Palliative Care. During this block, interns will begin to take buddy call overnight with more senior residents.

Rotation in Neurosurgery (6 months):

Interns will rotate on the Neurosurgery service for a total of 6 months. During the first three months the intern will focus on learning to see consults and performing procedures under the supervision of more senior residents and advance practice practitioners. During the second three months interns will begin to assume more responsibility by seeing consults independently and holding the service pager. Interns may be asked to work one weekend day per week. During the second 3 months interns will start to take overnight buddy call with more senior residents.

PGY-2

During this year, residents must complete a one-year rotation on the neurosurgical service at Upstate Medical University (UMU) as a junior resident. The PGY-2 resident is primarily responsible for all neurosurgery inpatient care under direction of the Chief Resident(s) and Attending Neurosurgeons.

PGY-3

During this year, residents must complete a six-month rotation on the neurosurgical services at St. Joseph’s Hospital and six months at the University Hospital as a junior resident.  While at University Hospital, residents will be primarily responsible for all neurosurgery inpatient care under direction of the Chief Resident(s) and Attending Neurosurgeons when the PGY2 resident is post-call or on vacation. Residents will also be expected to take an active role in the training of the interns with learning procedures and assisting with the floor work when needed.

St. Joseph’s Hospital Rotation Expectations: The experience at St. Joseph’s Hospital is designed to be an intensive spine experience.

PGY-4

During this year residents will complete a 6 month rotation at the VA hospital, 3 month rotation at Boston Children’s hospital, and a 3 month rotation at University Hospital. 

During the Upstate Rotation the residents are expected to focus on building their operative skills, however are still expected to help the more junior residents in teaching and assisting with difficult bedside procedures. 

VA Hospital Rotation Expectations:

  • Residents are responsible for all inpatient, consults, clinic and OR cases at the VA. Coverage is expected from 5:30am to 5:30pm Monday thru Friday (PC).
  • During this rotation residents will gain more experience in patient selection for elective cases and will have the opportunity to follow patient’s longitudinally through pre-operative counseling, peri-procedural care, and post-operative care (PC, PBL, P, ICS).
  • Understand differences in the VA health system from other rotations (SBP)

Boston Children’s Hospital Rotation Goals/Expectations:

  • Demonstrate competency in examining and evaluating pediatric neurosurgery patients (PC, MK).
  • Demonstrate competency in performing common pediatric neurosurgery procedures such as shunt placement, spina bifida closure, and craniosynostosis procedures (PC, MK).
  • Demonstrate competency in all major intracranial and intraspinal procedures, including craniotomy for brain and spinal cord tumors and vascular malformations, surgical treatment of pediatric epilepsy, and surgical management of spasticity (PC, MK).

PGY-5

This year residents will have 12 months of Elective Time. During this time residents are expected to engage in basic science or clinical research (PBL). Time may also be spent participating with clinical activities, such as completing additional ICU training to be eligible for Critical Care CAST certification upon graduation. Plans for elective time must be discussed and approved by the Program Director before the end of the PGY-4 year (P). Ideally, these discussions begin as early as the PGY 2 or 3 year. On-call activities will be divided between junior and chief call as judged by readiness as determined by PD and Chief Resident(s). The resident is expected to work on call in a more independent fashion including in the operating room (PC, PBL). The PGY-5 resident will typically be the resident representative to GME committees and also participate in resident applicant interviews (SBP, PBL, P, ICS)

PGY-6

Residents at the PGY-6 level must have passed the primary written board exam before starting PGY-6 and then complete a twelve-month rotation as Chief Resident on the neurosurgical service at University Hospital. Chief residents are expected to demonstrate competency in all major neurosurgical procedures encountered during training, but in particular adult and pediatric craniotomy for vascular disease, malignant and benign brain tumors, neuromodulation and ablative techniques for functional brain disorders, decompression and fusion for degenerative spine disease including deformity correction, resection of intradural and extradural spinal tumors, and surgical management of spinal trauma. In addition, competence in endoscopic, endovascular, and radiosurgical technique must be obtained (PC).

Chief residents are responsible for overall management of the inpatient University service and coordinate care between junior residents and Advance Practice Practitioners (SBP, P, ICS). They will communicate daily with the attending physicians and supervise procedures performed by junior members of the neurosurgery team. In the resident outpatient clinic, the Chief residents in conjunction with the attending will direct junior residents and students in the evaluation and disposition of patients (PBL, P, ICS). The Chief residents are responsible for scheduling resident teaching conferences as well as resident on-call schedules (P, ICS). The Chief resident is primarily responsible for reporting cases for M&M conference and to participate in Quality reviews under the direction of the Department Chief Quality Officer (PBL, P)

PGY-7

During the final year, residents will have an additional 12 months of elective time. During this period of time residents are again encouraged to engage in research projects, but are also encouraged to engage in additional clinical rotations and activities that are tailored to their interests and plans after graduation (PC, SBP, PBL, P).
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