Today is Tuesday, Oct. 17, 2017

Department of

Neurosurgery

Curriculum/Schedule

Below is a sample rotation.

Example Residency Schedule

* The research elective seeks to achieve the goal of integrating basic and clinical perspectives by involving the residents in a rigorous research program.

This program provides training in contemporary laboratory methods, immersion in the relevant primary literature and mentoring by an established investigator. It is a vital part of residency training and provides a full year of research.

One of the major goals of the research elective is to provide training in areas of neuroscience research that have direct relevance to clinical problems. This goal is realized through the exposure of trainees to didactic material in the clinical neurosciences, participation in journal club and Grand Rounds, and the undertaking of a research project that relates to a clinical area.

University of Cincinnati Medical Center (UCMC)

University of Cincinnati Medical Center Neurosurgery Service – Intern, PGY-1
The neurosurgery Intern will be exposed to the breadth of inpatient neurosurgical practice at a tertiary referral center and the sole level-I trauma center for over 2-million residents of the Cincinnati Metro Area.  Clinically, the neurosurgery intern is exposed to and ultimately assumes graded responsibility for the UCMC neurosurgery service along with the Junior Resident.  This includes the evaluation and treatment of neurosurgical ICU patients; post-operative spine and cranial inpatients; neurotrauma patients; inpatient consultations; and both UCMC ER and outside hospital consultations.   The intern will be exposed to overnight call through a small number of “buddy” calls with more senior residents during their time on the service. Operatively, the neurosurgery intern is expected to become adept at the spectrum of bedside neurosurgical procedures.  In the operating room, the intern will assist with and learn to perform basic elective neurosurgical procedures as well as emergent procedures for cranial trauma.  The neurosurgery intern will also be expected to participate in outpatient clinics to gain exposure to preoperative and postoperative neurosurgical care in the ambulatory setting.

In 2016-2017 the neurosurgery intern year is scheduled as follows:  Neurosurgery-6 months. Neurocritical Care– 3 months, SICU-1 month, Plastics-1 month, Neuroradiology-1 month.  

University of Cincinnati Medical Center Neurocritical Care Service, PGY-1
During time with the UCMC Neurocritical Care service the resident learns to identify which patients warrant an ICU level of care and is introduced to the principles of critical care management with a focus on neurological disorders.  General critical care medicine is also emphasized with concepts of cardio-pulmonary, fluid and electrolytes, infectious, hematologic and nutritional management addressed as an integral part of patient care.  Recognition of the need for consultation with other clinical subspecialists is also emphasized along with disposition planning for transfer/discharge from the NSICU.

Procedurally, the neurosurgery resident will be taught common critical care procedures: airway management including non-invasive management, intubation, and bronchoscopy; placement of central venous lines, arterial lines, and other advanced vascular access; and continued experience with invasive intracranial monitoring devices and other bedside neurosurgical procedures.  The nature of the NSICU is such that it provides the opportunity for the residents to experience multiple difficult psychosocial situations. The ability to deal with these situations effectively will be honed, reviewed, and emphasized throughout the rotation.

University of Cincinnati Medical Center Neurosurgery Service– Junior Resident, PGY-2
The junior resident is primarily responsible for the UCMC Neurosurgery Service under the direction and direct supervision of the Chief Resident and faculty.  Central to this responsibility is the evaluation and management of all referrals, consultations, postoperative inpatients, neurotrauma consultations/inpatients, and neurosurgical ICU admissions/inpatients. The junior resident will participate in inpatient care from initial evaluation and admission to discharge and placement.  The junior resident plays a significant role in teaching, supervising, and mentoring the neurosurgery intern.  Ideally this will lead to shared responsibility for the service between the PGY-1 and PGY-2, freeing the latter for greater time in the OR.  The junior resident will perform all bedside neurosurgical procedures independently. In the operating room, the junior resident will be exposed to a variety of the most common neurosurgical procedures, including emergent procedures for trauma.  The junior resident takes roughly 6 calls per month on service.

Neurosurgery 'First' Rotation, PGY-3
The PGY3 resident spends time with specific emphasis on Functional, Interventional Radiology, and Stereotactic Therapy procedures.  The time is spent in both the inpatient and outpatient setting participating in the spectrum of functional, endovascular, and radiation therapy.  This includes participation in corresponding faculty outpatient clinics.  The FIRST resident also participates in the UCMC service and participates in the neurosurgery resident clinic.  The FIRST resident takes roughly 6 calls per month.

University of Cincinnati Medical Center Neurosurgery Service, PGY 3-5
After completing the junior resident rotations, the PGY3-5 rotation on the UCMC Neurosurgery Service is primarily concerned with exposure to and increasing involvement performing the breadth of operative procedures.  Due to the procedures commonly performed at UCMC, an emphasis is placed on cranial neurosurgery with additional spine, functional, trauma, and CSF diversion procedures.  The more junior resident will spend much of their time one-on-one with faculty, scrubbed with a Chief Resident on complex cranial/spinal cases, or scrubbed with the junior resident to guide them through more basic operative procedures.  The PGY-5 may rotate on service as part of a clinical elective or to gain further exposure to specific cranial procedures. The PGY-3 takes roughly 6 calls per month on service; the PGY-4 takes roughly 4 calls per month on service; the PGY-5 takes roughly 3 calls per month on service.

The PGY-4 is responsible for running the Neurosurgery Resident Clinic each Wednesday afternoon under the supervision of Drs. Thomas Berger, Kerry Crone and Laura Ngwenya and performing cases booked through the clinic with the Ancillary Chief and/or faculty.  PGY3-5 residents attend the faculty’s outpatient clinics to become adept at the outpatient evaluation of cranial neurosurgery patients.

Research, PGY-5

As the current 6 year curriculum is restructured in compliance with the 2013 ABNS mandate requiring 7 years of post-graduate training, the resident research rotation will become the professional development rotation.  This rotation will not necessarily be completed during the PGY 5 year, and, as such, will be tailored on an individual basis to fulfill each resident’s professional development needs.  Residents may continue to use this rotation to pursue clinical or basic neuroscience interests, or rather, as an opportunity to obtain additional training in areas such as pediatric neurosurgery, spinal deformity correction, and endovascular neurosurgery-ultimately culminating in a meaningful contribution to the peer-reviewed literature.  Additional training certification may be available to those residents using the professional development rotation as a means to complete an enfolded fellowship.  

University of Cincinnati Medical Center Neurosurgery Service – Ancillary Chief Resident, PGY-6
The Chief Resident rotations enable residents to bring all of their previous training to bear as they prepare to graduate and enter the independent practice of neurosurgery. Residents mature as clinicians, surgeons, leaders, and administrators by honing their skills to ultimately provide the highest level of medical care in an efficient, effective, and compassionate manner. The Chief Resident rotations demand proficiency in the complete management of all neurosurgical problems with emphasis on sharpening their technical skills, in both cranial and spinal surgery, as they prepare to assume the role of independent practitioners.  Call is shared between two Chiefs and they serve as backup for each other during times when they have to be away from the service for conferences, job interviews and vacation time, etc.

The Ancillary Chief rotation emphasizes honing the management and teaching skills needed to help others progress in the clinical and operative management of neurosurgical disease.  The Ancillary Chief is responsible for supervising the junior resident and intern by serving as their immediate point of contact for staffing in-hospital neurosurgery consultations; rounding on consult patients with the junior residents on service; and implementing plans of treatment after appropriate discussion with the faculty involved.  The Ancillary Chief resident is responsible for staffing all patients booked through the resident clinic under the direct and indirect supervision of Dr. Thomas Berger and rotating faculty.  They serve as the primary surgeon of all operative procedures that are offered to the resident clinic patients under faculty supervision when not performing additional complex neurosurgical operations.  In this role, the ancillary Chief Resident is afforded the opportunity to hone not only their operative and management skills, but also refine their ability to supervise and instruct more junior residents. The Ancillary Chief scrubs all complex neurosurgical procedures not being staffed by the Chief Resident.  The Ancillary Chief is responsible for preparing and presenting patient’s complications and deaths at the monthly Morbidity and Mortality Conference. He/she is also responsible for documenting and providing operative statistics for all neurosurgical procedures performed at UCMC.

University of Cincinnati Medical Center Neurosurgery Service – Chief Resident, PGY-6

The Chief Resident rotations enable residents to bring all of their previous training to bear as they prepare to graduate and enter the independent practice of neurosurgery. Residents mature as clinicians, surgeons, leaders, and administrators by honing their skills to ultimately provide the highest level of medical care in an efficient, effective, and compassionate manner. The Chief Resident rotations demand proficiency in the complete management of all neurosurgical problems with emphasis on sharpening their technical skills, in both cranial and spinal surgery, as they prepare to assume the role of independent practitioners.  Call is shared between two Chiefs and they serve as backup for each other during times when they have to be away from the service for conferences, job interviews and vacation time, etc.

Ultimate authority of running the UCMC Neurosurgery Service is vested in the (primary) Chief Resident.  As the leader of the resident team, the primary Chief Resident must demonstrate their developed managerial, administrative, and leadership skills both clinically and academically to effectively guide and instruct the resident team, physician assistants, nurse practitioners, medical students, and all allied healthcare providers. The Chief Resident assumes the major teaching role for other members of the service.  The Chief Resident rotation is the culmination of six years of postgraduate training in neurological surgery designed to allow maturation in all aspects of their neurosurgical skill set and assure residents can apply their clinical skills, surgical skills, and medical knowledge base to pursue a career in academics, private practice, or a combination of both.

West Chester Hospital

West Chester Hospital Neurosurgery Service, PGY-2

The West Chester Hospital rotation focuses on furthering operative management skills in a busy private, general practice setting under the tutelage of Dr. Brad Curt.  There is an emphasis on spinal pathology from microdiscectomies to staged deformity corrections and minimally-invasive techniques. The resident spends two days per week in Dr. Curt’s clinic honing his/her skills in the outpatient evaluation and management of patients.  There is an emphasis on learning the necessary clinical and administrative skills to run a robust, efficient practice. When the clinic and operative schedule allows, time is also spent in the same office participating in radiosurgery procedures.  Throughout the rotation, the resident sees consults for the West Chester faculty.  During the WCH rotation the resident is remains in the call pool at UCMC and is responsible for roughly 4 overnight calls per month. Overall, the rotation is meant to provide a superior operative experience while also emphasizing the skills necessary to run one’s own practice, either academic or private. 

Cincinnati Children's Hospital Medical Center (CCHMC)

CCHMC Neurosurgery Service, PGY-3
During the CCHMC rotation, the resident’s education and service dedicated to the practice of pediatric neurosurgery service at Cincinnati Children’s Hospital Medical Center, one of the leading children’s hospitals in the nation with a robust national and international referral base.  CCHMC also serves as the sole pediatric trauma center for the Cincinnati metropolitan area.  The CCHMC resident functions as part of a large team that includes the pediatric neurosurgery fellow, visiting residents from outside institutions, physician’s assistants, nurse practitioners, and the pediatric neurosurgery faculty.  

The neurosurgery resident serves as the senior resident on service and co-directs the service with the pediatric neurosurgery fellow.  The rotation involves exposure to a wide variety of pediatric neurosurgical issues in children.  The resident is expected to encounter all aspects of pediatric neurosurgery, including congenital neurologic disorders, neurooncology, functional neurologic disorders with an emphasis on epilepsy, and neurotrauma.  The rotation is intended to maximize the resident’s education and focus on inpatient, outpatient and operative management of pediatric neurosurgery patients.  Operative time is spent under the instruction of Drs. Francesco Mangano—Chief of the Division of Pediatric Neurosurgery, Charles Stevenson, Sudhakar Vadivelu, and Jesse Skoch.  The rotation also emphasizes participation in attending clinics, including those of non-operative faculty.  There is also ample opportunity to become involved in the division’s robust research endeavors.  The resident takes 10 overnight calls and, once licensed, may elect to take additional call from home at the discretion of the neurosurgery faculty.  Primary call is from home with the resident only covering CCHMC during their rotation; call is divided with any visiting residents and the pediatric neurosurgery fellow. The pediatric neurosurgery fellow and faculty serve as backup while on primary call.

The Christ Hospital

TCH Neurosurgery Service – Senior Resident, PGY-4
oThe senior resident at the Christ Hospital is responsible for the neurosurgery service. The emphasis is on gaining independence performing the spectrum of general neurosurgical procedures under direct faculty supervision as well as becoming adept at the evaluation of preoperative and postoperative patients in a busy practice setting.  An emphasis is placed on basic and complex spine procedures including minimally invasive techniques and general cranial procedures.  The PGY 4 senior resident is responsible for the administration of the TCH service and takes 8 overnight calls from home.  Once licensed, residents PGY 3-6 may elect to take additional home calls at the discretion of the Chief Resident and faculty.

Good Samaritan Hospital

Good Samaritan Hospital Neurosurgery Service – PGY-4
The Chief Resident rotations enable residents to bring all of their previous training to bear as they prepare to graduate and enter the independent practice of neurosurgery. Residents mature as clinicians, surgeons, leaders, and administrators by honing their skills to ultimately provide the highest level of medical care in an efficient, effective, and compassionate manner. The Senior Resident rotations demand proficiency in the complete management of all neurosurgical problems with emphasis on sharpening their technical skills, in both cranial and spinal surgery, as they prepare to assume the role of independent practitioners.

The Good Samaritan Hospital Senior Resident rotation is a unique opportunity to polish all aspects of his/her training and development in the setting of a busy tertiary neurosurgical service but without the abundant trauma volume seen at UCMC. He/she is afforded time to concentrate their efforts on aspects of training that will prepare them to enter any type of practice upon completion of training.  The Senior Resident is responsible for all aspects (administrative, clinical and educational) of the neurosurgical service which includes supervising, teaching, and mentoring the PGY-3 resident. Clinically, the Senior gains first-hand experience in all aspects of neurocritical care including the appropriate use and timing of consultative services through their administration of the NSICU in concert with the PGY-3 resident and faculty.  The GSH residents will have the opportunity to follow the neurosurgical patients through the rehabilitation phase of care, taking advantage of the full service rehabilitation department at GSH.

Operative experience is spread across a broad range of neurosurgical cases from routine to complex cases. The caseload at Good Samaritan Hospital consists of:

  1. The breadth of spinal surgery, including complex instrumentation
  2. Cerebrovascular cases including endovascular interventions
  3. Neuro-oncology cases of both the brain and spine
  4. Functional cases with an emphasis on cranial and spinal pain procedures
  5. Peripheral nerve procedures

The Senior Resident is able to select cases that he/she participates in based on the techniques that he/she feels require further refinement.  

Administratively, the Senior Resident is responsible for preparing and presenting patient’s complications and deaths at the monthly Morbidity and Mortality Conference. He/she is also responsible for documenting and providing operative statistics for all neurosurgical procedures performed at Good Samaritan Hospital.

Residency_Rotations

More Information:

Neurosurgery Residency Coordinator:
Penny Schwab
513-558-3903 phone
513-558-7702 fax
penny.schwab@uc.edu

Residency Director:
Kerry Crone, MD

Education Director:
Jeffrey Keller, PhD

Mailing Address:
University of Cincinnati College of Medicine
Department of Neurosurgery
PO Box 670515
Cincinnati, OH 45267-0515

Office Location:
Stetson Building
260 Stetson Street, Suite 2200
Cincinnati, OH 45219