Neurosurgery

PGY3 Curriculum

PGY-III: NS-2, Junior Resident II: 4 months each at PAVAH, LPCH and SUMC

The second neurosurgical year is divided between PAVAH, LPCH and SCVMC. For 4 months at PAVAH, the resident is the primary resident for all neurosurgical care. The resident acquires increased independence in managing neurosurgical problems by acting as patients’ primary neurosurgeon during inpatient, outpatient, and consultative care. Proficiency in general neurosurgery, particularly that required by the degenerative diseases commonly encountered in the veteran population, is emphasized at PAVAH. The resident develops skills in neoplastic and degenerative spine surgery, craniotomy for straightforward aneurysms, tumors, and vascular malformations, carotid endarterectomy and transsphenoidal surgery. The resident supervises and teaches Neurology residents and medical students rotating on the VA service. The resident works under the supervision of 2 fulltime VA faculty/Stanford faculty who both cover challenging subspecialty cases. The resident evaluates all inpatient and outpatient consults, works up all new cases for admissions, participates in all operations as primary surgeon or first assistant, and directs postoperative care. The resident usually operates 2 full days at PAVAH and attends the outpatient PAVAH clinic 1 day per week. PGY-III residents cover occasional weekend calls only to help relieve PGY-II residents.

For the 4 months at SCVMC, the resident serves as the primary resident for all neurosurgical care. The resident operates daily under the direct supervision of 4 experienced attendings. As the area's main county hospital, SCVMC offers full exposure to the breath of neurosurgery as well as in-depth experience in neurosurgical trauma.

The last 4 months are spent as the primary resident on the LPCH Pediatric Neurosurgery Service. Under the supervision of 2 highly experienced pediatric neurosurgeons and the Chief Resident, the second year resident acquires more advanced diagnostic and patient management skills relevant to diseases of infants and children. Understanding of the unique conditions and the special considerations required in treating neurosurgical diseases in children is obtained. The resident is involved in initial assessment and case selection in clinic, preoperative evaluation, surgery, postoperative care and outpatient followup.

During this year, the resident should actively pursue clinical research interests, submit abstracts regarding this research to regional and national meetings, and present clinical data at local, regional and national conferences. The resident is also expected to expand basic knowledge of neuroscience, neurology and neurosurgery, and to take the Written Neurosurgical Boards for self-assessment.

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