Year One (PGY-1)

During PGY-1, the resident rotates on two months of general surgery (one month on trauma service and one month on general surgery intensive care unit), three months of neurology, three months of neuro-intensive care unit, one month of radiology and three months on the neurological surgery service.

During the month on the trauma service, the resident attends all trauma surgery-related conferences and learns how to provide acute, intensive care unit (ICU) and subacute care of multiple-trauma patients. This period includes the morbidity and mortality conference, and general surgery didactic conferences. During the month of general surgery critical care, residents participate in the ICU care of surgical patients, daily rounds, didactic lectures and conferences in the Department of Surgery.

The resident rotates on the neurology service for three months, during which the resident learns the subtleties of neurological examination and the care of various neurological conditions. During this time, the resident participates in the neurology subspecialty clinics of stroke, movement disorders, neuroinfectious disease, neuro-oncology, neuroinflammatory and neuromuscular, and participates in daily rounds, didactic lectures and conferences in the Department of Neurology.

One month is spent with neuroradiologists, reading scans such as X-rays, MRIs and CTs to demonstrate an understanding of neuroradiological imaging as it specifically relates to neurosurgical patients. During this month, the resident participates in imaging-related conferences.

For the last six months of PGY-1, the resident rotates on the neurosurgery and neurosciences intensive care service and is exposed to the care of the full spectrum of neurosurgical patients. The resident sees patients in the emergency room and for consultations on the patient floors, if the more senior residents are not immediately available. The resident reviews the consults with the appropriate senior resident on each subspecialty service, or with the chief resident, before staffing the consult with the appropriate attending physician. The resident also participates in the neuroscience intensive care rounds and conferences and continues to attend all Department of Neurosurgery didactic lectures, clinical conferences and teaching rounds.

During this year, the resident is expected to attain a set of objectives and essential skills:

Patient Care

The resident will develop the ability to:

  • Provide patient care that is compassionate, appropriate and effective.
  • Perform a concise and focused history and physical examination. The H&P should be focused and should represent the team plan of care, including the appropriateness of weight-loss surgery for the patient.
  • Execute patient care plans, under the direction of the senior and chief resident, fellow, and attending surgeon.

Medical Knowledge

The resident will develop the ability to:

  • Demonstrate basic knowledge of established clinical sciences, with application of this knowledge to care of patients with neurological disorders. Specifically, the junior resident must be aware of various neurosurgical techniques and the complications attributable specifically to each neurosurgical technique
  • Critically evaluate and demonstrate knowledge of scientific information about various neurosurgical procedures. Specifically, the junior resident will be responsible for giving a critical assessment of assigned journal articles during the monthly Journal Club conference.

Practice-Based Learning and Improvement

The resident will develop the ability to:

  • Investigate and evaluate care of the patients on the service, to appraise and assimilate scientific evidence and to continuously improve patient care based on constant self-evaluation and lifelong learning. The junior resident must be aware of the expected complications as related specifically to raised intracranial pressure, spinal disease, hydrocephalus and neurovascular disease
  • Identify strengths, deficiencies and limits in one's knowledge and expertise.
  • Set learning and improvement goals
  • Systematically analyze practice and implement changes with the goal of practice improvement. One means is by helping the chief resident maintain a daily tally of morbidities and mortalities on the service
  • Incorporate evaluation feedback into daily practice
  • Locate, appraise and assimilate evidence from scientific studies related to the respective patients' health problems. This is formally done during Journal Club conferences
  • Use information technology to optimize learning
  • Practice evidence-based approach to patient care
  • Participate in monthly M+M conferences in which patient outcome is critically evaluated

Interpersonal and Communication Skills

The resident will develop the ability to:

  • Demonstrate interpersonal and communication skills that result in the effective exchange of information, including collaboration with patients, their families and health professionals
  • Cross a broad range of socioeconomic and cultural backgrounds in one's interpersonal and communication skills
  • Effectively communicate with physicians and other health professionals
  • Maintain comprehensive, timely and legible medical records. This responsibility includes dictating discharge notes immediately — no later than within 24 hours
  • Help the chief resident maintain a daily database of patient-care team census, including morbidities and mortalities


The resident will develop the ability to:

  • Ensure that patient-care responsibilities supersede personal interests
  • Respect HIPAA regulations of patient privacy and autonomy
  • Be sensitive and responsive to diversities in patient population
  • Maintain a high standard of ethical behavior
  • Commit to the continuity of patient care. This ability includes ensuring thorough and safe transference of care during off hours

Systems-Based Practice

The resident will develop the ability to:

  • Demonstrate an awareness of a larger context and system of health care, including effectively using resources to provide optimal health care
  • Practice high-quality, cost-aware patient care