Year Six (PGY-6)

Senior Resident Rotation

The PGY-6 resident is considered the senior resident. This individual will rotate on the subspecialty services, with six months on the Blue (tumor/functional) service and the remainder on the Gold and White services. In this year, the resident takes back-up home call on some weekends to relieve the chief resident. The senior resident first-assists on more complicated tumor, pediatric, vascular and/or spine cases not covered by a chief resident.

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:

  • Perform and document a senior level neurosurgery history and physical, emphasizing quick patient assessment and concise communication to patients
  • Devise quickly and accurately senior-level care plans for patients with immediately life-threatening neurosurgical disorders, under appropriate supervision from attending surgeons, while also managing busy outpatient clinics
  • Establish and implement effective patient-care plans, assuming the leadership role on a healthcare team, under appropriate supervision by an attending surgeon
  • Counsel patients on the risks, goals, limits and alternatives to most neurosurgical procedures
  • Perform complex neurosurgery (cranial and spinal) procedures and begin to assist at the chief resident level with a higher degree of independence
  • Instruct residents and medical students regarding their performance of selected noncomplex surgical procedures appropriate to their level of training, acting as assistant to the chief resident in the management of a busy neurosurgical service


Medical Knowledge

The resident will develop the ability to:

  • Perform above the passing level on the ABNS primary examination (for credit)
  • Demonstrate advanced knowledge of anatomy, physiology and pharmacology related to inpatient and outpatient neurosurgery care, with special emphasis on traumatic nervous system injury and vascular neurosurgical disorders
  • Demonstrate advanced familiarity with the neurosurgical literature, with special emphasis on traumatic nervous system injury and vascular neurosurgery
  • Teach and mentor PGY-1 to PGY-4 residents and medical students


Practice-Based Learning and Improvement

The resident will develop the ability to:

  • Demonstrate an advanced ability to learn from errors
  • Finalize the design of a research project
  • Establish a solid, evidence-based approach to patient care
  • Critically appraise evidence from scientific studies in the neurosurgical literature
  • Identify areas of neurosurgical practice where current knowledge is inaccurate or inadequate and participate in clinical studies to improve the general fund of knowledge in neurosurgery


Interpersonal and Communication Skills

The resident will develop the ability to:

  • Provide compassionate care as determined by patients, families, colleagues and auxiliary health professionals on wards and in outpatient settings at a senior level while serving as the primary provider of care at Cedars-Sinai and related clinics
  • Work effectively as the leader of a healthcare team in both inpatient and outpatient settings
  • Participate meaningfully in multidisciplinary conferences, serving as the primary representative of neurosurgical practice


Professionalism

The resident will develop the ability to:

  • Demonstrate sensitivity and responsiveness to patients' culture, age, gender and disabilities
  • Demonstrate integrity and a commitment to patients that supersedes self-interest, serving as primary neurosurgeon
  • Participate meaningfully in ongoing professional development by submitting research for peer review to journals and national professional meetings


System-Based Practice

The resident will develop the ability to:

  • Demonstrate an understanding of practice types and opportunities, healthcare delivery systems and medical economics though participation at a chief level in a variety of healthcare delivery settings
  • Advocate for high-quality patient care and assist patients in dealing with system complexities, especially in settings providing care for the indigent or underserved
  • Use evidence-based medical practices to provide cost-effective health care and resource allocation that does not compromise quality of care
  • Understand practice management issues, such as patient processing, evaluation and management coding, procedural terminology, documentation of services rendered and other reimbursement process related to issues in both inpatient and outpatient settings, serving as the primary provider of care