Residency Rotation Schedule Overview
The Neurosurgery Residency Training Program is centered around the clinical service at the University of Utah Hospital (UH) and Primary Children’s Hospital (PCH), which are located in close proximity to one another on the University of Utah Campus, as well as the recently added George E. Wahlen Department of Veterans Affairs Medical Center (SLCVA). Together these form the major medical teaching complex in the Intermountain West, a large geographic area extending from the Canadian border to northern Arizona and from the Rocky Mountains to western Nevada.
We serve as the major referral hospital complex for patients with neurological and neurosurgical diseases, and provide neurosurgical care for many patients within Utah and the adjacent states. Every hospital offers advanced state-of-the-art technology and facilities.
This year is spent acquiring fundamental clinical skills through participation in 6 blocks of clinical neurosurgery, 3 months in the NCCU under the direction of our neurocritical care intensivists, 3 months of Neurology including 2 months of subspecialty outpatient clinics split between neuro-ophthalmology, stroke, neuromuscular, epilepsy, movement disorders, and neuro-oncology, and 1 month inpatient neurology.
Orientation to the PGY-1 year includes education on sleep and sleep deprivation by the University of Utah Graduate Medical Education (GME) department. The educational material on these topics is always accessible on the GME website.
*For purposes of this and the following descriptions, one block is equal to a four-week period of time.
During this year, the resident is a junior member of the house staff participating in patient care on the adult neurosurgery service. Here, residents participate in the junior call rotation including night-float call responsibilities and are introduced to the full spectrum of adult neurosurgical disorders. Residents also spend 3 block in clinical pediatric neurosurgery at PCH. During this rotation, the residents are involved in caring for children with neurosurgical disorders alongside a senior resident and a pediatric neurosurgery fellow. They have a one-in-three call rotation from home and obtain inpatient, outpatient, emergency department, and surgical experience.
During their Clinical Pediatric Neurosurgery at PCH (3 blocks) rotation, residents are involved in the care of children with neurosurgical disorders alongside a senior resident and a pediatric neurosurgery fellow. They have a one-in-three call rotation from home and obtain inpatient and outpatient, emergency department, and surgical experience.
Residents also rotate in Clinical Neurosurgery at UH. Continued training with increased responsibility as a junior member of the house staff participating in patient care on the adult neurosurgery service including night-float call responsibilities and more time in the NCCU as described above. During this year, the residents are exposed to inpatient and outpatient experience in endovascular neurosurgery (diagnostic and therapeutic techniques are learned, as are indications and complications. Time is spent with our three endovascular-trained neurosurgeons and one neuroradiologist). They also spend time in ambulatory care, including participating in stereotactic radiosurgery learning the indications, dosimetry, complications, and outcomes of patients treated with SRS. Outpatient and inpatient experience in spine, functional neurosurgery (Func), and peripheral nerve (PN), with subspecialty-trained neurosurgeons with emphasis on patient selection, preoperative workup, and clinical and operative management of these disease processes.
Woven into these rotations is time for board preparation including reviews with our neuropathology and neuroradiology service.
Elective (13 blocks). Several options for laboratory and/or clinical research in neuro-oncology, spine, skull base, pediatric neurosurgery, and clinical trials are available this year. Some residents participate in relevant coursework at the University of Utah School of Graduate Medicine, and several have earned graduate degrees. Residents on their elective rotations are responsible for two half-days per month of junior resident level call at UH and outpatient telemedicine clinics.
Senior resident on subspeciality elective (13 blocks). This time provides additional clinical experience that can be tailored to the resident’s needs and career aspirations. A rotation focused in a subspecialty elective area of clinical neurosurgery will be provided with the possibility of a subspecialty elective enfolded fellowship. If necessary, remedial work with focus on specific areas may also be completed.
Chief resident at UH (13 blocks). During this year the resident functions as the Chief Resident in charge of the service, performing a high volume of surgical cases with increasing complexity as their skills allow.
Residents take the written examination of the American Board of Neurological Surgery starting with the PGY-1 year. During the PGY-1 and PGY-2 years, residents takes the exam for self-assessment. PGY-3 and above residents will take it for credit only. All residents are required by the American Board of Neurological Surgery to pass this examination for credit satisfactorily. The department's goal is to have residents achieve a score in the 25th percentile or higher. If this is achieved on the first attempt, a second attempt is not necessary.
Scheduled didactic teaching conferences are an integral part of our residency. We have a regularly scheduled journal club, morbidity and mortality conference, cerebrovascular conference, and grand rounds. These are supplemented with resident presentations on selected topics and joint conferences with neurology. Our excellent neuroradiology section participates in most of our teaching conferences and actively collaborates with our department. The neurosurgery department also hosts the Lende Winter Neurosurgery meeting each February. This outstanding conference attracts many nationally and internationally known neurosurgeons each year, and residents are encouraged to present at this meeting.
Laboratory and/or clinical research in neuro-oncology, spine, skull base, pediatric neurosurgery, and clinical trials is available. Residents may also participate in relevant coursework at the University of Utah School of Graduate Medicine to earn a graduate degree.
Vacations are not taken during specific rotations or sites, and one resident may be gone from a service at a time. No vacation is permitted during the last two weeks of June and the first two weeks of July or during times of meetings. The department tries to accommodate residents’ vacation requests provided that they do not interfere with the proper functioning of the service.