Department of Neurological Surgery

Senior Resident (PGY4) Responsibilities

In the first year of the senior resident rotations there are two, 4-month rotations, one at the Veterans Administration Medical Center (VAMC) and the other at Doernbecher Children’s Hospital (DCH), providing experience in the management of two very distinct patient groups throughout their continuum of care. There are also 4 elective months.

1. Veterans Administration Medical Center (VAMC): The resident is responsible for all patient care activities at the VAMC and supervises a physician assistant and rotating medical students. The resident performs more advanced surgical procedures, including cervical laminectomy, craniotomy for brain tumor, cranioplasty, carotid endarterectomy and functional neurosurgery.

Educational Objectives:

  • To exercise the role of chief resident on a small neurosurgical service and to make independent decisions regarding patient care under appropriate supervision.
  • To observe and be part of comprehensive pre- and post-operative longitudinal care of all patients on the service, including clinical care, complication management and follow-up.
  • To observe and work within a governmental managed care environment.

2. Doernbecher Children’s Hospital (Pediatric Neurosurgery): The resident is responsible for all clinical and operative care on the DCH Pediatric Neurological Surgery Service, working with two surgical faculty and two pediatric nurse practitioners. Included are both routine pediatric neurosurgical procedures (tethered spinal cord, Chiari malformation, hydrocephalus, spasticity etc.) and also complex and challenging microsurgical and endoscopic surgery (midline brain tumors, AVMs, epilepsy monitoring and resection, third ventriculostomy, etc.). Both general pediatric neurosurgery and specialty clinics (craniofacial, tumor and spina bifida) are available, as well as special programs and conferences for pediatric CNS tumor and surgical epilepsy management.

Educational Objectives:

  • To obtain the knowledge and communication skills to work effectively with childrens’ families in coordinating treatment and postoperative care.
  • To learn effective interdisciplinary, team based care, including PT, OT, and Child Life, and to understand the programs available to developmentally or physically challenged children.
  • To function as Chief resident of a busy multiple attending and midlevel provider neurosurgical service.
  • To master pediatric neurological examination, medical management, and operative positioning within each principal age group (premature infant, term infant, toddler, child, adolescent).
  • To understand the incidence, pathophysiology and prognosis of CNS diseases in children.