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PGY 6 - Chief Year (or Research Year)

NOTE:  PGY-6 and PGY-7 of the neurosurgery residency can be performed in either order depending on the needs and desires of the individual resident and their satisfactory progression in the development of neurosurgical competencies.  One of the years will be spent as chief resident and the other year will be devoted to an internal “advanced clinical training” focus or a year of research.


  • Serve as chief resident on adult neurosurgical service.
  • Direct, with faculty supervision, the chief resident outpatient clinic.
  • Supervise and direct the daily activity of all residents under his/her level of training.
  • Perform all administrative aspects of running the neurosurgical service, to include administration of outpatient chief resident clinic, coordination of hospital admissions, coordination of operating room schedules, assignment of physician assistants, assignment of cases to junior residents, teaching of neurosurgery residents, medical students and rotating residents through the service and coordination/direction of neurosurgical teaching conferences, including the Wednesday morning didactic lecture series in coordination with the program director.
  • Create resident call schedules following all duty hour rules.
  • Serve as primary operating surgeon in the operating room.*
  • Direct daily rounds; establish management plan of inpatients.*
  • Pass neurosurgical board written examination, if not passed yet.
  • Serve as a member of the Neurosurgery Residency Oversight Committee and Residency Interview Committee.
  • Participate in clinical neurosurgical research and write at least one abstract, book chapter, or paper.
  • Attend one national neurosurgical conference and any major neurosurgery/neurosciences meeting where the resident has an abstract or paper accepted.
  • Consult with the program director concerning job opportunities, fellowship training, and career advancement.
  • Maintain case log through ACGME site and provide all required documentation for resident portfolio.

* Under faculty supervision.

Goals and Objectives

The primary objective of the chief resident year is to provide an increasing level of responsibility, technical expertise, and competency, both in and out of the operating rooms, so that the resident will be capable of functioning independently as a neurosurgeon on completion of the training program.


Medical Knowledge - The chief resident will become fully able to:

  • Manage outpatient, inpatient, critical care, operative evaluation and follow-up of all diseases/disorders currently under the preview of independent neurosurgical practice.
  • Supervise, teach, and mentor clinical growth for all lower level residents and neurosurgical healthcare team members.
  • Direct patient care conferences.
  • Successfully pass the neurosurgical written board examination (if not already passed).

Utilizing:                    Observed exam

                                    Written board exam


                                    Oral exam

                                    Skull base lab

                                    Bi-annual evaluations: competencies

Patient Care and Assessment – The chief resident will become fully able to:

  • Maintain and expand on skills and competencies learned in previous years.
  • Refine the highest level of patient care skills.
  • Refine all neurosurgical operative skills to be competent in performing all accepted/current neurosurgical procedures per specific core clinical knowledge requirements.
  • Independently (with appropriate faculty oversight) manage his or her own outpatient neurosurgical clinic.
  • Integrate applied research, current neurosurgical literature, and evidence-based guidelines directed to advancing patient safety and care.

Utilizing:                    Observed exam: clinics and operating room

                                    Patient survey: post-exam/feedback cards

                                    Bi-annual evaluations: procedures

Practice-Based Learning – The chief resident will become fully able to:

  • Develop skills and competencies to become an independent practicing neurosurgeon.
  • Develop administrative skills of the neurosurgical service by maintaining the resident call schedule ensuring adherence to the 80-hour work week restrictions, coordinate resident vacation schedules, coordinate all neurosurgical conferences and assign junior resident responsibilities for patient care, operating room, critical care and clinic responsibilities.
  • Refine his or her teaching skills.

Utilizing:                     Journal club with statistics

                                    Set new/evaluate old goals

                                    Case logs

                                    Yearly scholarship logs


Systems Based Practice
– The chief resident will be able to:

  • Know about cost-effective neurosurgical care.
  • Utilize consultants appropriately.
  • Understand the socioeconomic impact of clinical neurosurgical decisions.
  • Receive exposure to different practice types and opportunities.
  • Maintain a log of all procedures performed in the ACGME case log system.

Utilizing:                    QI team projects

                                    Formal lectures

Interpersonal and Communication Skills: - The chief resident will be able to:

  • Communicate effectively both verbally and in consultation reports, operative reports, and written communications with referring physicians.
  • Responsibly complete all medical records.
  • Communicate daily with program director regarding neurosurgical service issues.

Utilizing:                    Observed exam

                                    Patient survey

                                    Feedback cards

Professionalism – The chief resident will be fully competent to:

  • Function as a role model and mentor to junior residents.
  • Instill the professional characteristics of reliability, preparedness, cooperation and efficiency while demonstrating compassion, respect and consideration to the junior residents.
  • Maintain patient privacy and confidentiality and instill those characteristics in the junior residents.

Utilizing:                    Project professionalism/ AMA Virtual Mentor

                                    360-degree evaluation

                                    Feedback cards


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