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Education

PGY 3 - Rotating Resident

Curriculum

  • Rotate 6 months on elective/selective rotations in neuroradiology/radiation oncology and neuro-ophthalmology.
  • Rotate 2 months in neuropathology.
  • Rotate 4 months in pediatric neurosurgery at the Children’s Hospital of Pittsburgh (or another facility if approved).
  • Attend all mandatory Neuroscience Core Curriculum Conferences.
  • Prepare lectures for journal club, ethics, spine and morbidity and mortality conferences.
  • Write at least one abstract, book chapter or article for presentation at a national neurosurgical/neuroscience conference (attend conference if abstract accepted)
  • Take SANS on-line self assessment examination.
  • Review AANS/SNS on-line courses and complete the assessment exams.
  • Maintain case log thru ACGME site and provide all required documentation for resident portfolio.
  • Take call with senior and/or chief resident and the attending staff backup while rotating through subspecialties to maintain neurosurgical skills.
  • Take written neurosurgical boards for practice or credit.
  • Work with medical students teaching history and physical fundamentals.

 

Reading List, Supplemental Reading

The following AANS/SNS on-line sessions are expected to be completed during the summer months.  Go to the American Association of Neurological Surgeons website, "Education and Meetings" section, to complete each of the following:

  • Early Embryology of the Nervous System
  • Late Embryology of the Nervous System
  • Cerebral Blood Flow and Intracranial Pressure Regulation
  • Evidence Based Medicine
  • Introduction to Statistics
  • Neurological Examination of the Premature and Newborn Infant
  • The Diagnosis and Management of Craniosynostosis and Positional Plagiocephaly
  • Evaluation of the Newborn and Infant
  • Evaluation of CSF Shunt Malfunction
  • EMG Nerve Conduction:  Use and Interpretation

 

Goals and Objectives

During the PGY3 year, the resident will function as in integral member of the teaching program in each rotation under the direction of that program’s faculty.  He/she will prepare lectures for journal clubs, ethics, spine and morbidity and mortality conferences.  Extensive literature reading from text books, journals and computer-based learning will be expected from the resident.

The objective of these rotations during the PGY3 year is to expand and enhance all skills and competencies from the PGY2 year and utilize all knowledge obtained from specialty rotations in the practice of neurosurgery.

The objective of the neuroradiology rotation is to ensure fundamental competency and learning skills in the clinical and neuroanatomic interpretation (and in some instances performance) of all aspects of diagnostic neuroradiology.  Experience and knowledge with radiosurgery will be obtained.  Rotation supervised by Melanie Fukui, MD, Director of Neuroradiology.  (Separate detailed “goals and objectives” for neuroradiology is available.)

The objective of the neuropathology rotation is devoted to the fundamental competency and practical aspects of the neuropathological examination of the central nervous system.  Both technical and interpretative aspects of neuropathology are emphasized.  Rotation supervised by Frank Pu, MD, PhD, Director of Neuropathology, Department of Pathology, Allegheny General Hospital.  (See separate “goals and objectives” for Neuropathology.)

The objective of the neuro-ophthlamology rotation is for the resident to become familiar with the diagnosis and management of disorders commonly seen in neuro-ophthlamology and to learn the skills necessary for testing these disorders such as examining pupils, visual fields, motility and the fundus using an ophthamoscope.  Rotation supervised by Erik Happ, MD, Director of Neuro-ophthalmology. (Separate detailed “goals and objectives” for neuro-ophthlamology is available.)

The objectives for the pediatric rotation focus exclusively on the identification of disorders of the pediatric nervous system which require neurosurgical evaluation and/or treatment.  Specific areas to be developed or enhanced are detailed in Exhibit A.  Rotation at Children’s Hospital of Pittsburgh is supervised by Ian Pollock, MD, Director of Pediatric Neurosurgery. (Separate detailed “goals and objectives” for neuro- pediatrics is available.)

Competencies

Medical Knowledge - The resident will be able to:

  • Maintain and expand on all skills and competencies learned in the NS1&NS2 years (Refer to Exhibit A for specific knowledge and performance requirements)
  • Begin to direct critical care management and non-operative neurosurgical care under the direct supervision of a faculty member.
  • Accurately interpret laboratory and imaging studies (CT/MR/MRA/CTA/PET:CT).
  • Develop patient care treatment plans and effectively communicate these orders.
  • Acquire necessary skills to diagnosis and perform radiosurgery procedures.
  • Obtain educational skills in neuropathology, neuroradiology, neuro-ophthamology and neuro-pediatrics and begin implementation of these skills.
  • Take call with senior and/or chief resident and the attending staff backup to maintain and enhance neurosurgical skills.

Utilizing:        Written Board Exam

                        SANS-wired

                        Oral Exam

                        Skull Base lab workshops

                        Bi-annual evaluations

                        End of rotation evaluations

Patient Care and Assessment: - The resident will be able to:

  • Expand on their teaching skills while working with medical students on the fundamentals of history and physicals
  • Demonstrate clear and concise patient care plans and implement them under the direct supervision of a faculty member.
  • Perform selected surgical procedures under direct supervision such as laminectomy and intermediate-level craniotomies (refer to Specific Knowledge and Performance Requirements)
  • Assist in major surgical procedures and, under direct guidance of a faculty member, perform portions of the operation that are appropriate to the resident’s level of training.
  • Keep track of log of all procedures performed.

Utilizing:        Observed Exam: clinics/operating room

                        Patient survey:  post-exam/feedback cards

                        Bi-annual evaluations

                        End of rotation evaluations

Practice Based Learning – The resident will be able to:

  • Demonstrate an ongoing and improving ability to learn from errors.
  • Perform a clinical or basic neurosciences research project that is appropriate for presentation at a national scientific meeting and for subsequent publication.
  • Develop fundamental research skills.
  • Analyze complications and their avoidance in pediatric patients through regular morbidity and mortality conferences.
  • Seek out and utilize evidence-based guidelines in the evaluation and management of pediatric patients.
  • Analyze complications and their avoidance in pediatric patients through regular morbidity and mortality conferences at Children’s Hospital.
  • Seek out and utilize evidence-based guidelines in the evaluation and management of pediatric patients.

Utilizing:         Journal club with Statistics

                        Set new goals/evaluate old goals

                        Yearly scholarship logs

                        SANS-wired

                        Case Logs

Systems Based Practice – The resident will be able to:

  • Apply cost effectiveness and evidence-based approaches to the previously acquired clinical decision making skills
  • Understand practice management issues such as patient processing, E&M coding, procedural terminology, documentation of services rendered and reimbursement process related issues.
  • Demonstrate an understanding of practice opportunities, practice types, health care delivery systems and medical economics.
  • Utilize computer resources in evaluating and managing pediatric neurosurgical patients.

Utilizing:        QI Team Projects

                        Formal Lectures

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

  • Demonstrate ability to provide compassionate care to patients and their families.
  • Demonstrate a high level of interpersonal communication skills with other residents.
  • Demonstrate a compassionate and objective approach to patient counseling.
  • Effectively communicate with other members of the healthcare team with particular emphasis on patients and their families and the unique nature of the physician/parent/child interaction

Utilizing:        Observed Exam

                        Patient Survey

                        Feedback cards

Professionalism – The resident will be able to:

  • Demonstrate a high level of professionalism at all times with patients, family members, faculty, staff and other residents.
  • Exhibit good work habits such as reliability, preparation, cooperation and efficiency.
  • Demonstrate compassion, respect and consideration for the patients, their families and the unique physician/parent/child interactions in pediatric neurosurgery.

Utilizing:         Project Professionalism/ AMA Virtual Mentor

                        360-degree evaluation

                        Feedback cards

Evaluation         

The faculty will evaluate the residents on the core competencies and technical proficiencies bi-annually based on the goals and objectives outlined above

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