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Education

PGY 5 - Senior Resident

Curriculum

  • Rotate 12 months on neurosurgical rotation
  • Begin planning/formulating a research/academic plan for the following year (during last three months).
  • One day per week devoted to teaching in the outpatient clinics.
  • Attend all mandatory neurosurgical/neuroscience conferences.
  • Prepare lectures for journal club, ethics, spine and M&M conferences.
  • Attend all outpatient clinics with assigned faculty.
  • Take call with junior residents under direct attending faculty supervision.
  • Attend one national neurosurgical conference and any major neurosurgery/neurosciences meeting where the resident has an abstract or paper accepted.
  • Take written neurosurgical boards for credit (if necessary).
  • Maintain case log thru ACGME site and provide all required documentation for resident portfolio.

 

Goals and Objectives

The objective during this neurosurgical rotation is for the resident to assume the senior resident status with an increasing decision making role regarding patient care and to embrace more  responsibility in the management of patients serving as primary surgeon in selected cases where competency has been established.  A more active role is assumed in the teaching of junior residents and medical students, and emphasis is placed on developing competency in practice-based learning and improvement by providing the opportunity of organizing and implementing various clinical/didactic conferences.

The last 3 months of the NS-5 year are spent formulating a research/academic plan that will be enacted during the subsequent research year.  Those residents interested in basic neuroscience research will be assisted in identifying and developing their area of interest.  Once an area has been established, the resident will be directed to the appropriate basic scientist, in which the goals and objectives of the research can be best met.   This may be within the Allegheny General Hospital, Allegheny-Singer Research Institute, The Pittsburgh Tissue Engineering Initiative, Carnegie Mellon University, or another institution (either in Pittsburgh or nationally).  Research funding opportunities will also be identified and pursued.  Each resident will be assigned a faculty mentor to assist them step-by-step through this process.  For those residents inclined to pursue a clinical track, at this time they would select one of the areas of advanced clinical training.

Competencies

Medical Knowledge - The resident will be able to:

  • Maintain and expand their knowledge base in all skills and competencies from previous years.
  • Expand knowledge in neuroanatomy, neurophysiology, neuropharmacology and basic neurosciences with appropriate application to patient care issues.
  • Performing at the level of a senior resident with duties and responsibilities delegated by the Chief Resident.
  • Supervise and teach lower level residents the appropriate methods of evaluation, management and follow up of neurosurgical patients with elective, traumatic and emergency disorders/diseases.
  • Direct the critical care management and high-level non-operative neurosurgical care for patients.
  • Accurately interpret complex laboratory and imaging studies (MRA, CTA, angiography)
  • Assume an increasingly active role in didactic conference preparations and discussions.
  • If a research year is elected:
    • Evaluate scientific and clinical merits of neurosurgical literature.
    • Identify area of interest and appropriate basic science/clinical faculty mentor.
    • Identify available research resources; both within and outside of AGH.
    • Identify potential sources of funding; utilize offices of grants and contracts within ASRI and the AGH Institutional Review Board.
    • Develop background for research from comprehensive review of scientific literature and development of preliminary research proposal/protocol.
    • Develop a timeframe for research completion.
    • Learn the fundamentals of research methodology, biostatistics, literature review, critical analysis.

Utilize:            Written Board Exam
                       
                        SANS-wired

                        Oral Exam

                        Skull base lab workshops

                        Bi-annual evaluations: competencies

Patient Care and Assessment – the resident will be able to:

  • Refine and assume an increasing role in routine operative procedures by performing those components appropriate to faculty-observed skills and to first assist in complex cases.
  • Demonstrate microsurgical techniques for vascular and tumor surgery, spinal instrumentation surgery and epilepsy surgery.
  • Perform complex level procedures under close supervision.
  • Attend all outpatient clinics with assigned faculty.

Utilize:           Observed Exam: clinics and operating rooms

                        Patient survey:  post-exam/feedback cards

                        Bi-annual evaluations:  procedures

Practice Based Learning – The resident will be able to:

  • Expand and improve his patient care through increasing participation in morbidity and mortality conferences and development of an ongoing and improving ability to learn from errors.
  • Incorporate the principles of adult and lifelong learning into personal scholarship and scientific inquiry.
  • Demonstrate an ongoing and improving ability to learn from errors.
  • Participate in statistics course.

Utilizing:        Journal Club with Statistics

                        Set New/evaluate old goals      

                        Case Logs                               

                        Yearly Scholarship logs

                        SANS-wired

Systems Based Practice – The resident will be able to:

  • Evaluate the medical socioeconomic impact of neurosurgical practice and understanding the current environment in medical economics and malpractice issues.
  • Demonstrate an understanding of practice opportunities, practice types and health care delivery systems.
  • Keep track and log all procedures performed in ACGME case log system.

Utilize:           QI team projects

                        Formal Lectures

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

  • Coordinate communication with consultants, referring physicians and integrate neurosurgical healthcare providers into an effective patient care team.

Utilize:           Observed Exam

                        Patient Survey

                        Feedback Cards

Professionalism – The resident will competently function as:

  • A role model and mentor to instill good work habits and compassionate approaches to patient care in junior neurosurgical residents.

Utilize:            Project Professionalism/ AMA Virtual Mentor

                        360-degree Evaluation

                        Feedback Cards

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