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Program Description

The UVM Neurosurgical Residency Program is designed to provide the resident with the expertise for operative and non-operative management of patients with disorders of the nervous system, including both adult and pediatric patients.

Clinical neurosurgery training is obtained at the University of Vermont Medical Center and at the affiliated institution, University of Utah. The UVM Neurosurgical Residency Program dedicates 60 months to clinical neurological surgery and 12 months to dedicated basic science or clinical research. The resident is exposed to a full spectrum of neurosurgical issues, both non-operative and operative, at the sponsoring institution for 72 months and the University of Utah for 12 months. There is a graduated assumption of responsibility by the resident for the pre-operative workup, operative intervention and post-operative care of the patient. All aspects of clinical service and education are directly monitored by the neurosurgical faculty.

PGY-1: General Surgery/Neurosciences

The PGY-1 year will consist of three months of surgical critical care including two months in the surgical/neurosurgical intensive care unit and one month on the trauma service. The PGY-1 resident will also spend three one month blocks on neurology, neuro-otology, neuroradiology, neuro-ophthalmology or neuropathology. The remaining six months will be spent on the neurosurgery service.

PGY-2: Junior Resident

The PGY-2 resident is the junior neurosurgery resident at University of Vermont Medical Center. The PGY-2 resident provides assistance with the daily patient care for the inpatient neurosurgery service, including pre- and post-operative care. He or she provides neurosurgical consultation services to the emergency room and the UVM Medical Center. The PGY-2 resident also assists in the operating room as necessary.

PGY-3: Complex Spine Service and Senior Neurosurgery Resident

Six months of the PGY-3 year are spent on the complex spine service supervised by both orthopedic and neurosurgery spine surgeons. The focus of this time period is on complex spine management and includes trauma and deformity correction. Time is primarily spent in the operating room and is supplemented by a weekly spine conference as well as outpatient clinic.

For the remaining six months of the PGY-3 year, the resident functions as a senior clinical neurosurgery resident at UVMMC. Each Monday is spent on the neuroendovascular service with additional time as necessary on a case-by-case basis. The resident will also focus on radiosurgery at this time and will participate in all radiosurgery cases including frame placement, planning and delivery. There is also a focus on pediatric neurosurgery during this time. In this stage of training, the resident assumes more of a role in the operating room but acts as a backup to the PGY-2 resident with regards to emergency call, consults and ward duties.

PGY-4: Elective/Research Year

The PGY-4 year is an elective/research year. The resident’s primary responsibility is participating in basic science or clinical research in a project that has been approved by the Chair and Program Director. It is expected that this elective/research year is planned and finalized during the PGY-2 and PGY-3 years, including obtaining IRB approval and funding if necessary. If a clinical elective is planned, this must be approved prior to the start of the PGY-4 year. This resident is expected to attend clinical conferences and to be available for call duty. Activity of this resident is directly overseen by the Program Director and Chair.

PGY-5: University of Utah Rotation

Six months of the PGY-5 year are spent on the pediatric neurosurgery service at Primary Children’s Hospital in a senior resident role. They supervise the junior resident and share the operative experience with the pediatric neurosurgery fellow. The volume of cases is such that each can either be first assistant or primary operating surgeon as appropriate on a large number of pediatric cases. With increasing experience, the residents are allowed more operative responsibility appropriate to their skill level.

The remainder of the PGY-5 year is spent on the adult neurosurgery service at University Hospital in Utah as senior resident, with a focus on functional and epilepsy surgery. Time on the functional service is spent learning the surgical care and management of functional abnormalities such as epilepsy and movement disorders. The resident will gain considerable exposure to functional neurosurgery including deep brain stimulation for movement disorders, epilepsy surgery and the surgical management of trigeminal neuralgia. Additional subspecialty focus is at the discretion of the resident and Program Director as deemed appropriate.

PGY-6: Senior Neurosurgery Resident

During the PGY-6 year, the resident is assigned to the neurosurgery service at UVMMC as the senior neurosurgical resident. During this portion of their training, the resident should become more active in the operating room but again serves as backup to the more junior hospital staff in the ward and take on an active role in the outpatient clinic. They also serve as the administrative resident, coordinating the conference, vacation and call schedules.

PGY-7: Chief Resident

The PGY-7 resident is designated as the Chief Resident of the neurosurgery service at UVMMC. During this 12 month period, the resident should play a primary role in taking care of all neurosurgical patients on the inpatient service and serve as primary surgeon in both routine and complex neurosurgical operations. The Chief Resident is expected to perform as a leader of the neurosurgery service with teaching, administrative duties and clinical roles.