‐1 – First Year Resident in Neurosurgery
This is a clinical resident rotation where early skills and habits will be developed. Three months of the PGY‐1 year are spent on the General Surgery service establishing the fundamental clinical skills of the evaluation and management of the general surgery patient with an emphasis on trauma and critical care. Goals in the general surgery months are to develop skills in patient diagnosis and management, learn basic critical care and emergency management, learn to manage ICU patients, recognize the complications of surgery and trauma, and learn basic surgical techniques. The three months are spent on clinical Neurology and neurophysiology services learning to master the neurological examination and formulating a differential diagnosis in the neurological patient. Two months are spent at The Methodist Hospital in Houston for a Neuropathology rotation. The resident participates in brain cutting, tumor board, conferences, and book study to acquire appropriate knowledge and skills in neuropathology. The PGY‐1 resident also spends two months on a Neuro‐Interventional Surgery rotation at West Jefferson Medical Center. The goal of this rotation is primarily to acquire skill in diagnostic Neuro‐Intervention. Residents will also rotate with the Neuro‐Radiologists. CT of the brain and spine, CT angiography, MRI of the brain, spine, and peripheral nervous system, MRA, MR Spectroscopy, ultrasounds of the cerebrovascular system including transcranial Doppler, intraoperative ultrasound, cisternography, PET, SPECT, and performance and interpretation of myelography will be covered. There is two months of the PGY‐1 year that is spent on the general Neurosurgery service at West Jefferson Medical Center, learning the fundamentals of the evaluation and management of the Neurosurgical patient. Additional time will be spent rotating with endovascular and radiation oncology reviewing the fundamentals of stereotactic radiosurgery and neuroradiology.
‐2 – Second Year Resident in Neurosurgery
The majority of the PGY‐2 year is spent on the general neurosurgery service at University Medical Center (UMC). The resident will serve as the junior resident with the Chief (PGY‐6 or PGY-7) resident focusing on spinal, trauma, and general neurosurgery. The resident will attend one clinic every week at University Medical Center focusing on general neurosurgery working directly with faculty. This experience will allow the resident to acquire the ability to prepare treatment plans for patients presenting in a non‐urgent environment and follow the patient from first visit through surgery and recovery. The resident will begin to develop the skills of neurosurgical patient management by following the patient through the course of their treatment with more involvement in the surgical care.
‐3 – Third Year Resident in Neurosurgery
The PGY‐3 year is spent at WJMC for spine, tumor, functional, and cerebrovascular neurosurgery experience. Here the resident is exposed to a broad spectrum of neurosurgical disorders, working one on one with subspecialty neurosurgery faculty. The resident is involved in the work up of patients admitted to the neurosurgical service. He/she is responsible for history and physical examination on elective admits and develops a management plan in conjunction with the attending. He/she reviews the findings on diagnostic studies and discusses the treatment options with the attending neurosurgeon. Surgical treatment is discussed and the procedure reviewed in detail. The resident assists at operation and is included in the postoperative management. Rounds are made with the attending on a daily basis. Consults will be answered either with the attending or initially by the resident and then presented to the attending. Emergency Room consults may be answered initially by the resident and presented to the attending. The resident is on call every third to fourth night. The resident attends selected clinics and evaluates new patients and presents the findings to the attending. The resident keeps a personal log of all cases through the ACGME website.
PGY ‐4 – Fourth Year Resident in Neurosurgery
In the fourth year, the resident spends time at UMC functioning as a junior chief, typically focusing more on complex cranial and spine pathology. The resident also rotates at Children’s Hospital of New Orleans for pediatric exposure. The resident has more autonomy in the operating room under the direction of the neurosurgical staff. The fourth year manages the floor and ICU patients with assistance from the chief resident and staff. Additionally, the resident operates a staff assisted morning clinic once a week focusing on complex cranial cases and clinical trial patients. Leadership/managerial skills are developed and implemented during this year. Medical student and junior resident teaching are encouraged through daily rounds and conference lectures.
‐5 – Fifth Year Resident in Neurosurgery
The fifth year of training is spent in pursuit of neurosurgical scholarship, most frequently in a laboratory in the LSU Neuroscience Center of Excellence or lab of their choosing. The resident is expected to develop a plan well in advance with the program director. Clinical duties are strictly limited, though some call coverage may be expected to maintain clinical skills through this period. This academic year is an opportunity for the resident to fine‐tune their skills in academic pursuit including research design, conduct, and ethics, as well as academic professional communication skills. The content of the investigation is largely determined by the interests of the resident, but must of high quality as determined by the program director. It is fully expected that this work should result in at least one publication in a major peer reviewed journal.
** The department now offers residents the opportunity to complete a MHA or MBA during their research year through LSU-Shreveport. **
‐6 – Sixth Year Resident in Neurosurgery
The sixth year begins as the junior academic chief resident at WJMC and sharing chief call with the senior graduating chief resident. In the second six months, the PGY6 resident goes to lead the UMC service. In this year, the resident shares “chief call”, seeing all potential operative cases on call and reporting directly to the attending on call with their assessment. In addition, they function as the chief resident on their services, managing the patient care duties of one junior resident. It is expected that they will participate in the most complex procedures at each hospital during this year, functioning as a chief at both hospitals.
‐7 – Seventh Year Resident in Neurosurgery
At the conclusion of the PGY‐6 year, the resident is amply prepared for the true chief residency. First at University Medical Center and then at WJMC, the chief is fully responsible for coordination of all patient care on all the services, resident manpower decisions, complication review, journal club, conference and call schedules. In addition, they directly manage the service they are on.