Neurological Surgery Residency
Training Program
Mission, Goal, General Organization
Rotation, Objectives, Curriculum
General Information
Policies
Conferences
Courses and Meetings
Application Procedure
Current Residents
Resident Policy
Resident Selection
The Neurosurgery Program will select residents after screening applications,
inviting qualified candidates for interviews and evaluation by faculty and
current residents. The rank order list will be prepared by the Program
Director after consultation with the faculty and residents.
Promotion
A resident will be promoted when, in the opinion of the faculty, the
resident has performed acceptably and demonstrated mastery of the knowledge
and skills at the current level and has no non-academic performance matters
which warrant attention by the Program Director.
Evaluation
Residents will be evaluated, in writing, at least every six months by the
faculty. The Program Director will meet with each resident to discuss the
evaluation.
The residents are required to take the American Board of Neurological
Surgeons written exam for self assessment yearly, to pass the self
assessment exam prior to taking it for credit and to pass the written boards
prior to becoming Chief Resident (PGY 6).
Dismissal
The Program Director has broad latitude to act for the good of the program,
in the interest of patients and as a resident advocate.
A resident who fails to perform satisfactorily may be counseled by the
Program Director and other faculty as needed. A period of probation and
performance goals may be established by the program director and approved by
the faculty. A resident who fails to meet the established goals during the
period of probation may be dismissed. This information will be communicated
with the resident and documented in the file.
A resident may be dismissed when the Program Director finds academic
deficiencies or non-academic performance difficulties which cast grave
doubts upon the resident's potential capacities as a physician.
A resident will be afforded appropriate due process when the circumstances
warrant it.
Resident Supervision
The program director ensures, directs and documents proper supervision of
residents at all times. The attending physician has the overall
responsibility for the care of the individual patient, and supervision of
residents involved in the care of that patient. However, residents must
assume progressively increasing responsibility according to their level of
education, ability and experience.
The level of responsibility given to each resident must be determined by the teaching staff, and may vary with the clinical circumstances and the training level of that resident. Residents will be provided with prompt, reliable systems for communication and interaction with supervisory physicians. Faculty members must always be immediately available for consultation and support.
Evidence of resident supervision must be documented in the form of signed
notes in patient charts, and other records such as an indication of the
level of attending presence in procedure notes.
Progressive Responsibility
Resident participation in and responsibility for operative procedures
including the entire Neurosurgical spectrum will increase progressively
throughout the training period.
Duty Hours
- The program director has established an environment that is optimal for both resident education and patient care, while ensuring that undue stress and fatigue among residents is avoided. Residents will not be required to perform excessively difficult or prolonged duties regularly. Residents work schedules will be designed so that, on average, excluding exceptional patient care needs, residents will average at least 1 day out of 7 free of routine responsibilities and be on-call in the hospital no more often than every third night. Different rotations may require different working hours and patterns. There will be adequate backup so that patient care is not jeopardized during or following assigned periods of duty.
- A distinction is made between on-call time in the hospital and on-call availability at home vis-a-vis actual hours worked. The ratio of hours worked to on-call time will vary, particularly at the senior levels, and therefore necessitates flexibility.
- During on call hours, residents will be provided with adequate sleeping, lounge, and food facilities. Support services will be such that the resident does not spend an inordinate amount of time in non-educational activities that could be discharged properly by other personnel.
The goal of this policy is to assist the Department of Neurosurgery in its support of high quality education and safe and effective patient care. The Department of Neurosurgery is committed to meeting the requirements of patient safety and resident well being. Excessive sleep loss, fatigue and resident stress are serious matters. In the event that any resident experiences fatigue and/or stress that is interfering with his/her ability to safely perform his/her duties, they are strongly encouraged and obligated to report this to his/her senior resident or attending on service.
Appropriate backup support will be provided when patient care responsibilities are especially difficult and prolonged, and if unexpected needs create resident fatigue sufficient to jeopardize patient care during or following on-call periods.
All attendings and residents are instructed to closely observe other residents for any signs of undue stress and/or fatigue. Faculty and other residents are to report such concerns of sleepiness, tardiness, resident absences, inattentiveess, or other indicators of possible fatigue and/or excessive stress to the supervising attending and/or Program Director. The resident will be relieved of his/her duties until the effects of fatigue and/or stress are no longer present.