Educational Program: PGY-3
The PGY-3 year includes four clinical rotations: two months will be spent on the Pain Service, two months on the vascular service (for experience with carotid endarterectomy), two or three months on neurosurgery at the Nebraska Medical Center, and three or four months on the pediatric neurosurgery service at Children’s Hospital. One month each will be spent on neuroradiology and neuropathology (although the opportunity exists to overlap these rotations with two months total in each). In anticipation of the upcoming PGY-4 research year, the PGY-3 residents will participate in the Clinical Research Symposium sponsored by the UNMC College of Medicine. This symposium includes a week of didactic training during which participants will be given a broad overview of the research process, including study design, statistical design and analysis, ethical issues, and the Institutional Review Board application and consent process. The second part of the symposium, held later in the year, builds on the first week of training and includes hands-on experience in developing, writing, and revising a specific research project. The purpose of the PGY-3 year is to build on knowledge and skills obtained during the PGY-2 year in particular by assuming greater responsibility for patient care and by gaining more in-depth knowledge and skills of the subspecialty areas of pediatric neurosurgery and pain as well as to prepare residents for the research year and Board examination. During this year, residents will demonstrate greater independence and responsibility for inpatient and outpatient care, including evaluation and decision-making. Residents at this level are expected to evaluate patients in the inpatient and outpatient settings, establish a differential diagnosis, identify appropriate diagnostic tests, and develop a treatment plan. They may implement non-critical aspects of the evaluation but are expected to report in a timely fashion to Senior and/or Chief Residents and faculty. Residents will refine their abilities to perform the neurosurgical history and physical examinations. Additionally, residents will improve knowledge of indications and interpretation of laboratory and imaging studies, apply complex diagnostic and patient-management skills, including participation in inpatient and outpatient settings, establish and implement effective patient care plans, counsel patients on the risks, goals, limits and alternatives to neurosurgical procedures, perform selected surgical procedures under direct supervision, focusing on spinal neurosurgery (e.g., lumbar and cervical laminectomies, lumbar discectomy, anterior cervical discectomy with and without fusion), assist in major surgical procedures, and perform portions of the procedure that are appropriate to the resident's level of training under guidance, and practice critical care skills as required for inpatient neurosurgery. Global evaluation of resident performance will be performed by the neurosurgery faculty and support staff ("360 degree evaluation") at the conclusion of the neurosurgery rotations. Evaluation of resident performance in non-neurosurgery rotations will be provided by faculty supervising the resident in those rotations. The PGY-3 resident will take the written examination of the American Board of Neurological Surgery (ABNS) for self-assessment. Residents will provide evaluations of faculty in non-neurosurgery rotations following conclusion of those rotations and will complete a "self-assessment" and formal evaluation of the neurosurgery program and faculty annually.