PGY-5 Year

Educational Program: PGY-5

The PGY-5 year will be spent divided between Methodist/Children’s Hospitals (6 months) and NMC (6 months) with the individual serving as Senior Resident. The resident is expected to participate in patient care in the inpatient setting, the operating room, and emergency room. The senior resident will be responsible for the evaluation of new and follow-up patients, including consults, and will provide coverage of the emergency rooms at these institutions in collaboration with faculty neurosurgeons. The resident will operate on standard neurosurgical procedures up to and including major craniotomies and complex spinal surgery under the direction of the faculty. The Senior Resident will assist the Chief Resident as needed for administrative and clinical oversight of junior residents working on the neurosurgery service at these hospitals, including assigning clinical duties and establishing the call schedule. The Senior Resident will also be involved in quality improvement and teaching. This may include preparation and presentation of the morbidity and mortality conferences, grand rounds, and the neuro-oncologic tumor planning conferences.

During the PGY-5 year, the Senior Resident should assimilate the knowledge and skills learned in the preceding years of training, improve clinical judgment, and refine technical skills with the goal of developing progressively greater independence and autonomy with respect to patient care. In the PGY-5 year, the resident will be expected to evaluate patients independently (under supervision of faculty and the Chief Resident), order and interpret appropriate diagnostic tests, and formulate a treatment plan. The Senior Resident may implement the treatment plan for non-critical issues but is expected to report to faculty in a timely manner. The Senior Resident will be expected to participate in as many operative procedures as possible and with special attention to gaining exposure to a wide variety of cases, including complex spine, tumor, skull base, vascular, and peripheral nerve. The Senior Resident should serve as primary surgeon for all procedures for which s/he is qualified. As the year progresses, attention should be given toward participating in more complex cases and toward assuming progressively greater degrees of function as the primary surgeon. The Senior Resident is expected to work collaboratively with other members of the healthcare team, request and respond to consults in a timely and professional manner, and draw on the resources of the broader healthcare system as needed to provide optimal care to the patients. The Senior Resident is expected to increase the depth and breadth of knowledge of neurosurgical disorders and their management and apply this information to the care of patients. The Senior Resident should educate patients and their families regarding their medical disorders, be able to explain options for treatment and the relative advantages of each approach, and work with the patients to develop the treatment plan that is appropriate. The Senior Resident is expected at all times to maintain a professional demeanor and serve as a good role model for junior residents and students. Global evaluation of resident performance will be performed by the neurosurgery faculty and support staff ("360 degree evaluation") each 6 months. Residents will also complete a "self-assessment" and formal evaluation of the program and the faculty annually.