PGY-1 Year

Educational Program: PGY-1

The PGY-1 year consists of rotations through a variety of inpatient and outpatient clinical services that are intended to provide a foundation of knowledge and skills that will promote success in neurosurgery residency. Specific attention will be paid to surgical principles, emergency evaluation and management, basic patient care skills, and clinical neuroscience (e.g., neurology). Rotations are based at Nebraska Medicine, Nebraska Methodist Hospital, and Childrens Hospital. Upon completion of the initial year of training, the resident will have developed a broad base of knowledge and basic technical skills applicable to neurological surgery.

During this year, residents will develop their skills in performing history and physical examinations, including comprehensive neurological examinations, they will learn to order appropriate tests and follow-up with the results, participate in patient education, perform daily patient care and make appropriate notes, participate in discharge planning, and follow-up with patients after discharge as needed. On surgical rotations, residents will participate in the pre-operative and post-operative evaluation and care of patients. The residents will be expected to participate in surgical procedures at a level commensurate with their background and skills.

At all stages of training, residents’ clinical activities are monitored and supervised by faculty to ensure appropriate, safe, timely, and cost-effective care. At the same time, residents need to develop their independence so they will become capable, independent neurosurgical practitioners. We accomplish this goal by providing our residents, at each level of training, progressively greater freedom in evaluating and managing patients within the limits of their medical knowledge and technical expertise as judged by the supervising faculty. Junior residents are not expected at their level of experience to be accomplished diagnosticians or technicians, so junior residents work at all times under the supervision of their “senior consultants”, including the faculty, the Senior Resident, and the Chief Resident. During the first year of training, in particular, residents are expected to report frequently to their senior consultants. As they demonstrate competency in the evaluation and management of neurosurgical patients, particularly with more common, less critical disorders, they are given greater latitude and independence for the primary assessment (including ordering of diagnostic tests). They are encouraged to develop a management plan but are expected to present their plan to their senior supervisor(s) prior to initiating treatment. In the operating room, they will learn to perform minor cases as first surgeon and will learn to assist with major cases. Patient safety and quality of care are top priorities for us, so residents at all levels of training should never hesitate to call their senior consultants if they have questions regarding patient care.