Rotation Schedule Overview
The PGY-2 year is spent primarily on the service at the Los Angeles General Medical Center focused on basic clinical neurosurgery skills. These skills include:
- Becoming expert in the performance of the neurological examination in both elective and emergency situations
- Becoming fully cognizant of the measures necessary to stabilize the acutely ill neurosurgical patient and the need to render emergent neurosurgical treatment when necessary
- Mastering the full pre- and postoperative evaluation and treatment of neurosurgical patients
- Acquiring operative skills on cases that range from traumatic head and spinal injury to complex elective cases
During the PGY-3 year, the resident has several focused rotations:
- Pediatric neurosurgery at the Children’s Hospital of Los Angeles: It is expected that the resident will become familiar with those disorders that occur with greatest frequency in the pediatric population and the surgical techniques applied to their correction including neonatal populations and mastering performance of shunting procedures for hydrocephalus.
- Endovascular neurosurgery at Keck Hospital of USC and Los Angeles General Medical Center: This rotation focuses on interventions for stroke and cerebrovascular disorders and diagnostic angiograms.
- Spinal neurosurgery at Keck Hospital of USC: Residents learn the basics of complex spine neurosurgery as well as the pre- and postoperative care of these patients in the hospital, and decision-making in the clinical setting with faculty members.
During the PGY-4 year, residents build on their spinal neurosurgery skills at Los Angeles General Medical Center and have training at Keck Hospital of USC in cranial neurosurgery and radiosurgery.
- The resident develops facility in the surgical management of basic and complex spinal disorders including the utilization of metallic fixation devices necessary to assure stability of the spine
- At Los Angeles General Medical Center residents gain a large experience in treating traumatic spine injuries as chief of the combined spine service
- There also is time dedicated to stereotactic radiosurgery during this rotation and additional time to continue or develop basic science, clinical research or outcomes projects
Residents spend the PGY-5 year at Keck Hospital of USC as the respective chiefs of the services focused on complex cranial neurosurgery and complex spinal Neurosurgery. They also spend time dedicated to their ongoing research projects.
- The resident is an active operative participant in the full spectrum of cases on the service with the expectation that the resident will acquire a broad exposure to microsurgical techniques in the adult patient
- He/she will subsequently understand the principles of microsurgery along with the technical aspects of utilization of the operative microscope and other surgical technologies in complex cranial and spinal cases
- The chief resident, under supervision of the attending staff, acquires an understanding of the administrative operation of a neurosurgical service and is responsible for the assignment of residents to specific surgical cases in addition to providing general administrative assignments for day-to-day operation
The sixth year of residency is spent exclusively pursuing a focused area of interest either clinically or with research. This year provides the individual with an opportunity to avail themselves of the facilities of the entire university community, providing the resources of a major research university that ranks amongst the 10 leading research-funded universities in the United States. This year also can be used to pursue an enfolded fellowship in a particular area of clinical interest.
As a PGY-7, the resident is promoted to a position of resident supervisor, which entails the following:
- Assumes primary responsibility of the day-to-day operation of one of the two services at the Los Angeles General Medical Center
- All of the administrative needs of these services are provided by the resident supervisor, who has the authority to assign operative cases at all levels
- This year provides a broad opportunity to finely tune one’s operative skills and provide oversight for the entire management of the patient population on the service utilizing the consultative opportunities provided by the attending staff
- Upon completion on this experience, it is anticipated that the individual will be able to manage the full spectrum of neurosurgical disease and to understand the mechanisms of and needs for supervision at every level of resident education
- The individual will be fully prepared to assume total care of any patient with any neurosurgical problem and to establish the foundation of a career in either academic or community based practice