Program Details

 

PGY1

The PGY-1 year includes 3 months of critical care, 3 months of general surgery rotations (including trauma), 3 months of clinical neuroscience (including neuropathology, neuroradiology and neuro-oncology) and 3 months of neurosurgery.  These rotations occur primarily at Zuckerberg San Francisco General Hospital and UCSF Medical Center.

During the PGY-1 rotations, residents develop the skills required to diagnose and manage inpatients with acute neurological disorders. Residents will then transition their skills to caring for patients with neurological and neurosurgical disorders in rotations that do not require advanced technical skills. By the end of this year, residents have acquired expertise in the management of patients with neurovascular, neuromuscular, and seizure disorders, as well as other neurological conditions. Rudimentary surgical skills are acquired as they pertain to neurosurgical cases. Residents also acquire skills such as history taking, performing comprehensive neurological examinations, and evaluating routine and complex neuroimaging and neurophysiological tests.
 

PGY2

The PGY-2 year consists of 4-month rotations as a junior resident at UCSF Medical Center.  Residents will rotate on the Tumor A, Tumor B and Spine B services, although there is formal exposure to the full range of neurosurgical care provided at UCSF Medical Center including functional neurosurgery, pain, peripheral nerve and vascular.

Working directly under the supervision of the Chief Resident and the full-time faculty, the PGY-2 residents assist at operations, record patient histories, and perform physical examinations on patients admitted to the Neurosurgery Service. This includes providing initial assessment and management of all inpatient consults, transfers, and emergency room consults to the neurosurgery service. They also manage inpatient care for all neurosurgery patients, including critical care, under the direct supervision of the Chief Resident and attending neurosurgeons. The residents participate in multidisciplinary care conferences and develop discharge plans taking into account patient, family, and health-care provider requirements. Residents are on call every 5th night in house and follow all duty-hour guidelines. This rotation is supervised by the program director, chair, and appropriate departmental neurosurgeons.
 

PGY3

The PGY-3 year includes the first formal 4 month rotation in pediatric neurosurgery, as well as 4 month rotations on the Spine A and Vascular services at UCSF Medical Center.  During the pediatric rotations in the program, residents will rotate at the Benioff Children’s Hospitals in both San Francisco (at the Mission Bay campus) and Oakland.

 

PGY4

The PGY-4 year consists of a 4-month rotation as Chief Resident at Zuckerberg San Francisco General Hospital, a 4-month rotation as Chief Resident at the San Francisco VA Medical Center and an additional 4 month rotation at the Benioff Children’s Hospitals.  The focus of the PGY-4 year is a transition to more independent patient care, with residents assuming more responsibility for outpatient evaluation of patients, surgical planning and execution, and postoperative care (both inpatient and outpatient).

 

PGY5

During earlier years of the program, residents are expected to have identified a research mentor and developed a proposal for a 12-month research project in basic or clinical neurosurgical science that is pursued during the PGY-5 year. The Department sponsors an interdisciplinary research and publishing course that includes research design, basic biostatistics, and grant writing. Residents take advantage of the large research administrative office in preparing and submitting their research proposals for outside funding under the direction of Dr. Daniel Lim. Most residents apply for and receive competitive NIH R25/F32, NRSA training grants or Neurosurgical Research Foundation (NREF) grants for this component of training. In the event that a resident is unable to obtain independent funding for their work, the Department assumes responsibility for the resident’s salary if such funding is not available.  The Department has many basic neuroscientists to oversee research, but residents may work with any neuroscientist in residence at UCSF or with clinical neurosurgical faculty who maintain active scientific interests, as approved by the program director and chair. PGY-5 residents are expected to function as independent investigators within the limits determined by their backgrounds and aptitudes. Under the direct supervision of their research mentors, the residents are expected to acquire facility in the research process and scientific methods of investigation, bring a clearly defined scientific project to completion, and gain experience in medical writing and publishing as well as presenting data at neurosurgical meetings.  During this year, residents are required to take the ABNS written exam for credit. Based on federal guidelines, residents with NIH or NRSA training grants have no clinical duties. Similar guidelines are applied to all residents in this year of training. Occasional requests to cover chief residents for vacation or other needs are granted by the program director. 

 

PGY6

The PGY6 year consists of 12 months of either research where R25 funding is available or clinical work to support a subspecialty interest. The second year of R25 funding can be used in the first year of academic practice to help support research work in preparation for a K Award. For those residents who are able to obtain R25 research funding and wish to continue research during the PGY6 year, the 12 months can be solely dedicated to research efforts, such that 2 years of research are completed. For those who pursue clinical rotations these rotations will be focused on the resident’s area of subspecialty interest and will include operative and clinical outpatient experience. Some of the administrative responsibilities at Moffitt Hospital will be shared with the PGY7 chief resident such as weekend call coverage and weekday night coverage. The rotation for such coverage will be worked out between the PGY6 and PGY7residents. PGY6 residents may also rotate other training sites depending on their area of clinical subspecialty interest such as Zuckerberg San Francisco General, Benioff Children’s Hospital or Kaiser Sacramento. During this year, it is expected that for those doing clinical work, academic productivity will be maintained. 

 

PGY7

The entire final year is spent as Chief Resident of the UCSF Neurosurgery Service at Moffitt/Long Hospital and is divided into three 4-month rotations with special emphasis on different aspects of the extremely busy Moffitt/Long service: spine, tumor, and vascular. The Moffitt/Long Chief Residents share full responsibility for the Moffitt/Long neurosurgical service under the direct supervision of attending staff.  Residents evaluate, treat medically or surgically, and make surgical recommendations to patients.  Skills honed include the use and integration of diagnostic techniques such as CT, MRI, EEG, EMG, angiography, and electroencephalography.  The Moffitt/Long Chief Residents plan and carry out all surgical procedures in cranial, spinal, and peripheral neurosurgery, including micro-dissection techniques and the use of surgical navigation systems, endoscopic techniques, intraoperative MRI, electrocorticography, and cortical motor and speech mapping, sensory- and motor-evoked potentials, and spinal instrumentation.  They also evaluate and discuss surgical findings and the associated prognoses with patients and their families after treatment.  They evaluate and manage surgical complications, including presentations at monthly Morbidity & Mortality (M&M).