This year is important in providing the necessary background
knowledge and skills to begin training in neurosurgery as a
junior resident. It includes rotations in of general surgery,
trauma and critical care. Three months are spent in neurology and
another three as the intern on the MedStar Georgetown
neurosurgery service. The residents are expected to develop basic
surgical skills, learn techniques for procedures in the intensive
care unit, as well as acquire knowledge necessary for
neurological diagnosis during this year.
PYG-2: Junior resident
The first year of neurosurgery training is split between the
clinical neurosurgery services at MedStar Georgetown University
Hospital and the MedStar Washington Hospital Center. The
residents learn to evaluate patients in the outpatient settings
of the clinic and emergency room, as well as to manage
neurosurgical patients on the busy inpatient services. The
patient population are quite different at the 2 hospitals, and
the residents will gain significant exposure to neurotrauma at
the MedStar Washington Hospital Center. An emphasis is placed on
gaining experience in the neurosurgical ICU at both affiliates.
The residents will take major part in basic neurosurgical
procedures in the operating room.
PGY-3: Mid-level resident
This year is split between the Children's National Medical Center
(CNMC) and MedStar Georgetown University Hospital. At CNMC, the
residents are expected to acquire critical knowledge in all
aspect of pediatric neurosurgery including the management of
shunts and pediatric brain tumors. They will also play major
roles in procedures for craniofacial reconstruction, tumor
resection and epilepsy.
This year is reserved for clinical and basic science research.
The area of research is chosen by the resident, in consultation
with the neurosurgical faculty, with considerations of long-term
career plans. The resident is expected to present the data of
this research at national neurosurgical conferences, and publish
the results in peer-review journals.
PGY-5: Senior Resident
For 6 months, the residents are at the MedStar Georgetown
University Hospital as the senior resident on the clinical
service. Functioning with increasing autonomy, the residents
continue to refine the skills needed for more advanced
neurosurgical procedures, and manage the inpatient service under
the supervision of the chief resident. The other half of the year
is split among radiosurgery, neuro-radiology and peripheral nerve
surgery. The residents are expected to take part in procedures
involving the Gamma knife, Cyberknife® and endovascular
interventions. The MedStar Georgetown Neurosurgery program is one
of very few with a dedicated peripheral nerve rotation.
PGY-6: Chief Resident
This is the chief residency year of training. In addition to
being responsible for the daily activity of the inpatient
neurosurgical team at both hospitals, the chief residents refine
the management and surgical skills necessary for graduation from
the training program and entrance into practice. Along with the
program director, the chief residents administer the conference
schedule, and monthly quality assurance reports.
The time-line for training is summarized in the Rotational Block Diagram.