The PGY5 year is spent at Rush University Medical Center in a combined clinical neurosurgery rotation and in a intra-mural elective. The intra-mural elective time may be used by the resident to further their training in a neurosurgical sub-specialty, i.e. trauma, vascular, interventional neuroradiology or as additional research time either clinical or lab-based. The possibility of outside rotations exists but this requires prior RRC approval. Should the PGY5 not choose an elective, the PGY-5 continues on the clinical service at Rush.

The PGY5 resident will assist the junior chiefs and chief residents in making the service run smoothly. These activities include the oversight of resident assignments, daily patient care, teaching of junior residents and medical students as well as intensive O.R. experience as surgeon. Progressive clinical and administrative responsibilities are assumed in anticipation of the transition to his/her junior chief year. Professionalism and communication skills are emphasized.

• Demonstrate the ability to teach effectively
• Demonstrate the ability to develop operative plans
• Demonstrate detailed knowledge of microscopic surgery
• Demonstrate detailed knowledge of spinal neuroanatomy
• Demonstrate detailed knowledge of cranial Neuroanatomy
• Demonstrate detailed knowledge of peripheral neuroanatomy
• Demonstrate detailed knowledge of post-operative complications and their avoidance in pediatric neurosurgery and pediatric neurosurgical trauma
• Demonstrate detailed knowledge of the principles of stereotactic frame placement
• Demonstrate detailed knowledge of dose selection for individual diseases, i.e. tumors, AVM’s

• Demonstrate competencies in surgical care of neurological trauma
• Demonstrate competencies in diagnosis and surgical management of neurosurgical emergencies
• Demonstrate competencies in recognizing and managing complications of radiosurgery
• Participate in an elective situation designed to focus their attention on neurosurgical subspecialties including research
• Teach more junior level residents, interns, and students in the performance of critical care and basic operative procedures
• Perform complex neurosurgical procedures, i.e. multi-level spinal fusion, craniotomies for tumors, and cerebral vascular disease
• Develop and implement patient care plans that are concise and complete
• Provide second call coverage
• Identify and treat brain and spinal cord injuries

• Continue ongoing research efforts and/or perform a clinical/lab based project possibly leading to a national presentation or publication
• Perform critical evaluation of medical literature for presentation at Journal Club
• Utilize CNS SANSwired, MedHub, GME-Today and other web-based tools
• Utilize literature and web-based material to prepare care plans
• Utilize literature and web-based material to prepare operative plans
• Demonstrate critical self-assessment
• Demonstrate understanding of neurotrauma guidelines
• Demonstrate understanding of the practical aspects of stereotactic radiosurgery

• Continue to demonstrate a high level of interpersonal communication skills
• Demonstrate the ability to intervene effectively in patient care issues
• Demonstrate leadership skills
• Provide constructive criticism to members patient care team
• Motivate members of patient care team using values based motivation
• Communicate with families of pediatric patients
• Communicate with families of tumor patients

• Attend daily neurosurgery ward rounds on time
• Interact effectively with interns, medical students, nursing and discharge planners
• Maintain professional rapport with the patient, the patient’s families, nurses, other physician teams and other hospital personnel
• Demonstrate a compassionate, caring approach to patients and their families
• Demonstrate respect for patients and colleagues from diverse cultural, ethnic and religious backgrounds
• Demonstrate honesty in all professional interactions
• Demonstrate good dress and grooming style constituent with institutional and departmental guidelines
• Comply with all GME and Departmental policies regarding duty hours restrictions
• Accurately self-report fatigue in situations that may compromise safety and/or patient care
• Maintain primary focus on patient’s concerns

• Exhibit an understanding of legal and political issues in neurosurgery
• Be readily conversant regarding practice types, medical economics, and health care delivery systems
• Understand and exhibit knowledge of procedural terminology, processing and reimbursement issues
• Understand the important role neurosurgery plays in emergency care
• Participate and demonstrate an understanding of current trends in medical care by keeping up-to-date with reading of Medical Economics and MGMA
• Participate in quality assessment and improvement initiatives instituted by national organizations JCAHO, etc)
• Participate in quality assessment and improvement initiatives instituted by the hospital and chief medical officer
• Participate in quality assessment and improvement initiatives instituted by the department of neurosurgery

The PGY5 resident performs and assists with complex surgical procedures with the neurosurgery attending. The skull base, vascular and epilepsy surgery experience expose the senior resident to interdisciplinary patient and operative management. The resident is expected to prepare for surgical cases by review of the patient’s records, film studies, literature searches and know possible complications and outcomes. The PGY5 resident also participates in the CNS-sponsored chief resident surgical anatomy course. The senior resident is expected to mentor the junior residents and provide instructions on patient care issues. This mentoring is supervised by the junior chief resident, chief resident and attendings.

PGY5 Competencies Evaluation Methods:

• Twice a year electronic evaluation by neurosurgical attendings in MedHub
• Evaluation by neurotrauma specialists and pediatric neurosurgeon
• Annual 360 degree electronic evaluation by operating room nurses, ICU and Ward nurses, and out-patient clinic staff in MedHub
• Annual Mock Orals
• Annual self-evaluation
• Quarterly oral evaluations by attendings at a private conference portion of Department meeting
• Regular review of medical documentation in patient’s charts by neurosurgery attending(s)
• MedHub resident learning portfolio
• MedHub duty hours report/analysis
• MedHub conference attendance report/analysis
• Graduation Day/Academic Day – Research Presentation
• End-of-Rotation review of all evaluations and data by Program director