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Residency Program: Year-by-Year Details
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Home > Academics/Residency > Residency Program > Year-by-Year Details
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Educational Goals and Objectives of Training Year NS-1
 
Patient care: The resident will develop the ability to
  • Perform and document a comprehensive neurosurgery history and physical examination
  • Understand the indications for and interpret the meaning of presurgical laboratory studies and imaging
  • Develop patient care plans appropriate to a patient's presenting problems or postoperative course in consultation with the chief resident or attending surgeon
  • Establish and implement effective patient care plans
  • Counsel patients on the risks, goals, limits, and alternatives to simple neurosurgical procedures and more complex procedures under supervision of the chief resident or attending surgeon
  • Perform selected surgical procedures under direct supervision (e.g., ventriculostomies, VP shunt placement, simple craniotomies)
  • Assist in major surgical procedures and perform those portions of such procedures, under supervision, that are appropriate for his or her level of training
  • Work with health care professionals composing the neurosurgery team and other members of the health care team from other disciplines
Medical Knowledge: The resident will develop the ability to
  • Perform above the 10th percentile on the ABNS primary examination
  • Demonstrate a solid foundation of knowledge of anatomy, physiology, and pharmacology related to inpatient neurosurgery patients
  • Correctly interpret basic laboratory and radiological studies
  • Demonstrate a growing familiarity with classic and current aspects of the neurosurgical literature
  • Demonstrate a foundation for clinical neurosurgery problem solving and decision making
Practice-Based Learning and Improvement: The resident will develop the ability to
  • Demonstrate an ongoing and improving ability to learn from errors
  • Locate, appraise, and assimilate evidence from scientific studies related to common neurosurgical problems
  • Identify areas of neurosurgical practice where current knowledge is inaccurate or inadequate, and participate in clinical studies to improve the general fund of knowledge in neurosurgery
Interpersonal and Communication Skills: The resident will develop the ability to
  • Provide compassionate ward and outpatient care as determined by patients, families, colleagues, and auxiliary health professionals
  • Work effectively as a member of a health care team
  • Communicate effectively with other health care professionals on consulting services
Professionalism: The resident will develop the ability to
  • Demonstrate sensitivity and responsiveness to patients' culture, age, gender, and disabilities
  • Demonstrate integrity and a commitment to patients that supercedes self interest
  • Participate meaningfully in ongoing professional development by submitting research for peer review to journals and national meetings
System Based Practice: The resident will develop the ability to
  • Understand the university-based practice of neurosurgery, including its interactions with other health care organizations and how these elements of health care affect the university practice
  • Advocate for quality patient care and assist patients in dealing with system complexities
  • Practice cost-effective health care and resource allocation through evidence-based medical practice that does not compromise quality of care
 
Educational Goals and Objectives for Training NS-2
 
Patient Care: The resident will develop the ability to
  • Perform and document a neurosurgery history and physical examination, with emphasis on spinal, pediatric, and complex neurosurgical disorders
  • Understand the indications for and interpret the meaning of laboratory studies and imaging as relates to neurosurgery in general, with a specific emphasis on spinal and pediatric neurosurgery
  • Develop complex diagnostic and patient-management skills, including participation in busy outpatient neurosurgical clinics (spine and pediatric neurosurgery)
  • Establish and implement effective patient care plans
  • Counsel patients on the risks, goals, limits, and alternatives to neurosurgical procedures, with an emphasis on spinal and pediatric neurosurgery
  • Perform selected surgical procedures under direct supervision, focusing on spinal neurosurgery (e.g., lumbar and cervical laminectomies, lumbar discectomy, anterior cervical discectomy with and without fusion)
  • Assist in major surgical procedures, focusing on spinal and pediatric neurosurgery, and perform those portions of the operation that are appropriate to the resident's level of training under guidance
  • Competently perform inpatient procedures
  • Practice critical care skills as required for inpatient neurology
Medical Knowledge: The resident will develop the ability to
  • Perform above the 15th percentile on the ABNS primary examination
  • Demonstrate a solid foundation of knowledge of anatomy, physiology, and pharmacology related to inpatient neurosurgery patients, with an emphasis on spinal and pediatric neurosurgery, pain management, and critical care neurology
  • Demonstrate an expanded familiarity with the neurosurgical literature, with special emphasis on spinal and pediatric neurosurgery and critical care issues
  • Demonstrate accuracy in clinical evaluation skills, including the correct interpretation of basic and advanced laboratory and radiological studies
Practice-Based Learning and Improvement: The resident will develop the ability to
  • Demonstrate an ongoing and improving ability to learn from errors
  • Construct and implement educational goals for instruction in different elective fields (e.g., neuropathology, radiosurgery, neuro-oncology)
  • Develop fundamental research skills that can be used to develop a fundable basic science research proposal
  • Locate, appraise, and assimilate evidence from scientific studies related to common neurosurgical problems, with emphasis on spinal and pediatric neurosurgery
  • Identify areas of neurosurgical practice where current knowledge is inaccurate or inadequate and participate in clinical studies to improve the general fund of knowledge in neurosurgery
Interpersonal and Communication Skills: The resident will develop the ability to
  • Provide compassionate ward and outpatient care as determined by patients, families, colleagues, and auxiliary health professionals, with special emphasis on pain management, joint orthopedic/neurosurgical spine, and multidisciplinary pediatric clinics
  • Work effectively as a member of a health care team, especially in an outpatient specialty clinic setting
  • Participate meaningfully in multidisciplinary conferences focused on specific neurosurgical fields (pediatric and spinal neurosurgery)
Professionalism: The resident will develop the ability to
  • Demonstrate sensitivity and responsiveness to patients' culture, age, gender, and disabilities
  • Demonstrate integrity and a commitment to patients that supercedes self interest
  • Participate meaningfully in ongoing professional development by submitting research for peer review to journals and national professional meetings
Systems Based Practice: The resident will develop the ability to
  • Understand the university-based practice of neurosurgery, including its interactions with other health care organizations and how these elements of health care affect the university practice
  • Advocate for quality patient care and assist patients in dealing with system complexities, especially in an outpatient setting
  • Practice cost-effective health care and resource allocation through evidence-based medical practice that does not compromise quality of care
  • Understand practice management issues, such as patient processing, evaluation, and management coding, procedural terminology, documentation of services rendered, and other reimbursement process related issues in outpatient clinic setting (spine clinic, elective rotations)
  • Demonstrate an understanding of practice opportunities, practice types, health care delivery systems, and medical economics
 
Educational Goals and Objectives for Training Year NS-3
 
Patient Care: The resident will develop the ability to
  • Perform and document a senior level neurosurgery history and physical, with special emphasis on quick patient assessment and a concise communication for patients with immediately life-threatening traumatic and vascular neurosurgical disorders
  • Understand indications for and interpret the meaning of routine and more complicated laboratory studies and imaging, with an emphasis on angiography and the rapid assessment of traumatic nervous system injury
  • Devise patient care plans at a senior level, with the speed and accuracy needed for patients with immediately life-threatening neurosurgical disorders, under appropriate supervision from attending surgeons, while also managing busy outpatient clinics (SFGH and the SFVAMC)
  • Establish and implement effective patient care plans, assuming the role of leader on a health care team, under appropriate supervision of an attending surgeon
  • Counsel patients on the risks, goals, limits, and alternatives to most neurosurgical procedures
  • Perform complex neurosurgery procedures (cranial and spinal) and begin to assist at the chief resident level with a higher degree of independence
  • Instruct residents and medical students regarding their performance of selected noncomplex surgical procedures appropriate to their level of training, acting as assistant to the chief resident in the management of a busy neurosurgical service or as chief resident at SFGH and the SFVAMC
Medical Knowledge: The resident will develop the ability to
  • Perform above the passing level on the ABNS primary examination (for credit)
  • Demonstrate an advanced knowledge of anatomy, physiology, and pharmacology related to inpatient and outpatient neurosurgery care, with special emphasis on traumatic nervous system injury and vascular neurosurgical disorders
  • Demonstrate an advanced familiarity with the neurosurgical literature, with special emphasis on traumatic nervous system injury and vascular neurosurgery
  • Teach and mentor Year 1 and Year 2 residents
Practice-Based Learning and Improvement: The resident will develop the ability to
  • Demonstrate an advanced ability to learn from errors
  • Finalize the design of a research project to be carried out during the 4th year
  • Establish a solid evidence-based approach to patient care at a more senior level
  • Demonstrate senior level critical appraisal of evidence from scientific studies in the neurosurgical literature, with emphasis on traumatic nervous system injury and vascular neurosurgery
  • Identify areas of neurosurgical practice where current knowledge is inaccurate or inadequate and participate in clinical studies to improve the general fund of knowledge in neurosurgery
Interpersonal and Communication Skills: The resident will develop the ability to
  • Provide compassionate ward and outpatient care at a senior level as determined by patients, families, colleagues, and auxiliary health professionals, serving as the primary provider of care at SFGH and the SFVAMC
  • Work effectively as the leader of a health care team in both inpatient and outpatient settings
  • Participate meaningfully in multidisciplinary conferences, serving as the primary representative of neurosurgical practice at the SFGH and SFVAMC
Professionalism: The resident will develop the ability to
  • Demonstrate sensitivity and responsiveness to patients' culture, age, gender, and disabilities, especially in the setting of providing care to the indigent and underserved
  • Demonstrate integrity and a commitment to patients that supercedes self interest, serving as primary neurosurgeon at SFGH and the SFVAMC
  • Participate meaningfully in ongoing professional development by submitting research for peer review to journals and national professional meetings
System Based Practice: The resident will develop the ability to
  • Demonstrate an understanding of practice opportunities, practice types, health care delivery systems, and medical economics though participation at a chief level in a variety of health care delivery settings (UCSF, SFGH, the SFVAMC)
  • Advocate for high-quality patient care and assist patients in dealing with system complexities, especially in the setting of providing care for the indigent or underserved
  • Practice cost-effective health care and resource allocation through evidence-based medical practice that does not compromise quality of care
  • Understand practice management issues such as patient processing, evaluation, and management coding, procedural terminology, documentation of services rendered, and other reimbursement process related issues in both inpatient and outpatient settings, serving as the primary provider of care (SFGH and the SFVAMC)
 
Educational Goals and Objectives for Training Year NS-4
 
This is a dedicated research year; residents during this year of training do not participate in any clinical duties or activities.
    Patient Care: The resident will develop the ability to
  • Understand indications for and interpret the meaning of routine and complex laboratory studies and imaging
  • Counsel patients on the risks, goals, limits, and alternatives to most neurosurgical procedures
Medical Knowledge: The resident will develop the ability to
  • Perform above the passing level of the ABNS primary examination (for credit)
  • Demonstrate an advanced knowledge of anatomy, physiology, and pharmacology related to inpatient and outpatient neurosurgical care
  • Demonstrate an advanced familiarity with the neurosurgical literature
  • Demonstrate the ability to evaluate and synthesize hypotheses regarding basic scientific investigations
Practice-Based Learning and Improvement: The resident will develop the ability to
  • Demonstrate an ongoing and improving ability to learn from errors
  • Demonstrate a high capacity for work and intensity in a basic science research environment
  • Develop problem solving skills that can be used to design, implement, analyze, and report basic science research that is relevant to the clinical arena
  • Establish sound research and research-related problem-solving habits, including the establishment of familiarity with relevant research literature
  • Become an integral component of a research team
  • Learn significant features of outcomes research and clinical epidemiology by participating in courses offered in the UCSF Department of Epidemiology
Interpersonal and Communication Skills: The resident will develop the ability to
  • Communicate effectively with all members of the research team
  • Utilize communication and interpersonal skills to effectively participate in and lead research projects
  • Communicate research results effectively and persuasively through written and oral presentations
Professionalism: The resident will develop the ability to
  • Demonstrate a commitment to academic and scientific integrity through participation in Department-sponsored educational forums on basic and clinical research
  • Participate meaningfully in ongoing professional development by submitting research for peer review to journals and national meetings
System Based Practice: The resident will develop the ability to
  • Demonstrate an understanding of practice opportunities, practice types, health care delivery systems, and medical economics
 
Educational Goals and Objectives of Training Year NS-5
 
Patient Care: The chief resident will develop the ability to
  • Gather essential and accurate information about all presurgical patients, either directly or through the management of more junior residents
  • Understand indications for and interpret the meaning of all laboratory studies and imaging used in neurosurgery
  • Devise patient care plans at the level of an independent neurosurgeon, under appropriate supervision from attending surgeons; and also guide more junior residents in the evaluation and management of patients
  • Establish and implement effective patient-care plans, assuming the role of primary leader on the neurosurgery service, under appropriate supervision of an attending surgeon
  • Counsel patients on the risks, goals, limits, and alternatives to all neurosurgical procedures
  • Demonstrate the ability to perform all major neurosurgical procedures at an independent level, under appropriate supervision of an attending surgeon
  • Manage and administrate the complexities of a large clinical and academic service
Medical Knowledge: The chief resident will develop the ability to
  • Demonstrate an advanced knowledge of anatomy, physiology, and pharmacology related to all aspects of neurosurgery
  • Demonstrate a familiarity with the neurosurgical literature appropriate for an independent surgeon capable of life-long learning
  • Manage and lead academic conferences
  • Participate actively and lead conferences in a manner that demonstrates a high level of global awareness regarding clinical neurosurgery, basic and applied research, and understanding of the literature, neurosurgical education, and program building
Practice-Based Learning and Improvement: The chief resident will develop the ability to
  • Manage and administrate the complexities of a large clinical and academic service
  • Develop skills as a program builder and an administrator of the neurosurgical service
  • Demonstrate a solid evidence-based approach to patient care at the level of a practicing surgeon
  • Demonstrate sound habits of personal scholarship and inquiry
Interpersonal and Communication Skills: The chief resident will develop the ability to
  • Assist the PD and Resident Education Committee in overseeing the personal, academic, and clinical growth and development of junior residents
  • Instruct and nurture junior residents in all aspects of neurosurgical patient care (outpatient, inpatient, and ICU settings)
  • Demonstrate the ability to interact with many different health care personnel with efficiency and efficacy in the pursuit of patient care and service management
  • Demonstrate leadership skills in the management of more junior residents
Professionalism: The chief resident will develop the ability to
  • Demonstrate sensitivity and responsiveness to patients' culture, age, gender, and disabilities
  • Demonstrate integrity and a commitment to patients that supercedes self interest, serving as primary neurosurgeon
  • Participate meaningfully in ongoing professional development by submitting research for peer review to journals and national professional meetings
Systems Based Practice: The chief resident will develop the ability to
  • Demonstrate an understanding of practice opportunities, practice types, health care delivery systems, and medical economics at a level that is expected of an independent neurosurgeon
  • Advocate high-quality patient care and assist patients and the responsible junior residents in dealing with system complexities
  • Guide junior residents in the practice of cost-effective health care and resource allocation through evidence-based medical practice that does not compromise quality of care
  • Understand practice management issues such as patient processing, evaluation and management coding, procedural terminology, documentation of services rendered, and other reimbursement process related issues in both inpatient and outpatient settings, serving as the primary provider of care
 
 
Affiliated Institutions
 
The University of California, San Francisco (UCSF) is the primary training institution. It is the academic home of the program, and as a tertiary care referral center, it provides a large variety and volume of complex cranial and spinal neurosurgical cases. It also houses the UCSF Children's Hospital, and provides the resident training in pediatric neurosurgery, excluding some trauma. It is the home of Departmental interdisciplinary programs in neuro-oncology and in neurovascular, stem cell, movement disorder, peripheral nerve, and spinal neurosurgery. As the center for many of the Departmental research laboratories, it allows for integration of basic science advances into ongoing clinical research efforts. This is also the main center for outpatient neurosurgical evaluation and provides residents exposure to outpatient evaluation, decision making, and follow-up evaluation during the spine, pediatrics, and elective rotations. This is the main training center for affiliated clinical programs (neurology, neuroradiology, interventional neuroradiology, neuropathology, neuro-ophthalmology, otolaryngology-head and neck surgery, orthopaedics, pediatrics, anesthesiology, endocrinology), and serves as the main center for elective rotations. Most conferences for resident education (except as noted in the program narrative) occur at UCSF.
 
SFGH is the designated Level I Trauma Center for the City and County of San Francisco. It is also the major center for health care of the under-served populace of the city. It provides residents with an intensive and extensive experience in the rapid evaluation and management of life-threatening traumatic nervous-system injury. The service also provides broad exposure to all aspects of critical care management that affects neurosurgical patients; this exposure is enhanced by the integration of the UCSF Department of Neurology neuro-critical care fellow as a participant of the neurosurgery team. The Department of Neurological Surgery has established the Center for Neurological Injury and Repair (CNIR), which has participated in national multicenter clinical trials and is now expanding to include basic investigations into the biological understanding of traumatic nervous system injury with direct application to patient management. In addition, the growing population of San Francisco, combined with the growing faculty at SFGH and recent infrastructure investments by the City & County of San Francisco (approximately $1.5 million in surgical and intensive care unit upgrades), has led to an expanding elective neurosurgical service that provides comprehensive neurosurgical care; residents have expanded opportunity to assume primary responsibility for outpatient evaluation, decision making, surgical management, and follow-up evaluation of patients with complex central and peripheral nervous system disorders under appropriate supervision by SFGH faculty.
 
The SFVAMC is an affiliated institution that provides residents the opportunity to assume greater responsibility for outpatient evaluation, decision making, surgical management, and follow-up evaluation of the community served at this hospital. The majority of patients present with degenerative spinal disorders, but because of the growing coverage provided by the SFVAMC (Martinez CA; Sacramento CA; Reno NV; Boise ID; Hawaii), the number of complex central and peripheral nervous system disorders treated at this institution continues to grow. In addition, the SFVAMC is one of six Parkinson's Disease Research, Education, and Clinical Centers (PADRECCs) in the US VAMC system and is an established center for the treatment of all patients with movement disorders in the US VAMC system. Thus it provides residents a comprehensive exposure to the outpatient and surgical management of movement disorders.
 
UCSF UCSF Medical Center UCSF School of Medicine
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