Residents in the Department of Neurological Surgery fall under the supervision of the Graduate Medical Education division. For details involving terms, benefits, and conditions of appointment, see the Housestaff Information Booklet.
 
Residency Program - Year-By-Year Description
 
The Department of Neurological Surgery offers three appointments each year in a 6-year program consisting of:
 
4 months of general patient care;
3 months of neurology;
12 months of laboratory research; and
53 months of clinical neurological surgery.        
 
Applications should be received by the Department eight months before the starting date of residency. An evaluation performed at the end of each rotation and peformance measured at the end of each year determines if the resident will advance to the next phase of training. The primary (written) examination given by the American Board of Neurological Surgery is taken for self-assessment in the third year, and must be taken for credit by the fourth year. A grade at or above the 60th percentile is required for completion of this program.
 
Sites
 
Residents rotate through four sites during training:
 
Moffit/Long Hospital at the University of California, San Francisco (M/L);
San Francisco General Hospital (SFGH);
San Francisco Veterans Affairs Medical Center (SFVAMC); and
Children's Hospital & Research Center Oakland (CHRCO).
 
Year 1 (PGY-1):
 
Beginning with the 2009-2010 academic year, PGY-1 residents will enter the Neurological Surgery Residency Program and all rotations will be under the direction of the Neurological Surgery Program Director (Nicholas Barbaro, MD). The PGY-1 year begins with a 4-month block covering general patient care, which includes:
 

trauma (SFGH)

vascular surgery (M/L)

otolaryngology (M/L)

intensive care medicine (SFGH)

  
The second 4-month block of the PGY-1 year includes 3 months of neurology and 1 month of clinical neurosurgery. Neurology rotations will be at SFGH (1 month) and M/L (1 month endovascular care and 1 elective month); the clinical neurosurgery rotation will be at M/L under the supervision of the Neurological Surgery Program Director.
 
The final 4-month block consists of the following neurosurgery rotations:

neurosurgical trauma (SFGH)

radiosurgery and radiation oncology (M/L)

clinical neurosurgery (M/L)

  
Year 2 (PGY-2):
 
The entire PGY-2 year is spent in rotations at Moffitt/Long Hospital (M/L). Many of the skills developed in the PGY-1 year are expanded as residents gain experience with neurosurgical patient management. Residents record histories and perform physical examinations on patients admitted to the neurosurgical services. They provide initial assessment and management of all inpatient consults, emergency room consults, and transfers from outside institutions. The residents 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 multi-disciplinary care conferences and develop discharge plans taking into account patient, family, and health-care provider requirements. In the operating rooms, PGY2 residents act primarily as assistants to faculty and are allowed to perform portions of procedures under direct faculty supervision to acquire new surgical skills.
 
More detail on the PGY-2 year
 
Year 3 (PGY-3):
 
During the PGY-3 year, residents spend four months on the neurospinal disorders service, four months on the pediatric neurosurgery service at Moffitt/Long Hospital (M/L), and four months on the pediatric neurosurgery service at Children's Hospital & Research Center Oakland (CHRCO). Residents record histories and perform physical examinations on patients, which includes providing initial assessment and management of all inpatient consults, transfers, and emergency room consults. They formulate diagnoses and plan care based on interpretation of neuroimaging and neurophysiological tests. The residents may assist in operations based on graded experience and under the direct supervision of the attending neurosurgeon. They also evaluate patients in the outpatient clinic and participate in decision-making and follow-up evaluations.
 

PGY-3 Spine Rotation: The spine rotation is performed at M/L under the supervision of the co-directors of the Neurospinal Disorders Program, Drs. Christopher Ames and Praveen Mummaneni, in conjunction with the program director and chair. In addition to the above responsibilities, the residents participate in multi-disciplinary patient care conferences with nurses, pharmacists, physical and occupational therapists, orthopedic surgeons, neurologists, and social service specialists. During this rotation the emphasis is on expanding clinical and surgical skils in the treatment of patients with complex spinal disorders, with particular emphasis on spinal instrumentation and pain management.

 

PGY-3 M/L Pediatrics Rotation: In addition to the above responsibilities, residents on the pediatric neurosurgery service at M/L manage inpatient care of all pediatric neurosurgery inpatients in conjunction with pediatric subspecialists. They are also required to participate in multidisciplinary patient care conferences with pediatric nurses, physical and occupational therapists, and social service specialists to develop patient-care and discharge plans that take into account patient, family, and health-care provider requirements. During this rotation, patient care, decision-making, and basic neurosurgery techniques are stressed with emphasis on pediatric patients. Supervision is by the Chief of Pediatric Neurological Surgery, Dr. Nalin Gupta, in conjunction with the program director and chair.

 

PGY-3 CHRCO Pediatrics Rotation: Pediatrics residents at CHRCO perform all of the clinical responsibilities described above for the Pediatrics service at M/L. At CHRCO there is a special emphasis on pediatric trauma in a trauma ICU and UCSF residents work with pediatric intensive care faculty and fellows. Residents participate in the operating room under the direct supervision of the pediatric neurosurgery faculty. Supervision is by the CHRCO Chief of Pediatric Neurosurgery, Dr. Peter Sun.

  
More detail on the PGY-3 year
 
Year 4 (PGY-4):
 
The PGY-4 resident serves as senior resident on the UCSF Neurosurgery Service for a four-month period, working closely with the Chief Resident in conducting the operating room schedule at Moffitt/Long Hospital (M/L). Together with the second-year residents, the PGY-4 resident records histories and conducts physical examinations on patients who are admitted to the neurosurgical service. The senior resident will evaluate and formulate diagnoses based on neuroimaging and neurophysiological tests, and assist in and/or make surgical approaches in graded but more advanced cases under the direct supervision of the Chief Resident and attending neurosurgeons. Neurocritical care, neuroanesthesia, and more advanced neurosurgical techniques, including microsurgical skills, are emphasized. The PGY-4 resident also spends four months as the chief neurosurgical resident at the San Francisco Veterans Affairs Medical Center (SFVAMC) and four months as the chief resident at San Francisco General Hospital Medical Center (SFGH). At SFGH, under the supervision of the chief of service, the resident is exposed to a broad spectrum of neurosurgical cases with an emphasis on neurotrauma. The SFGH Chief Resident has full responsibility for the neurosurgical service under the supervision of the attending surgeons, with the assistance of three general surgery interns. The SFVAMC is home to a Parkinson's Disease Research, Education and Clinical Center (PADREC) and the SFVAMC chief resident participates in the multi-disciplinary care of patients with advanced Parkinson's Disease, including clinical assessment and surgical management. The SFVAMC chief has full responsibility for the neurosurgical service at the SFVAMC under the direct supervision of the attending staff.
 
More detail on the PGY-4 year
 
Year 5 (PGY-5):
 
The PGY-5 year is devoted to laboratory research and basic science under the supervision of a faculty member. During earlier years of the program, the resident is expected to have identified a research mentor and developed a proposal for a 12-month research project in basic or clinical neurosurgical science. 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. The resident is expected to function as an independent investigator within the limits determined by their background and aptitude. This year of laboratory research provides an opportunity for the resident to acquire facility in scientific methods of investigation and to bring a clearly defined project to completion. The resident also gains experience in medical writing and is encouraged to present data at neurosurgical meetings. In advance of the research year, the resident is encouraged to seek outside funding, such as through the National Research Service Awards (NRSA) grant process. Although successful attainment of outside funding is not required, the process of grant writing is a valuable part of the research experience and further prepares the resident for a career in academic neurosurgery. Based on federal guidelines, residents with NRSA training grants have no clinical duties and similar guidelines are applied to all residents in this year of training.
 
More detail on the PGY-5 year
 
Year 6: PGY-6
 
During the final year of the program, residents rotate through three four-month Chief Resident services: Spine, Tumor and Vascular. The Chief Residents have full responsibility for the neurosurgical service under the direct supervision of the attending staff. The division of the NS-5 year into three distinct rotations is intended to provide advanced, concentrated training in each of these areas. Skills honed include the use and integration of diagnostic techniques such as CT, MRI, EEG, EMG, angiography. The M/L Chief Residents plan and carry out all surgical procedures in cranial, spinal, and peripheral neurosurgery, including microdissection techniques and the use of surgical navigation systems, endoscopic techniques, intraoperative MRI, electrocorticography. They also further develop skills using cortical motor and speech mapping, sensory- and motor-evoked potentials, and spinal instrumentation. The Chief Residents are also responsible for teaching junior residents on the service, and assisting the Department Chair and Program Director in many administrative tasks, including scheduling of conferences and Grand Rounds.
 
More detail on the PGY-6 year
 
Evaluation
 
The Program Director meets with junior residents on clinical rotations individually every 12-14 weeks to review their progress, evaluations, and publications. Other residents meet with the Program director every 6 months for a similar review.
 
How to Apply
The Residency Training Program in Neurological Surgery uses the Electronic Residency Application System (ERAS), www.aamc.org/students/eras/start.htm, and the National Residency Matching Program (NRMP). For information about registering, please visit their Web site, www.nrmp.org, or call them at (866) 617-5834. UCSF applications or the Universal Application will not be accepted.
 
Application materials must be received in ERAS by October 20, 2008.
 
Sample Agreement/Appointment Letter(PDF)
 
Contact Information
For additional information, e-mail: mercurio@neurosurg.ucsf.edu
 
Medical Centers Affiliated with the Residency Program