Residency Program Curriculum

Neurological surgery is a discipline of medicine and the specialty of surgery that provides the operative and non-operative management (i.e. prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes that modify the function or activity of the nervous system, including the hypophysis; and the operative and non-operative management of pain.  As such, neurological surgery encompasses the treatment of adult and pediatric patients with disorders of the brain, meninges, skull and skull base, and their blood supply, including the surgical, endovascular, or radiosurgical treatment of disorders of the intracranial and extracranial vasculature supplying the brain and spinal cord; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including these that may require treatment by fusion, instrumentation, or endovascular techniques; and disorders of the cranial and spinal nerves throughout their distribution.

This curriculum is designed to assist residents in understanding the breadth and depth of clinical neuroscience and to allow residents to interact with faculty in a more objective and less subjective way as they progress through their training.  Residents will have a readily available resource to guide their studies and acquisition of surgical skills so that milestones can be reached at each level of training.  The curriculum will provide faculty mentors and the Program Director a highly structured and objective means of assessing the resident’s progress and identifying  gaps in knowledge or experience at the earliest possible time so that remedies can be put in place.  The curriculum will involve clinical rotations at Northwestern Memorial Hospital, Evanston Northwestern Healthcare-affiliated hospitals, and Children’s Memorial Hospital.

Guiding Principles of the Curriculum

I.        Core Training

The residency will be divided into three distinct levels of training: Junior Resident Level (PGY2-3), Mid-Resident Level (PGY 4-5), and Senior Resident Level (PGY 6-7).  Goals and objectives as well as specific cognitive, medical, and surgical milestones must be reached during each interval, or the resident will not be allowed to progress to the next tier of training.

II.       Faculty Advisors

Upon entering the training program (PGY2), each resident will be assigned a single faculty advisor.  In addition to standard mentoring, the faculty advisor will meet with the resident semi-annually to evaluate his/her progress through the core curriculum.  At the end of each two-year interval, if the resident has not satisfactorily completed each requirement, remedial training will be mandated.

III.      Core Competencies

This curriculum will be driven by the six core competencies embraced by the ACGME, RRC (Neurosurgery), ABMS, and the ABNS:

A.          Medical Knowledge

1. Acquire general medical knowledge and practice-specific knowledge
2. Know and critically evaluate current medical information
3. Understand and incorporate evidence-based decision-making

B.          Patient Care

1. Medical interview and physical exam
2. Synthesis of clinical data, performance skills

C.          Interpersonal and Communication Skills

1. Communicate effectively with other professionals and team members
2. Maintain comprehensive, legible medical records

D.          Professionalism

1. Demonstrate self-awareness and knowledge of limits
2. Demonstrate high standards of ethical and moral behavior
3. Demonstrate reliability and responsibility
4. Demonstrate respect for patient’s dignity and autonomy

E.          Practice-Based Learning and Improvement

1. Engage in ongoing learning to improve knowledge and skills
2. Analyze one’s practice to recognize strengths and deficiencies
3. Seek input to improve practice and quality care

F.          Systems-Based Practice

1. Promote patient safety within the system
2. Provide value for patients through cost-effective care
3. Promote health and prevention of disease and injury
4. Demonstrate effective practice management

IV.     Broad Curriculum

While organized neurosurgery continues to monitor the impact of new technology, subspecialization, and evolving practice patterns, the definition of “What is a Neurosurgeon?” continues to change.  The Department is committed to ensuring that the educational content of the training program will prepare each resident for successful examination and certification by the ABNS and the safe practice of general neurosurgery.

Curriculum Structure

I.       Junior Resident Level (PGY 2-3)

A.          Core Competencies

1. Medical Knowledge
2. Patient Care
3. Interpersonal and Communication Skills
4. Professionalism
5. Practice-Based Learning and Improvement
6. Systems-Based Practice

B.          Subspecialty Content

1. Spine
2. Cerebrovascular Disease
3. Neuro-Oncology
4. Pediatric Neurosurgery
5. Functional/Restorative Neurosurgery
6. Trauma/Critical Care
7. Neurology

II.       Mid-Resident Level (PGY 4-5)

A.          Core Competencies

1. Medical Knowledge
2. Patient Care
3. Interpersonal and Communication Skills
4. Professionalism
5. Practice-Based Learning and Improvement
6. Systems-Based Practice

B.          Subspecialty Content

1. Spine
2. Cerebrovascular Disease
3. Neuro-Oncology
4. Pediatric Neurosurgery
5. Functional/Restorative Neurosurgery
6. Trauma/Critical Care

III.      Senior Resident Level (PGY 6-7)

A.          Core Competencies

1. Medical Knowledge
2. Patient Care
3. Interpersonal and Communication Skills
4. Professionalism
5. Practice-Based Learning and Improvement
6. Systems-Based Practice

B.          Subspecialty Content

1. Spine
2. Cerebrovascular Disease
3. Neuro-Oncology
4. Functional/Restorative Neurosurgery
5. Trauma/Critical Care