Duties by Year
UVA Neurosurgery Residency Training Program
The program includes 42 months of clinical neurosurgery at the University of Virginia (including 6 months during the R1 year, 24 months during the R2 and R3 years, and 12 months as Chief Resident). Either one or two years are devoted to Clinical or Basic Science research and one elective year is spent abroad. Residents in the joint NIH-UVA Neurosurgical Residency Program will spend 3.5 years on the clinical service at UVA, and 3.5 years at NIH Clinical Center in Bethesda, MD.
In the first post-graduate year, residents participate in clinical and didactic activities that develop fundamental skills. These skills include assessment and initiation treatment for surgical and medical problems, care of critically ill surgical and medical patients, and basic surgical technique and an understanding of surgical anesthesia. This year consists of 3 months of general surgery (including trauma, critical care, pediatric surgery and other related rotations as determined by the program director), 3 months of Neurology, and six months of neurosurgery. We have incorporated neurology into the first postgraduate year in order to prepare residents with the appropriate fundamental skills in neurological examination and diagnosis prior to beginning their clinical neurosurgery rotations.
PGY-2 & 3
After the PGY-1 year, residents spend 24 months on clinical neurosurgery, rotating on specific subspecialty areas. These first two years are designated as "junior residency". Junior residents rotate on each subspecialty at least once during each year of their two-year junior residency. There are graded responsibilities and supervision during these two year period that distinguishes the experience of the PGY-2 and PGY-3 residents. We have incorporated 5 supervised clinics that are attended during the junior residency including Complex Spine, Pediatrics, Neuroendocrine, Functional, and Vascular. These rotations provide the opportunity to direct a clinical service with a defined patient population and longitudinal follow-up of all service patients from their initial consultation to postoperative follow-up.
PGY-4 & 5
After successful completion of the two junior resident years, residents spend two years pursuing clinical or basic science research interests. Time may also be spent pursuing resident-specific clinical interests. These years are devoted to a hypothesis-driven basic science or clinical research projects in order to establish the foundation for an academic or other innovative neurosurgical career. There is limited call or other clinical duties during these years. Residents may pursue their work in an appropriately mentored environment in any UVA science laboratory and residents are encouraged to look beyond the department for projects most suited to their intellectual and career interests. Click here to see the department's current significant research initiatives. Residents continue to attend neurosurgical didactic conferences and other major Department events during their research years.
Subsequent to the two-year research period, residents spend a clinical elective year (PGY-6) in New Zealand. This is a non-accredited clinical rotation in which the residents participate in the care of adult and pediatric neurosurgical patients in a Universal Health Care system. Residents participate in the inpatient and outpatient care of patients with a wide variety of neurosurgical disorders gaining perspective from neurosurgeons not only from a different part of the world but also in a different health care system.
The final year of residency (PGY-7) is spent as Chief Resident in which there are greater administrative, clinical, teaching, and operative responsibilities and training. Chief residents have a major responsibility for patient management with faculty supervision. The Chief resident assigns duty schedules and operative cases for residents, the call and vacation schedules for all residents in the Department. The Chief resident participates in the triage of emergent add on cases and the distribution of consults to the appropriate on-call and subspecialty staff surgeons. The Chief resident supervises and serves for a resource between staff rounds for junior and senior resident evaluations of consult patients and other acute clinical problems, serving as a teacher-in-training and formulating definitive care plans for final review with the attending staff before implementation of major decisions (admission, discharge, care setting transfer, operation). Thus, the Chief resident serves as a nexus for management and communication of a complex interdisciplinary surgical department, with practical emphasis on systems based practice, communication and professionalism skills.