Ascension Providence Neurosurgery Residency Curriculum
Hospital of Michigan*
Skull Base Surgery
*Denotes an affiliate hospital of the Detroit Medical Center.
The curriculum described below is compliant with ACGME and ABNS training requirements.
Residents' Role in Hospital and Clinical Training
First Year (PGY-1)
The neurosurgery residency program begins as a surgical focused internship with rotations in vascular surgery, trauma surgery, neurosurgery, and the neurosurgery ICU. Medical rotations include internal medicine and neurology. Time is also spent throughout the entire year with the neurosurgical service to learn how day-to-day and call operations run in preparation for PGY-2 year. The first year resident will obtain entry-level exposure to the operating room and also become proficient in many neurosurgical bedside procedures including external ventricular drain placement, intracranial pressure monitoring, cerebral blood flow devices such as Licox, and lumbar punctures.
The first year resident is expected to participate and be present at all neurosurgical conferences and academic related activities regardless of primary service.
Second Year (PGY-2)
The second year resident will be expected to complete three months of neuropathology before December 31 of the PGY-2 year. The remaining nine
months of the PGY-2 year will consist of neurological surgery, split between Ascension Providence Hospital in Southfield and Ascension Providence Hospital in Novi. Expectations include maintaining the day-to-day operations of the neurosurgical service at their institution (morning rounds (non-ICU), consultations, management of mid level providers and on-call throughout the day for the emergency department as needed). Decisions for patient management are discussed with the chief resident and monitored daily by the senior staff. The PGY-2 resident performs all bedside procedures, assists in major surgical procedures, and performs surgical procedures of intermediate complexity under direct faculty supervision. A significant amount of time is spent in the operating room in addition to maintaining floor duties.
Basic operative techniques are emphasized and the typical PGY-2 resident will participate in over 200 operative procedures and over 50 bedside procedures during their second year. Call on service includes 7-9 night shifts per month.
Third Year (PGY-3)
The third year includes three months of pediatric neurosurgery at Children's Hospital of Michigan, six months of neurological surgery split between Ascension Providence Hospitals (Novi Campus/Southfield Campus), and three months of endovascular surgery at Ascension Providence Hospital. While on the neurosurgery service at Ascension Providence, the resident will be the primary neurosurgical resident at the hospital. In addition to regular neurosurgery floor and ICU duties, an extensive amount of one-on-one time with the faculty is spent daily in the operating room performing moderate to advanced complexity procedures.
Typical case volume is over 400 cases per year. Call on service includes 6-7 shifts per month.
Fourth Year (PGY-4)
The resident will be on service for six months of neurological surgery at Ascension Providence Hospital Novi Campus and Ascension Providence Hospital. The resident will also spend six months on research based at Ascension Providence Hospital in Southfield.
Primary call on the main neurosurgery service includes 3-5 shifts per month. The fourth year resident will also splits time on back-up call with the chief resident.
Fifth Year (PGY-5)Six months of time is spent on the neurosurgery service at Ascension Providence Hospital. The remainder of the year will consist of three months of radiosurgery at Ascension Providence Hospital in conjunction with the Providence Cancer Center and three months of endovascular surgery at Ascension Providence Hospital.
Sixth Year (PGY-6)
Six months of elective are allowed during the PGY-6 year, and must be approved by the Program Director. The program offers a standing elective in neuro-oncology at Northwell Health in New York, NY. Residents are strongly encouraged to participate in an in-folded neurosurgical fellowship with this time. Residents may also choose to dedicate block time towards pursuing clinical or bench research during this period. The other six months will be pediatric neurosurgery at Children's Hospital of Michigan in Detroit.
Elective options: Endovascular Surgery, Spine Surgery, Basic Science/Clinical Research, Subspecialty electives
Chief Resident (PGY-7)
The chief resident has direct responsibility for the management of the service and supervision of the junior residents. Twelve months are spent as chief at Ascension Providence and Ascension Providence Park Hospital. The resident is in charge of making therapeutic and diagnostic decisions for inpatients and performs the majority of the surgical procedures with significant operating independence. The chief resident is responsible for the administrative management of the junior residents, coordinates the call schedule, and the vacation schedules for the residents. The chief resident attends the departmental faculty meetings, participates in the departmental decisions, and serves as a liaison for the residents and faculty.
The chief resident performs over 500 complex cases each year with a significant level of autonomy in preparation for clinical practice.
In addition to daily teaching rounds led by an individual faculty member, all residents are required to engage in a comprehensive didactic and teaching schedule. The neurosurgery training program includes the following conference schedule. Attendance at each event by all residents is mandatory. The topics of the lectures is guided by the SNS Neurosurgery Portal.
- Neurosurgery grand rounds
- Lectures/case presentations
- Neurosurgery clinic
- Tumor board
- Vascular and stroke conferenc
- Clinical pathological conference
- Spine lab
- Spine conference
- Journal Club
- Skull base conference
- Brain cutting
- Neurosurgery board review
- Cranial/skull base lab
- Neurosurgery in-service exam
- Morbidity & mortality conference
- Quality Improvement