Rotation Descriptions
PGY 1 - Preliminary Year
The resident will learn basic surgical techniques and patient management. Critical care skills will be emphasized.
Primary Clinical Skills Performance Based Objectives:
The resident will demonstrate mastery of the following skills:
- History and Physical differential diagnosis
- Procedures
- Route: Subclavian, Jugula
- A line
- Arterial blood gas-femoral, radial
- Chest tube
- Lumbar Puncture
- Skin suture
- Open/close simple incision or biopsy (1 or 2 layers)
- ACLS/ATLS certification
- Reading EKG, chest x-ray, MRI/CT of brain and spine, laboratory data interpretation of tsets.During this year, the resident will be assigned to 3 months of neurology and 3 months of neurosurgery. Assignments in neurology consist of 6 weeks on the Consult service where the resident gains practice in the identification and emergent treatment of a number of neurological diseases and syndromes. A part of the assignment may be on a neurology inpatient service where the resident may assist in the therapy of patients assigned to the Neurology service. Disorders encountered may include seizures, movement disorders, headaches, neuromuscular disorders, and other syndromes of primary concern to the neurologist. The resident is assigned for 6 weeks on the Neurology Stroke Service, a multidisciplinary group of stroke specialists. The resident will gain familiarity and understanding in all aspects of clinical management of stroke. The Albany Medical Center has an extremely active Neurodiagnostic Unit including EMG, EEG and evoked potential. World-class faculty in epilepsy, dementia and neuromuscular disorders also enhance the residents' experience.
Neurology Goal:
Demonstrate an understanding of the neurological examination, diagnostic neurological testing, and neurological diseases and their treatment.
Neurosurgery Goal:
To gain familiarity with neurosurgical issues, including intensive care, in the daily management of neurosurgical patients.
Educational Goals and Objectives of Training Year NS-1 (PGY 2)
Residents in the Albany Medical Center Neurological Surgery Residency Program are expected to reach goals and objectives in six areas. Those areas and the expectations to be achieved in each area for NS-1 are:
Patient Care
The resident will develop the ability to:
- Take and document a comprehensive neurosurgery history and do a physical examination
- Understand when to order presurgical laboratory studies and imaging and what the results of such studies mean in the context of treatment
- Develop and implement appropriate care plans in consultation with the chief resident or attending surgeon
- Counsel patients on the risks, goals, limits and alternatives to both simple and more complex neurosurgical procedures supervised by the chief resident or attending surgeon
- Perform selected surgical procedures (e.g., ventriculostomies, VP shunt placement, simple craniotomies) under direct supervision of Chief resident or faculty
- Assist in major surgical procedures and perform, under supervision, portions of such procedures that are appropriate for his or her level of training
- Work with other health care professionals on the neurosurgery team and health care professionals from other disciplines who are involved in a patient's care
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 increasing 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
Interpersonal and Communication Skills
The resident will develop the ability to:
- Provide compassionate care as determined by patients, families, colleagues and auxiliary health professionals in wards and outpatient settings
- 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:
- Advocate for quality patient care and assist patients in dealing with system complexities
- Practice cost-effective health care and resource allocation by using evidence-based medical practice that does not compromise quality of care
Educational Goals and Objectives of Training Year NS-2 (PGY3)
Residents in the Albany Medical Center Neurological Surgery Residency Program are expected to reach goals and objectives in six areas. Those areas and the expectations to be achieved in each area for NS-2 are:
Patient Care
The resident will develop the ability to:
- Take and document a neurosurgery history and do a physical examination, with emphasis on spinal, pediatric and complex neurosurgical disorders
- Know what laboratory and imaging studies should be ordered when and be able to interpret the results as relates to neurosurgery
- Apply complex diagnostic and patient-management skills, including participation in busy outpatient neurosurgical clinics
- Establish and implement effective patient care plans
- Counsel patients on the risks, goals, limits and alternatives to neurosurgical procedures
- 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, and perform portions of the procedure that are appropriate to the resident's level of training under guidance
- Practice critical care skills as required for inpatient neurosurgery
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.
- Demonstrate an increasing familiarity with the neurosurgical literature, particularly as relates to spinal and pediatric neurosurgery and critical care issues
- Accurately do clinical evaluations, including correctly interpret ting basic and advanced laboratory and radiological studies
Practice-Based Learning and Improvement
The resident will develop the ability to:
- Demonstrate an 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 neurosurgical knowledge
Interpersonal and Communication Skills
The resident will develop the ability to:
- Provide compassionate care * Work effectively as a member of a health care team, particularly in outpatient specialty clinics
- Participate meaningfully in multidisciplinary conferences focused on specific neurosurgical fields
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:
- Advocate for quality patient care and assist patients in dealing with system complexities, especially in an outpatient setting
- Use evidence-based medical practice to provide cost-effective health care and resource allocation 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
- Demonstrate an understanding of practice types and opportunities, health care delivery systems and medical economics.
Educational Goals and Objectives of Training Year NS-3 (PGY4)
This is a dedicated research year. Residents participation in the clinical service is limited to covering call other residents during vacations or other appropriate absences. However, Albany Medical Center Neurological Surgery residents are expected to reach goals and objectives in six areas. Those areas and the expectations to be achieved in each area for NS-3 are:
Patient Care
The resident will develop the ability to:
- Understand the role of clinical trials in care of patients
- Understand inclusion and exclusion criterion for enrollment in clinical trials
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 applicable to design, implementation, analysis and reporting basic science research relevant to the clinical arena
- Establish sound research and related problem-solving habits, including a familiarity with relevant research literature
- Become an integral component of a research team
- Learn significant features of outcomes research and clinical epidemiology
Interpersonal and Communication Skills
The resident will develop the ability to:
- Communicate effectively with all members of the research team
- Use communication and interpersonal skills to effectively participate in and lead research projects
- Communicate research results effectively and persuasively in writing and speech
Professionalism
The resident will develop the ability to:
- Demonstrate a commitment to academic and scientific integrity through participation in 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-4 (PGY5)
Residents in the Albany Medical Center Neurological Surgery Residency Program are expected to reach goals and objectives in six areas. Those areas and the expectations to be achieved in each area for NS-4 are:
Patient Care
The resident will develop the ability to:
- Perform and document a senior level neurosurgery history and physical, emphasizing quick patient assessment and concise communication to patients
- Devise quickly and accurately senior level care plans for patients with immediately life-threatening neurosurgical disorders, under appropriate supervision from attending surgeons, while also managing busy outpatient clinics
- Establish and implement effective patient care plans, assuming the leadership role on a health care team, under appropriate supervision by an attending surgeon
- Counsel patients on the risks, goals, limits and alternatives to most neurosurgical procedures
- Perform complex neurosurgery (cranial and spinal) procedures 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
Medical Knowledge
The resident will develop the ability to:
- Perform above the passing level on the ABNS primary examination (for credit)
- Demonstrate 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 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
- Establish a solid evidence-based approach to patient care
- Critical appraisal of evidence from scientific studies in the neurosurgical literature
- 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 care as determined by patients, families, colleagues and auxiliary health professionals on wards and in outpatient settings at a senior level while serving as the primary provider of care at Albany Medical Center Medical Center and related clinics
- 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
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, serving as primary neurosurgeon
- 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 types and opportunities, health care delivery systems and medical economics though participation at a chief level in a variety of health care delivery settings
- Advocate for high-quality patient care and assist patients in dealing with system complexities, especially in settings providing care for the indigent or underserved
- Use evidence-based medical practices to provide cost-effective health care and resource allocation 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
Educational Goals and Objectives of Training Year NS-5 (PGY6)
During this year of training, the candidate will serve as chief resident. Chief residents in the Albany Medical Center Neurological Surgery Residency Program are expected to reach goals and objectives in six areas. Those areas and the expectations to be achieved in each area for NS-5 are:
Patient Care
The chief resident will develop the ability to:
- Gather accurately essential information about all presurgical patients, either directly or by managing more junior residents
- Understand indications for and interpret the meaning of all laboratory and imaging studies 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 evaluating and managing patients
- Establish and implement effective patient-care plans, assuming the role of primary leader on the neurosurgery service, under appropriate supervision of an attending surgeons
- 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
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
Practice-Based Learning and Improvement
The chief resident will develop the ability to:
- Develop skills as a program builder and administrator of a 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 Program Director in overseeing the, 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 efficiently and effectively with many different health care personnel 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
