The seven-year neurosurgical residency program at the University of Iowa is designed specifically to prepare residents for a career as senior surgeon-scientists, and future leaders in the field of Academic Neurosurgery. It is the intent of this seven-year training program to develop world class neurosurgeons. Residents completing the program will be eligible for certification by the American Board of Neurological Surgery (ABNS) with an ultimate goal of a 100 % pass rate on both the qualifying and the certifying examinations. Categorical residents are required to pass the written examination for primary certification, prior to becoming Chief Resident.
In order to attain these goals, the program requires residents to develop the following competencies:
- A solid foundation of basic and clinical knowledge of neurosurgery.
- The ability to provide compassionate and effective care to all patients.
- The ability to perform general neurosurgical procedures safely and effectively.
- The exercise of clinical judgment to critically select the appropriate course of action in the management of patients.
- The capacity to communicate effectively with all healthcare personnel and with patients.
- Knowledge about established and emerging biomedical, clinical and cognitive sciences, and the application of this knowledge to neurosurgical patient care.
- Ability to analyze practice experience and perform practice-based improvement activities using a systematic methodology
- Apply knowledge of study designs and statistical methodology to the appraisal of clinical studies and information regarding diagnostic and therapeutic effectiveness
- A demonstrated commitment to carrying out professional and administrative duties, adherence to ethical principles and sensitivity of diverse patient populations, required in the surgical profession.
- The constant pursuit of improvement in patient care practices by systematic evaluation of current practices in relation to outcomes and to new scientific knowledge.
- An awareness of and responsiveness to the underpinnings of the health care system, and the dilemmas of practicing healthcare that is of optimal value, and cost effective.
Residents are expected to develop these elements of clinical competence by assimilating the teaching provided by the faculty, by maintaining an active reading plan for neurosurgical sciences, by practicing their clinical/surgical skills, and by attending the educational activities offered by the residency program. During the seven years of intensive training, each of the above elements of clinical competence is periodically assessed by direct faculty supervision and by senior resident colleagues with subsequent review by the program director. Re-appointment and promotion to the subsequent PGY year requires a satisfactory progression in the development of these elements of clinical competence.
The educational program of the residency is designed to meet specific goals and objectives at each level of training as outlined in the following table. The program is designed in accordance with the ACGME core competencies.
PGY 1
Patient care:
1. Perform thorough history, physical, and neurological examinations with complete, accurate and timely documentation.
2. Understand indications for and interpret lab and imaging studies
3. Learn to counsel patients appropriately for obtaining informed consent
4. Learn basic operative skills such as tying, suturing, instrument and tissue handling.
5. Manage common post-operative complications
6. Learn to provide exemplary patient care using a team approach
Medical Knowledge:
1. Complete ABNS basic clinical skills requirements via rotations in neurosurgery, general surgery, neurology, neuro-ophthalmology, critical care and orthopedics.
2. Pass USMLE step 3 examination.
3. Establish an effective self-study reading program including textbooks and literature.
4. Demonstrate a solid foundation of knowledge of anatomy, physiology, and pharmacology related to peri-operative surgical patients
5. Develop a foundation for clinical problem solving and decision making
Professionalism:
1. Demonstrate professional behavior at all times including appearance, promptness, and interactions with patients, family, staff, and healthcare providers.
2. Demonstrate sensitivity and responsiveness to patients' culture, age, gender, and disabilities
3. Demonstrate integrity and a commitment to patients that supercedes self interest
Communication & Interpersonal skills:
1. Provide compassionate patient care as determined by patients, families, colleagues, and ancillary members of the health care team
2. Work effectively as a member of a health care team
3. Meet expectations on all 360 evaluations.
Systems-based practice:
1. Understand the practice of neurosurgery in a quaternary care hospital, including interactions with other health care organizations and how these elements of health care affect the university practice
2. Advocate for quality patient care and assist patients in dealing with healthcare system complexities
3. Practice cost-effective health care and resource allocation through evidence-based medical practice that does not compromise quality of care
4. Maintain a learning portfolio.
Practice-based learning:
1. Learn information technology skills to access available patient-care and educational resources.
2. Demonstrate an ongoing ability to learn from errors
3. Begin to locate, appraise, and assimilate evidence from scientific studies related to clinical neurosurgical practice and neuroscience research
PGY 2
Patient care:
1. Perform thorough history, physical, and neurological examinations with complete, accurate and timely documentation.
2. Understand indications for and interpret lab and imaging studies.
3. Learn to counsel patients appropriately for obtaining informed consent for all neurosurgical procedures
4. Learn operative skills needed to perform basic neurosurgical procedures (e.g. ventriculostomy, shunt, trauma craniotomy, lumbar discectomy, laminectomy).
5. Manage neurosurgical peri-operative complications.
6. Generate patient care plans under direction of chief residents and faculty.
7. Provide exemplary patient care as part of a neurosurgery team.
Medical Knowledge:
1. Pass ABNS written examination.
2. Establish an effective self-study reading program including textbooks and literature.
3. Demonstrate a solid foundation of knowledge of anatomy, physiology, and pharmacology related to peri-operative neurosurgical patients
4. Develop a foundation for neurosurgical problem solving and decision making
Professionalism:
1. Demonstrate professional behavior at all times including appearance, promptness, and interactions with patients, family, staff, and healthcare providers.
2. Demonstrate sensitivity and responsiveness to patients' culture, age, gender, and disabilities
3. Demonstrate integrity and a commitment to patients that supercedes self interest
Communication & Interpersonal skills:
1. Provide compassionate patient care as determined by patients, families, colleagues, and ancillary members of the health care team
2. Work effectively as a member of a health care team
3. Meet expectations on all 360 evaluations.
Systems-based practice:
1. Understand the practice of neurosurgery in a quaternary care hospital, including interactions with other health care organizations and how these elements of health care affect the university practice
2. Advocate for quality patient care and assist patients in dealing with healthcare system complexities
3. Practice cost-effective health care and resource allocation through evidence-based medical practice that does not compromise quality of care
4. Maintain a learning portfolio.
Practice-based learning:
1. Learn information technology skills to access available patient-care and educational resources.
2. Demonstrate an ongoing ability to learn from errors
3. Begin to locate, appraise, and assimilate evidence from scientific studies related to clinical neurosurgical practice and neuroscience research
PGY 3
Patient care:
1. Perform thorough history, physical, and neurological examinations with complete, accurate and timely documentation.
2. Understand indications for and interpret lab and imaging studies.
3. Counsel patients appropriately for obtaining informed consent for all neurosurgical procedures
4. Learn operative skills needed to perform more advanced neurosurgical procedures (e.g. ACDF, tumor craniotomy, lumbar instrumentation).
5. Generate and implement patient care plans under chief resident and/or faculty supervision.
6. Provide exemplary patient care as part of a neurosurgery team.
Medical Knowledge:
1. Pass ABNS written examination at above the 10th percentile.
2. Continue an effective self-study reading program including textbooks and literature.
3. Demonstrate advanced knowledge of anatomy, physiology, and pharmacology related to peri-operative neurosurgical patients
4. Demonstrate complex and appropriate neurosurgical problem solving and decision making
Professionalism:
1. Demonstrate professional behavior at all times including appearance, promptness, and interactions with patients, family, staff, and healthcare providers.
2. Demonstrate sensitivity and responsiveness to patients' culture, age, gender, and disabilities
3. Demonstrate integrity and a commitment to patients that supercedes self interest
Communication & Interpersonal skills:
1. Provide compassionate patient care as determined by patients, families, colleagues, and ancillary members of the health care team
2. Work effectively as a member of a health care team, including teaching of medical students, residents, and ancillary healthcare providers.
3. Meet expectations on all 360 evaluations.
Systems-based practice:
1. Understand the practice of neurosurgery in a quaternary care hospital, including interactions with other health care organizations and how these elements of health care affect the university practice
2. Advocate for quality patient care and assist patients in dealing with healthcare system complexities
3. Practice cost-effective health care and resource allocation through evidence-based medical practice that does not compromise quality of care
4. Maintain a learning portfolio.
Practice-based learning:
1. Demonstrate advanced information technology skills to access available patient-care and educational resources.
2. Demonstrate an ongoing ability to learn from errors
3. Locate, appraise, and assimilate evidence from scientific studies related to clinical neurosurgical practice and neuroscience research
PGY 4,5
Patient care:
1. Properly interpret all lab and neuroimaging studies.
2. Counsel patients appropriately for obtaining informed consent for complex neurosurgical procedures.
3. Learn operative skills needed to perform advanced neurosurgical procedures.
4. Begin to guide all aspects of patient management with faculty supervision.
6. Provide exemplary patient care as a leader of a neurosurgery team, with delegation of appropriate tasks to more junior residents.
Medical Knowledge:
1. Pass ABNS written examination for credit at above the 70th percentile by the PGY 5 year.
2. Demonstrate advanced knowledge of anatomy, physiology, and pharmacology related to peri-operative neurosurgical patients
3. Demonstrate complex, efficient and appropriate neurosurgical problem solving and decision making
Professionalism:
1. Demonstrate professional behavior at all times including appearance, promptness, and interactions with patients, family, staff, and healthcare providers.
2. Demonstrate sensitivity and responsiveness to patients' culture, age, gender, and disabilities
3. Demonstrate integrity and a commitment to patients that supercedes self interest
Communication & Interpersonal skills:
1. Provide compassionate patient care as determined by patients, families, colleagues, and ancillary members of the health care team
2. Work effectively as a leader of a health care team
3. Meet expectations on all 360 evaluations.
Systems-based practice:
1. Understand the practice of neurosurgery in a quaternary care hospital, including interactions with other health care organizations and how these elements of health care affect the university practice
2. Advocate for quality patient care and assist patients in dealing with healthcare system complexities
3. Practice cost-effective health care and resource allocation through evidence-based medical practice that does not compromise quality of care
4. Maintain a learning portfolio.
Practice-based learning:
1. Demonstrate advanced information technology skills to access available patient-care and educational resources.
2. Demonstrate an ongoing ability to learn from errors
3. Demonstrate advanced knowledge of neurosurgical literature and apply this to clinical decision-making and patient management
4. Fully integrate into a basic research laboratory and publish these results
PGY 6
Patient care:
1. Properly interpret all lab and neuroimaging studies.
2. Counsel patients appropriately for obtaining informed consent for complex neurosurgical procedures.
3. Refine operative skills needed to perform advanced neurosurgical procedures.
4. Guide all aspects of patient management with faculty supervision.
6. Provide exemplary patient care as a leader of a neurosurgery team, with delegation of appropriate tasks.
7. Effectively teach students, nurses, and colleagues basics of neurosurgical patient care.
Medical Knowledge:
1. Demonstrate advanced knowledge of all aspects of inpatient and outpatient neurosurgical practice.
2. Demonstrate complex, efficient and appropriate neurosurgical problem solving and decision making
Professionalism:
1. Demonstrate professional behavior at all times including appearance, promptness, and interactions with patients, family, staff, and healthcare providers.
2. Demonstrate sensitivity and responsiveness to patients' culture, age, gender, and disabilities
3. Demonstrate integrity and a commitment to patients that supercedes self interest
Communication & Interpersonal skills:
1. Provide compassionate patient care as determined by patients, families, colleagues, and ancillary members of the health care team
2. Work effectively as a leader of a health care team
3. Meet expectations on all 360 evaluations.
Systems-based practice:
1. Lead the practice of neurosurgery in a quaternary care hospital
2. Advocate for quality patient care and assist patients in dealing with healthcare system complexities
3. Practice cost-effective health care and resource allocation through evidence-based medical practice that does not compromise quality of care
4. Maintain a learning portfolio.
Practice-based learning:
1. Demonstrate advanced information technology skills to access available patient-care and educational resources.
2. Demonstrate an ongoing ability to learn from errors
3. Demonstrate advanced knowledge of neurosurgical literature and apply this to clinical decision-making and patient management
4. Effectively organize and conduct neurosurgical departmental and interdisciplinary conferences |
