Neurosurgery

Curriculum
Research Opportunities
Hospital Facilities
Application Process
Current Residents

The program at Harvard Medical School / Brigham & Women's Hospital / Children's Hospital is a fully integrated neurosurgical residency program at Children's Hospital Boston and Brigham and Women’s Hospital.  The faculty is dedicated to producing the highest quality clinical and academic neurosurgeons, with the aim of launching graduates into academic careers.  The program has a strong neurosurgical tradition:  Harvey Cushing was the first Surgeon-in-Chief at the Brigham and Women's Hospital, and Franc D. Ingraham and Donald D. Matson developed the subspecialty of pediatric neurosurgery at Children's Hospital Boston.

Curriculum

This program is six years in length following the PGY-1 / surgical internship and includes:

• 36 months of clinical neurosurgery
• 24 months of clinical or basic science research in an area of interest
• Neurology, Neuropathology and Neuroradiology rotations
• 12 months of Chief Residency

Each resident also participates in a neuroscience/neuroanatomy course at least twice during their residency.  The rotations in neurology, neuropathology, and neuroradiology are distributed throughout the training program beginning in the internship year. Each level of training combines components of the curriculum into a dynamic program that balances challenge and responsibility with time for rest and reflection.  The elements of the program are arranged into categories of gradually increasing responsibility and challenge based on the number of 3-month rotations successfully completed on the clinical service. 

A resident reaches educational milestones as he/she progresses through program based on actual experience rather than tenure.  These milestones are:

• Intern = PGY 1
• Junior Level:  1 to 4 clinical neurosurgical rotations (3 months long) generally completed during PGY 2
• Intermediate Level:  5 to 8 clinical neurosurgical rotations generally completed during PGY 3 to PGY 5
• Senior Level:  9 to 12 clinical neurosurgical rotations generally completed during PGY 6
• Chief Resident:  Has completed 12 clinical neurosurgical rotations as well as up to 24 months of clinical or basic research, at least 3 months of Neurology, 3 months of Neuropathology and Neuroradiology, and has passed the written examination towards certification by the American Board of Neurological Surgery

Each level of training has its own set of competencies that a resident is expected to master under the tutelage of the faculty.  As he/she masters these skills and at the discretion of the faculty, a resident is granted greater independence in the routine care of patients, who at all times, remain responsible for all aspects of the care of patients. The program is also designed to graduate neurosurgeons who are skilled in every area of neurosurgical clinical practice, including cranial neurosurgery, spine, and pediatrics.  There are four services on which a resident receives training during his/her clinical neurosurgical rotations prior to the Chief Residency:

• Tumor / Functional
• Spine
• Cerebrovascular / Critical Care (ICU)
• Pediatrics

The Chief Residency year consists of 6 month rotations which occur at the Children's Hospital and at the Brigham & Women's Hospital.

Research Opportunities

The research year generally occurs during the PGY 4-5 years.  Each resident is expected to plan a research project in an area of clinical or basic research that interests him/her and to apply for and hopefully will secure outside funding for the work.  The depth and breadth of resources available to residents in the laboratories within the Department and at Harvard Medical School should minimize the need to travel to other universities for robust basic science experience.  Dr. Joseph Madsen's group studies brain dynamics during cognition, seizures, and mechanical alterations such as hydrocephalus.  Dr. Larry Benowitz heads the neurosurgical laboratories at Children's Hospital, and his work focuses on spinal cord (axonal) regeneration.  The remaining laboratories are located in the Longwood Medical Research Building at Brigham & Women's Hospital.  Dr. Robert Friedlander’s lab investigates apoptosis in ischemia and neurodegenerative diseases such as Huntington’s Disease.  Dr. Lois Lampson heads up a lab that studies the immunology of brain tumors.  Dr. Craig van Horne's lab works on neural transplantation for the treatment of Parkinson’s Disease.  Finally, Dr. Peter Black’s lab investigates the biology of meningiomas and gliomas.

Hospital Facilities

The program is located at two hospitals:  Brigham & Women's Hospital and Children's Hospital Boston.  The inpatient facility at Children's Hospital is located on the 9th floor of the Main Hospital Building and is shared with the Department of Neurology.  Completed in 1990, these facilities are very comfortable for patients, their families and the doctors and staff caring for them.  The ICU is a multi-disciplinary unit staffed by anesthesiologists and intensivists.  The outpatient facility at Children's Hospital is located in the Fegan Building.  The clinic is equipped with exam rooms, a large work area, a chart room, and discussion/teaching areas.  The outpatient clinic and is staffed by clinic nurses and is run by the neurosurgical residents under the supervision of Dr. Joseph Madsen.  At Brigham & Women's Hospital, the outpatient clinic is a dedicated surgical outpatient clinic with examining rooms, conference and consultation rooms, and a film-viewing area.  The inpatient facility is shared with Neurology on the 10th floor of the inpatient tower. The Neuro ICU is an eight-bed facility in the same building and is staffed by attending staff from Neurosurgery and Neurology.

Elective surgical cases are scheduled Monday through Wednesday and Fridays.  Thursday is reserved for weekly conferences and emergency surgeries.  Children's Hospital has one or two operating rooms for Neurosurgery four days per week. The Brigham and Women’s Hospital has three or four operating rooms dedicated to neurosurgical cases for each of those four days.  The Brigham also offers the Intraoperative MRI facility, which is used by neurosurgery  a minimum of three days a week.  All operating rooms offer state of the art equipment including microscopes, lasers, frame-based and frameless image-guided surgery systems.

Application Process

The program participates in the Neurosurgical Matching Program and interested candidates should submit an application through the SF Match.  Applications are considered on a rolling basis and approximately 24 candidates are interviewed each year for two positions.  These interviews take place in October, November, and December.  Candidates are encouraged to submit their applications as early as possible because applications will no longer be considered after all interview slots are filled.  Strong candidates demonstrate a commitment to academic neurosurgery (clinical and basic science) and the ability to work on a team.

The Residency Program in Neurological Surgery at Harvard Medical School / Brigham & Women's Hospital / Children's Hospital Boston does not discrimate on the basis of age, gender, race and ethnic orientation.

For more information, contact:
Education Coordinator
Department of Neurosurgery
300 Longwood Avenue
Boston, MA  02115
Voice:  (617) 732-8719
Fax:  (617) 713-3050
Email:  ccirignano@partners.org