Program Structure
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PGY-1
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PGY-2
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PGY-3
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PGY-4
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PGY-5
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PGY-6
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PGY-7
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Neurosurgical ICU and floor (4 months)
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Cushing Junior (4 months)
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Cushing Junior (3 months)
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Research
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Research/Fellowship
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Cushing Senior (4 months)
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Cushing Chief (4 months)
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IR/OR (2 months)
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Dandy Junior (4 months)
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Dandy Junior (4 months)
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Penfield Senior (4 months)
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Dandy Chief (4 months)
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Ingraham Intern (Pediatrics at BCH, 2 months)
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Penfield Junior (2 months)
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Penfield Junior (2 months)
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Ingraham Chief (4 months)
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Penfield Chief (4 months)
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Nights & Neurosciences (4 months)
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Ingraham Junior (2 months, BCH)
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VA (3 months)
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Neurosciences: Neuroradiology, NeuroIR, Neuropathology, Radiosurgery (2 months)
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Cushing Service: Tumor, Skull base
Dandy Service: Spine, Peripheral nerve
Penfield: Open/Endovascular, Functional/Epilepsy
Ingraham: Pediatrics
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PGY-1 (Intern)
Residents spend six months rotating on the neurosurgical intensive care unit and the floor, developing their basic skills on the management of neurosurgical patients and frequently encountered medical and neurologic diseases. Residents are trained to be independent and competent in performing basic neurosurgical procedures (e.g. external ventricular drains, lumbar drains, central lines, arterial lines) and management of acute neurological and medical issues by the end of rotation.
Interns also spend 1-2 months rotating in non-neurosurgical services, including general surgery, plastic surgery, neuroradiology, neurointerventional radiology, neuropathology and radiosurgery to develop introductory skills in these areas.
PGY-2 - PGY-3 (Junior Resident)
Residents are part of the team of a respective service (Cushing, Dandy, Penfield, Ingraham) under the direct supervision of senior and chief residents. Junior residents learn the non-surgical and surgical management of neurosurgical patients. PGY2 junior resident spend 4 months taking day call and 8 months dedicated to the operating room developing surgical skills. PGY3 junior residents are in the operating room during the day and share overnight calls with the PGY2-4. PGY3 junior residents also rotate at the Massachusetts General Hospital.
PGY-4 - PGY-5 (Research Resident)
Residents are encouraged to pursue research or a clinical fellowship during their PGY4-5 years. PGY4 responsibility include overnight call one weekend per month and PGY5 is protected time used to focus on research, training and career development.
Residents sit for the written neurosurgery board examination during this time and are encouraged to participate in neurosurgical courses, national meetings, and educational events. Research residents can teach as neuroanatomy lab as an instructor at Harvard Medical School, the BWH Skull Base Dissection Lab, and may host monthly Harvard Medical Student neurosurgical teaching sessions and resident journal club.
PGY-6 (Senior Resident)
Senior residents play an even greater role in the operating room, and as a leader on the clinical team in the clinical management of patients. Senior residents are responsible for organizing the resident curriculum conference for weekly teaching sessions, and inviting Grand Rounds speakers and visiting professors.
PGY-7 (Chief Resident)
Chief Residents oversee the entire neurosurgical program with administrative and educational responsibilities. Chief residents are expected to demonstrate knowledge, skills, behaviors, and attitudes that are exemplary in each area of the ACGME’s core competencies.