PROGRAM OVERVIEW

The residency program is structured into six-weeks to six-months blocks. All residents proceed through the various rotations sequentially, gaining experience and responsibility as they progress. The structured nature of the program allows the trainees to plan their time, studies, and research efforts.This organization leads to a more predictable and productive training experience.

PGY Overview:

Program Descriptions:

• Neurosurgery & ICU - MGH (three months)
  
• Neurology Service - MGH (three months)
  During this rotation the resident shares clinical responsibilities with MGH Neurology residents taking part in the activities and conferences of that service. This includes familiarization with MRI, CT, EEG and other diagnostic techniques.
  
• General Surgery - MGH (six months)

• Interventional Radiology - MGH (three months)
• West Team Junior - MGH (six weeks)
• Radiosurgery - MGH (six weeks)
• North Team Junior - MGH (six months)
  This rotation is the resident’s initial exposure to clinical neurosurgery. He or she assists the recently graduated North Service Attending. Clinical responsibilities include Emergency Ward and ICU coverage and a significant operative experience under the supervision and guidance of senior residents and staff. During this period residents gain tremendous diagnostic and operative skills.

• East Team Junior - MGH (three months)
  The resident shares clinical responsibilities with the East Senior Resident to care for patients on the East Team. The East Team includes staff members with interests in vascular, functional, and pediatric neurosurgery. The East Junior has a significant operative experience and shares in the clinical management of the patients
  
• Children’s Hospital Junior - Boston Children's Hospital (three months)
  Every year, MGH residents exchange with residents at the Boston Children’s Hospital. During this period, the residents gain additional experience in the clinical and surgical management of pediatric patients.
  
• Spine Team Senior - MGH (six months)
  This rotation provides a concentrated, systematic exposure to the management of spinal disorders including spinal tumors and spinal instrumentation. The spine senior is also responsible for organizing material for the weekly resident journal club.

Research [Residents at MGH are currently doing research in.... ]

Research / Fellowship

Years four and five are dedicated to research. Residents are encouraged to immerse themselves in one of the many excellent neuroscience labs. Clinical responsibilities are proportionately decreased. Residents take the written portion of the neurosurgery boards.

Residents can work with the program director and Chief of Neurosurgery to make the program as flexible as possible. Dr. Brian Hoh said “I came to Mass General for the excellent clinical experience, wide range of neurosurgical specialization, excellent mentoring from leaders and experts in their respective fields, and excellence in laboratory and basic science research. I knew early on from my research experience and interest in the pathophysiology of cerebrovascular disease that I wanted to pursue a career in cerebrovascular. I knew that in order to pursue [this career] I would like to do a two-year fellowship in endovascular neurosurgery and interventional neuro-radiology and Dr. Martuza and Dr. Chapman allowed me the flexibility to complete that full training within my residency.”

PGY 6 - Year Six

• East Team Senior - MGH (six months)
  The East Senior assumes a large role in the operative and clinical management of complex cases under the supervision of the staff neurosurgeons on the East Team. The East Senior works closely with the East Junior and plays an important teaching role. Operative experience is extensive with a special emphasis on vascular problems including aneurysms, arteriovenous malformations, and occlusive cerebrovascular disease.
  
• West Team Chief Resident - MGH (six months)
  The West Chief Resident plays a large role in the operative and clinical management of complex tumor and spine cases under the supervision of the staff neurosurgeons on the West Team . There is a special emphasis on technically difficult tumors of the skull base. The West Chief resident is also in charge of the call schedule, the operating room assignments, and has considerable responsibility for the teaching and supervision of other residents.
  

• South Team Chief Resident - MGH (six months)
  The South Chief Resident manages the South Team and works closely with the Chief of Service, Dr. Robert Martuza. The clinical emphasis is on brain tumors and on learning the issues involved in managing a busy academic practice. In addition, there is a significant experience with the transsphenoidal approach to pituitary tumors.
  
• North Attending - MGH (six months)
  The North Attending is appointed as full member of the neurosurgery staff. The North attending has his or her own office, secretary, and clinic. In addition, the North attending has full admitting and operating privileges. The North Attending is assisted by the North Junior Resident, a physician assistant, and residents. During this period, the North attending performs a wide spectrum of cases including brain tumors, aneurysms, trauma and a variety of spinal cases. Most graduates feel that this period is the highlight of the training because they are performing a large and varied number of major cases while still having the support of the other attendings for particularly unusual or challenging cases. Formal teaching rounds are held on a weekly basis and with the Attending neurosurgeon of the week.

  In addition to formal rounds, the North Attending meets informally with other attendings for case management and teaching discussions. The North Attending does not take part in the in-hospital call rotation.

“ I think what initially drew me to Mass. General and what is still the most attractive aspect of the residency here is the North Chief-ship which gives you the opportunity to operate as an independent surgeon for an outstanding number and variety of cases, yet with the full advantage of the neurosurgery staff here for advice and guidance when necessary, ” said Joseph Neimat, who joined the clinical faculty in the North Attending position in June 2004. “I think as the Chief Resident in most programs you are afforded some responsibility; you get your choice of cases but you still are not operating independently, not making your own decisions, and that I think is the biggest leap forward that you make as a surgeon. I think everybody does this during their first year of practice, but the opportunity to do it while still with the ability to fall back on experts in every area of the field is a real advantage, and is a nice way to take that first step.”

• MGH / Harvard Neurosurgical Service
• Brain Tumor Center at MGH
• Research @ MGH Neurosurgery
• MGH Neurosurgery Alumni

• Brain Tumor Research Center
• www.Neurosurg.Info
• History of Neurosurgery at MGH
• Neurosurgery Grand Rounds