Neurological Surgery Residency Program

"The neurosurgical residency program at USC provides a strong combination of clinical and academic training. The experience of training at LA County Hospital provides a unique opportunity to diagnose and treat a wide spectrum of advanced neurosurgical disorders in an indigent population. From the first week of junior year at LA County Hospital, residents are immersed in performing neurosurgical procedures, clinical decision-making, and patient care. This learning environment fosters surgical and clinical autonomy like few other programs can. Learning from world-renowned faculty that serve as leading academicians and editors of prominent neurosurgical journals is a privilege. A flexible sixth year, dedicated to research or an infolded fellowship, is a great benefit to our academic development. The opportunity to apply this cumulative knowledge as a junior staff member and resident educator at the County Hospital during the chief year is an optimal transition into academic neurosurgery. The next few years at USC will be exciting, with new medical facilities opening at all four sites, including a much-anticipated new LA County Hospital."
Gabriel Zada, MD
July 2007, PGY-4

Many of the alumni from the training program now hold academic appointments in some of the most prestigious Neurosurgical Departments in the Country.

Information about the Program requirements, rotations, educational goals and objectives, interview dates and contact information can all be found below. Please use the links on the left to find out more information about our faculty, clinical actvities and research.

Requirements and Rotations

The Neurosurgery Residency Program at the University of Southern California affiliated hospitals is a six year program. In order to be eligible for the Neurosurgery Program, the candidate must have had one year of post graduate training as a straight surgical intern, straight medical intern, or a rotating internship. If the candidate has a straight surgical internship in a hospital in the United States or Canada accredited by the Accreditation Council for Graduate Medical Education (ACGME) through the RRC for Surgery, this will be considered as satisfying the PGY I requirements of the American Board of Neurosurgery and the Program. It would then not be necessary for the candidate to take additional training in general surgery prior to entering into the program unless he/she wishes to do so. If the candidate enters the Program from a straight medical, rotating, or mixed internship, he/she will be required to spend at least one year in our basic surgical program which consists of six months of General Surgery, two months of Orthopedics, two months Anesthesiology and two months elective. Individuals selected through the neurosurgical match during their fourth year of medical school are automatically accepted into the GY-1 categorical neurosurgical year at the USC Medical Center.

The Neurosurgical Residency Program is comprised of 48 months of clinical neurosurgery in addition to 12 months of electives including those sciences considered basic to neurosurgery followed by a final year as Supervisor of Residents at the Medical Center. During the first year, the resident spends 12 months in clinical neurosurgery at the LAC/USC Medical Center. The second year of the residency program is comprised of 6 months of Pediatric Neurosurgery at the Childrens Hospital of Los Angeles in addition to 6 months in Neurology. The resident returns to the clinical service for 12 months of clinical neurosurgery during the third year of the residency, 6 months at the LAC/USC Medical Center as the Chief Resident on the Pediatric and Spine Neurosurgical Services and 6 months at the USC University Hospital. The fourth year of the training program (GY-5) embraces 12 months at the University Hospital. Six months of responsibility as Chief Resident as well as 6 months with a radiosurgery emphasis. The fifth year (GY-6) provides an opportunity for uninterrupted participation in the in-depth acquisition of technical expertise within a given neurobiological discipline. This year, devoted exclusively to research endeavors, provides the individual with an opportunity to avail themselves of the facilities of the entire University community providing the resources of a major research University that ranks amongst the ten leading research funded universities in the United States. In place of research endeavors this year can also be used to pursue an infolded fellowship in a particular area of clinical interest. The final year in the Program is spent as Supervisor of Residents at the USC Medical Center. During this year the individual has an appointment as Clinical Instructor at the School of Medicine and has administrative and clinical supervisory responsibilities as well as broad operative experience on the neurosurgical services at the USC Medical Center. The goals and objectives for each year can be found below.

This program provides opportunity for graduated responsibility for the resident throughout the years of training. The large patient population provides an excellent opportunity for exposure to the full spectrum of neurosurgical problems with dedicated full time attending staff at each of the affiliated hospitals. The clinical years provide intensive and extensive experience complemented by ample basic science opportunity in preparation for certification by the American Board of Neurological Surgery.

Educational Goals and Objectives

PGY-2
The PGY-2 year is spent on the clinical service at the LAC+USC Medical Center. During this year, the resident should:
· Become expert in the performance of the neurological examination in both elective and emergency situations.
· Become fully cognizant of the measures necessary to stabilize the acutely ill neurosurgical patient and the need to render emergent neurosurgical treatment when necessary.
· Master the full pre and postoperative evaluation and treatment of neurosurgical patients.
· Acquire the technical skills that will allow him/her to open and close the scalp and skull as well as the spinal column including the skills for meticulous hemostasis requisite for operative neurosurgery.
· Be able to counsel and educate patients and their families.
· Be able to use technology to support their own education.
· Be able to facilitate the learning of students and other health care professionals.
· Be able to work effectively with others as a member of a health care team.
· Be able to demonstrate sensitivity and responsiveness to patients’ culture, age, gender and disabilities.
· Be able to assist patients in dealing with health care system complexities.

PGY-3
During the PGY-3 year, the resident spends six (6) months at the Children’s Hospital of Los Angeles, six (6) months on the Neurology Service. It is expected that the resident will:
· refine his/her capabilities with the neurological examination and gain broad understanding of the differential between those diseases of medical rather than surgical significance.
· Be capable of performing a consultation on a patient harboring any disorder of the nervous system in addition to initiating a treatment protocol for that patient
· Become familiar with the gross and microscopic appearance of most structural lesions of the central and peripheral nervous system
· Understand the special staining techniques necessary to establish specific diagnoses.
· Become familiar with those disorders that occur with greatest frequency in the pediatric population and the surgical techniques applied to their correction.
· Master the specific variables about the examination of the neonatal populations
· Develop expertise in the performance of select pediatric neurosurgical procedures commensurate with their technical skills.
· Master performance of shunting procedures for hydrocephalus.
· Be able to counsel and educate patients and their families.
· Be able to use technology to support their own education.
· Be able to facilitate the learning of students and other health care professionals.
· Be able to work effectively with others as a member of a health care team.
· Be able to demonstrate sensitivity and responsiveness to patients’ culture, age, gender and disabilities.
· Be able to assist patients in dealing with health care system complexities.

PGY-4
During the PGY-4 year, the resident spends six (6) months as the “spine resident” at the LAC+USC Medical Center in addition to being the resident in charge of the pediatric neurosurgery service at the Medical Center; the remaining (6) months are spent as senior resident at the University Hospital. During this time, it is expected that:
· The resident will acquire in depth understanding of structural problems of the spinal column, spinal cord and peripheral nerves.
· The resident should develop facility in the surgical management of these disorders including the utilization of metallic fixation devices necessary to assure stability of the spine.
· The resident will be responsible for the management (both operative and non-operative) of pediatric neurosurgical cases so that he/she will enhance their experience in this arena under supervision of a resident supervisor/attending neurosurgeon.

At the University Hospital, the resident will gain exposure to the tertiary care problems that are referred to that facility. It is expected that:
· the resident will have opportunity to apply his/her diagnostic/therapeutic skills to the evaluation of these patients and their postoperative management.
· The resident will be an active operative participant in those cases on the service with the expectation that the resident will acquire a broad exposure to microsurgical techniques in the adult patient.
· He/she should subsequently understand the basic principles of microsurgery along with the technical aspects of utilization of the operative microscope.

On both rotations the resident will:
· Be able to counsel and educate patients and their families.
· Be able to use technology to support their own education.
· Be able to facilitate the learning of students and other health care professionals.
· Be able to work effectively with others as a member of a health care team.
· Be able to demonstrate sensitivity and responsiveness to patients’ culture, age, gender and disabilities.
· Be able to assist patients in dealing with health care system complexities.

PGY-5
In the fourth year of residency, the individual will spend six (6) months as a senior resident at the University Hospital with a Radiosurgery emphasis and six (6) months as the Chief Resident at the University Hospital. It is expected that:
· The resident will be an active operative participant in the full spectrum of cases on the service with the expectation that the resident will acquire a broad exposure to microsurgical techniques in the adult patient.
· He/she should subsequently understand the principles of microsurgery along with the technical aspects of utilization of the operative microscope.
· It is assumed that this will allow the resident, under supervision of the attending staff, to acquire an understanding of the administrative operation of a neurosurgical service.
· Learn not only the mechanical component of stereotaxic radiosurgery, but also learn the cognitive elements of planning and administering the radiosurgery.
· The resident will also have the opportunity to solidify his/her microsurgical skills in anticipation of assumption of chief residency at the LAC+USC Medical Center.
· The chief resident is responsible for the assignment of residents to specific surgical cases in addition to providing general administrative assignments for the day to day operation of the service.
· At the conclusion of this experience, it is expected that the resident will be able to provide full supervision of a dedicated neurosurgical service utilizing only the consultative strength of the attending staff.
· Be able to counsel and educate patients and their families.
· Be able to use technology to support their own education.
· Be able to facilitate the learning of students and other health care professionals.
· Be able to work effectively with others as a member of a health care team.
· Be able to demonstrate sensitivity and responsiveness to patients’ culture, age, gender and disabilities.
· Be able to assist patients in dealing with health care system complexities.

PGY-6
The fifth year of residency is spent exclusively pursuing a focused area of interest to the resident. This year provides the individual with an opportunity to avail themselves of the facilities of the entire University community providing the resources of a major research University that ranks amongst the ten leading research funded universities in the United States. In place of research endeavors this year can also be used to pursue an infolded fellowship in a particular area of clinical interest. There is no clinical call during this year.

PGY-7
As a PGY-7, the individual is promoted to a position of Clinical Instructor.
· Assumes primary responsibility of the day to day operation of one of the two services at the LAC+USC Medical Center.
· All of the administrative needs of these services are provided by the resident supervisor, who has the authority to assign operative cases at all levels.
· This year provides a broad opportunity to finely tune one’s operative skills and provide oversight for the entire management of the patient population on the service utilizing the consultative opportunities provided by the attending staff.
· Upon completion on this experience, it is anticipated that the individual will be able to manage the full spectrum of neurosurgical disease and to understand the mechanisms of and needs for supervision at every level of resident education.
· The individual will be fully prepared to assume total care of any patient with any neurosurgical problem and to establish the foundation of a career in either academic or community based practice.
· Able to counsel and educate patients and their families.
· Able to use technology to support their own education.
· Able to facilitate the learning of students and other health care professionals.
· Able to work effectively with others as a leader of a health care team.
· Able to demonstrate sensitivity and responsiveness to patients’ culture, age, gender and disabilities.
· Able to assist patients in dealing with health care system complexities

Applications are accepted through the Central Application Service. We also request that you send us a recent CV. Interviews are held on Saturdays. The interview dates for 2007-2008 are October 20, 2007, December 8, 2007 and January 5, 2008.

Contact information if you have any further questions:

Kathy Guzman
Residency Coordinator
Phone (323) 226-7421
E mail kguzman@usc.edu