The Carilion Clinic curriculum for a residency in neurosurgery is modeled upon the American College of Surgeons (ACOS), “Osteopathic Neurological Surgery Model Curriculum for Residency Training” as well as the Congress of Neurological Surgeons (CNS) “University of Neurosurgery Resident Curriculum Guidelines for Neurosurgery.”
The majority of the program’s education takes place at Carilion Roanoke Memorial Hospital (CRMH) where state-of-the-art facilities and an ample case load are available to complete the majority of necessary pre and post operative care and intra-operative care training.
Members of the Carilion Clinic Neurosurgery faculty and staff provide the bulk of educational and case materials for the training of residents. Adjunct faculty resources will also be utilized at the same institution, on various out rotations, and through elective and selective non-neurosurgical and neurosurgical sub specialty rotations. Built into the curriculum is significant flexibility and fluidity to adjust to the needs and capabilities of the trainee.
A minimum of 36 months will be spent in clinical neurological surgery. Twelve months will be spent as a chief resident at the primary training institution, Carilion Clinic, under appropriate supervision and increasing levels of responsibility.
Twelve months of electives may be spent in subspecialty areas at the parent institution or at other sites with departmental approval. Regional options currently include neurological surgery, spine surgery, orthopedic spine surgery, outpatient neurosurgery, neurology, research, and orthopedic hand/peripheral nerve surgery.
Non-regional rotations at affiliated training sites are not permitted during the Osteopathic Graduate Medical Education (OGME) training years one and two (OGME – 1 and 2), and may not exceed a total of 15 months during the residency.
Residents are expected to present papers at national neurosurgical meetings and regularly host world renowned visiting professors.
For orientation to office practice and to extended patient follow-up, residents will be assigned regular and intensive outpatient clinic duties.
Resident trainees at Carilion experience extensive training in core neurosurgical skills as well as subspecialty areas such as epilepsy surgery, complex spine surgery, minimally invasive surgery, pituitary surgery, functional surgery, peripheral nerve surgery and more. They participate in various learning experiences with multiple supporting specialties such as Neurology, Orthopedics, Physical Medicine and Rehab, Medical Oncology, Pediatric Oncology, Neuroradiology, Interventional Neuroradiology, Otolaryngology, Internal Medicine, Trauma Surgery, Intensive Care, Pediatrics, and others.
Critical to resident education is experience in the operating rooms. Residents spend a vast amount of time developing skills in the surgical manipulation and repair of nervous system and spinal structures. As a resident’s skills progress (aided by virtual surgery simulations labs and cadaver dissections), his or her involvement in various operations expand. Residents always learn at the side of a highly experienced attending neurosurgeon. At no time do trainees proceed without direct supervision. At all times staff neurosurgeons assure the safe and proper progression of a patient’s treatment.
Pre and post-operative care
Pre and post-operative care is also be heavily emphasized. Pre-operatively residents evaluate patients in the clinic setting as well as in hospital rooms and the emergency room. Non-operative alternatives (conservative management) of neurologic and spinal disease are aggressively pursued with surgery resorted to only as a last resort or when absolutely necessary. Post-operatively, residents participate in the care of patients in the ICUs and on the hospital floors. Furthermore they follow their patients throughout the courses of their disorders to appreciate the long term ramifications of the patients’ diseases and their neurosurgical management.