Neurosurgery

Curriculum

The Carilion Clinic-Virginia Tech Carilion (CC-VTC) neurosurgery residency is modeled after the Congress of Neurological Surgeons (CNS) “University of Neurosurgery Resident Curriculum Guidelines for Neurosurgery.”   It is in full compliance with the ACGME program requirements for Graduate Medical Education in Neurological Surgery.  The majority of the program’s education takes place at Carilion Roanoke Memorial Hospital (CRMH).  There, state-of-the-art facilities and an abundant patient case load are available to complete all required pre and post operative care and intra-operative care training.  Additionally, PGY1 residents will s;pend 4 months training with the exceptional neuroscience team at the University of Virginia Medical Center in Charlottesville Virginia.

Members of the CC-VTC 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 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 each 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.

Up to 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 general neurological surgery, complex spine surgery, orthopedic spine surgery, outpatient neurosurgery, neurology, orthopedic hand/peripheral nerve surgery, functional neurosurgery, neurosurgical oncology, and skull base neurosurgery, stereotactic radiosurgery, as well as open and endovascular neurosurgery.

All residents are afforded 12-18 months of dedicated time for clinical and/or bench research.  Bench research is strongly encouraged due to the readily available outstanding neuroscience resources at the Virginia Tech-Carilion Research Institute, the Virginia Tech School of Neuroscience, and Virginia Tech proper.  Residents are expected to produce at least one publishable neuroscience paper between their PGY2 and PGY6 training years.  Residents are fully supported to attend and present at national scientific meetings.  Residents are afforded additional time yearly as desired for research efforts. 

Residents develop exceptional teaching skills through active participation in the education of undergraduate students, medical students, graduate students, and other residents.  Residents participate in a truly unique teaching experience with undergraduates at the Virginia Tech School of Neuroscience.  All residents hold academic positions at the school.

For orientation to office practice and to extended patient follow-up, residents are assigned regular and intensive outpatient clinic duties.  Residents attend their own half-day outpatient clinic weekly.

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, tumor surgery, pediatric neurosurgery, vascular surgery, endovascular surgery, shull base surgery, trauma neurosurgery, stereotactic radiosurgery, carotid 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.

All residents learn extensive endovascular procedural skills through multiple rotations on our combined neurosurgery interventional neuro-radiology endovascular team.

All residents participate in a unique burnout prevention and wellness building program.  The CC-VTC neurosurgery team is a national leader in research and writing in this field.

OPERATING ROOM

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.