Progressive Resident Responsibility by Year
PGY-1/NS1: Multiple Services
The first-year residents will gain familiarity with the hospital systems and personnel of the North Shore LIJ Health System, and in particular the working of the Neurosurgical service. Responsibilities will include:
- Patient admissions
- Daily rounds with the neurosurgical team
- Night call - will contact senior residents and/or faculty for most questions/ problems
- Routine management of floor patients, including awareness of laboratory data, radiologic data, and clinical information (vital sign changes, neurological examination, opinions of consultants, postoperative checks, etc.)
- Consult on patients in the hospital and the ER patients, as well as assist in the management of ICU patients, as directed by the Chief Resident and faculty.
- Attendance at hospital clinics and involvement in outpatient workups
- Assisting in the OR as assigned by the Chief Resident
- Patient discharges, including medications and followup as appropriate
- Dictating discharge summaries
In the 2nd year the residents will be considered junior but will have increased responsibilities compared to the first year. They will still be under close supervision for clinical duties but will be expected to show some increased independence. Their specific responsibilities will be the same as in the PGY-1 year, and in addition they will be responsible for:
- Writing daily progress notes/orders on patients in the ICU
- Evaluating ER and inpatients before discussing with the responsible faculty member
- Writing admission H&Ps/orders
- Assisting in the OR on cases assigned by the Chief Resident; the resident will be expected to prepare for elective surgery by reviewing the patient’s images, discussing the surgical plan with the attending surgeon, and performing a history and examination on the patient before the surgery.
- Maintaining the neurosurgical patient work list
PGY-3/NS3: NUMC and NSUH
- At NUMC residents will manage the inpatient service and clinic with the help of an intern from General Surgery and a PA, and obtain faculty supervision.
- At NSUH, will make morning rounds with the Neurosurgery team and take call.
- OR assignments will focus on the service on which they are rotating at the time. They will assist in the admission, inpatient management, and discharge responsibilities of patients on these services.
- When on call, responsibilities will mirror those noted above, especially regarding consults and patient management.
- Will be expected to function at a more senior level in presenting new elective and emergency cases to faculty, and to formulate management plans, including deciding when surgery is indicated.
- Will work on their basic science or clinical research during weekdays
- Take call on the neurosurgery service at the program training sites, alternating on a monthly basis.
- When on call the residents may act in a senior capacity. On weekend days and holidays they will lead rounds, and take the lead in managing the service and making patient management decisions under faculty supervision.
- Calls will be minimized so as to lessen the impact on the research experience, but will provide a transition for residents to enter the next year of senior residency.
PGY-5/NS5: Research or In-Folded Fellowship
- Responsibilities will be similar to those described in the PGY-4/NS4 year.
- Residents electing to do an infolded subspecialty fellowship will take call on the general neurosurgical service, so that they will continue to improve their overall clinical and technical skills.
PGY-6/NS6: Senior resident NSUH and LIJ
- The Senior Resident will make daily rounds with the inpatient care team and may take the lead in seeing and making management decisions (subject to faculty review) the service as per the Chief Resident’s discretion.
- Be the Acting Chief Resident when the latter is unavailable
- On most weekdays, will assist in the OR and be expected to have reviewed the patient’s clinical presentation and images with the attending neurosurgeon, to have read appropriately in preparation for the surgery, to have examined the patient before surgery, and to otherwise be prepared to take a lead role in the OR (under direct faculty supervision).
- Present patients at morbidity and mortality conference.
PGY-7/NS7: Chief resident NSUH and LIJ
- The Chief Residents will be responsible for the functioning of the neurosurgical services at each of the two major training sites of the training program. Their duties will include making daily rounds (excluding weekends and holidays when not on call) to oversee all patients on the service, with delegation to the senior resident as appropriate.
- Making management plans subject to faculty review.
- Being in the OR most weekdays and being the primary surgeon, under faculty supervision, after appropriate preparation as outlined above.
- Undertaking all administrative duties including the preparation of call schedules, assigning residents to clinical tasks and specific surgical cases; overseeing resident involvement in the conference schedule, and preparing for M&M conferences.