Neurosurgery Residency Rotations
The General Surgery rotation is based at North Shore University Hospital. The resident develops a solid foundation in the general principles of surgery and surgical basic science. He/she will learn to perform a comprehensive history and physical examination and effectively communicate the assessment of the patient to the senior residents and faculty. The resident will learn the fundamental skills and techniques essential for the care/management of the critically ill patient, and will also learn the general principles of preoperative, intraoperative and postoperative management of patients including fluid and electrolyte balance and pain management. Residents learn general surgical techniques including operating room conduct and surgical asepsis. They perform surgical incisions and closures, surgical knot tying and instrumentation. Under supervision, the resident begins to perform basic surgical procedures commensurate and appropriate for his/her level.
The Orthopedics rotation is based at North Shore University Hospital. On this rotation the residents learn the biomechanical principles in managing patients with spinal disorders. They understand the assessment, nonoperative and surgical management and postoperative care of these patients from the orthopedic viewpoint, and participate in surgery under the direction of the Senior Resident and the Attending surgeons.
The Otolaryngology rotation is based at Long Island Jewish Medical Center. On this rotation the residents learn the evaluation of patients with disorders of the head and neck and of the ears. This includes indications for surgical versus medical management. The resident learns the principles of endoscopic surgery, the indications for this versus open approaches to the anterior skull base, and participates in surgery under the direction of the attending surgeons.
The Anesthesiology rotation is based at North Shore University Hospital. On this rotation the residents learn basic principles of anesthesiology including the use of intravenous and inhalational agents and of muscle relaxants. They are taught the principles of intraoperative homeostasis, avoidance of injury from surgical positioning and emergence from anesthesia. In addition, the resident learns the principles of control of intracranial pressure during surgery and the indications for the use of blood products. Residents participate in endotracheal intubation of patients under the supervision of the attending anesthesiologists.
The Trauma rotation is based at North Shore University Hospital. On this rotation the residents learn general principles of trauma management, including triage, the rapid assessment of airway, breathing and circulation, principles of patient resuscitation and stabilization, imaging of the acute trauma patient, indications for surgical intervention and nonsurgical management of these patients. They assist in surgery under the direction of the Trauma Surgery Chief Resident and Attending surgeons, and learn fundamental surgical skills.
The Neurosurgical ICU rotation is based at North Shore University Hospital. This experience provides focused training in concepts and skills of ICU management, including fluid and electrolyte balance, ventilation, alimentation, line placement, hemodynamic management of patients with cerebrovascular disease and the systems approach to complex patient problems. This includes the special context of neurological examination, the recognition of neurological and neurosurgical emergencies and the management of intracranial pressure and CSF drains. The residents learn to identify patients requiring neurocritical care and learn the principles of critical care management and the systems approach to the care of patients with complex illness.
Clinical Neurosurgery at North Shore University Hospital (NSUH, Manhasset)
NSUH is where the majority of clinical neurosurgical training takes place. Junior and mid-level residents split their time between managing the inpatient service, assisting in operating room, and seeing consults on the floors and in the emergency room. Senior residents manage the service under attending supervision and have increasing responsibilities in the operating rooms. NSUH has a 16-bed Neurosurgical ICU, staffed by dedicated neurointensivists, with a dedicated mobile CT scanner. Annually, there are over 2,000 neurosurgical cases at NSUH. Endovascular surgery is based here, as is the stereotactic radiosurgery program. Other technological capabilities include intraoperative MRI and three surgical navigation stations. Ground will be broken soon on a major expansion of NSUH that will include new dedicated neurosurgical ORs and an expanded NSICU.
Clinical Neurosurgery at Long Island Jewish/Steven and Alexandra Cohen Children’s Medical Centerof New York
The residents at LIJ/CCMC manage an integrated service. Annually, there are approximately 300 pediatric neurosurgical cases and over 400 adult neurosurgical cases. In addition, most surgery for epilepsy is done here. There are two dedicated surgical navigation stations in the ORs.
Nassau University Medical Center (NUMC)
The NUMC resident functions as a senior/chief resident, working with the director of neurosurgery at NUMC and the covering attendings. NUMC provides the resident with an extensive trauma experience. The outpatient clinic and in-house consults support an elective neurosurgical service.
Neurology at North Shore University Hospital North Shore University Hospital (Manhasset)
The resident on neurology works as a team member of the neurology staff and functions as a neurology junior resident. The objectives of the rotation are to provide the resident with adequate exposure to the evaluation and treatment of variety of neurologic pathology, not all of which is surgical. Residents have the option of rotation on pediatric neurology and/or neuroophthalmology services.
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Neuroradiology/Neuropathology at North Shore University Hospital (Manhasset)
On this three-month required rotation residents spend six weeks each on the Neuroradiology and Neuropathology services. Intensive instruction is provided by fellowship-trained faculty from each service. At the conclusion of this rotation, the residents should be familiar with the advanced interpretation of CT, MR, and angiographic images, be able to recognize histological patterns of common neurosurgical diseases, and understand contemporary diagnostic methods of immunopathology and molecular genetics.