PGY-1 / NS-1: Multiple Services

Neurosurgery at North Shore University Hospital – Residents become familiar with the workings of the hospital and the clinical neurosurgical service while they are mentored in basic clinical and operative skills.

Neurology – Residents learn to perform a comprehensive neurological history and physical examination, as part of the inpatient and consult services. They are taught concepts of anatomical and etiological localization of neurological disorders. The resident will understand fundamentals of such neurological problems as movement disorders, neuromuscular diseases, seizures, chronic pain and acute and chronic alterations of mental status.

Neurosurgical ICU – this experience provides the resident with 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.

Anesthesiology – Resident learn endotracheal intubation techiniques, principles of operative anesthetic management in the operating room, including intravenous and inhalational control of intracranial pressure and fluid and blood replacement.

Orthopedic spine – Residents spend a month on the Orthopedic Spine service at North Shore University Hospital. They learn biomechanical principles appropriate for the management of patients with spinal disorders from the orthopedic viewpoint, and will understand the options of surgical versus nonsurgical management of such patients.

PGY-2 / NS-2: Neurosurgery, Neuroradiology, and Neuropathology

Neurosurgery at LIJ – This rotation features concentrated experience in pediatric neurosurgery and epilepsy surgery, along with general neurosurgical practice. Cohen Children's Medical Center, an integrated facility on the LIJ campus, is a nationally recognized pediatric hospital. Neurosurgical care is provided by two fellowship-trained and board-certified pediatric neurosurgeons. This rotation teaches residents the fundamentals of pediatric neurosurgery that they will apply as senior and chief residents on the Long Island Jewish Medical Center site.
The Northwell Health epilepsy program is based at LIJ, and includes full-time epileptologists and a 4-bed unit for inpatient video EEG monitoring.

Neuroradiology/Neuropathology – Residents learn the radiological approach to image interpretation at the North Shore University Hospital campus, which is staffed by four fellowship-trained neuroradiologists. This includes instruction in functional neuroimaging, using functional MRI  and diffusion tensor imaging (DTI), and positron emission tomography. Neuropathology instruction is under the auspices of two fellowship-trained neuropathologists and includes understanding techniques and interpretation of intraoperative pathology, immunohistochemistry and molecular genetics. Residents take call on the neurosurgery service during this rotation, which provides them with the opportunity to strengthen their management and operative skills.

Neurosurgery – Residents devote their time to increasing neurosurgical management and operative skills as junior residents, at the North Shore University Hospital and LIJ Medical Center campuses. At NSUH, residents are introduced to the principles of stereotactic radiosurgery and participate in patient planning and treatment.

Stereotactic radiosurgery – The Northwell Health Center for Stereotactic Radiosurgery and Radiation Therapy is located on the North Shore University Hospital campus and is under the direction of Dr. Michael Schulder. Dr. Schulder is a world-renowned neurosurgeon who received advanced training in SRS at the University of Florida and at the Brigham and Women’s Hospital, and is a member of the International Stereotactic Radiosurgery Society.

PGY-3 / NS-3: NSUH

Neurosurgery at North Shore University Hospital (NSUH) – Residents have a more senior role on the service. They spend more time in the operating room and are able to instruct first year residents and mid-level providers in aspects of neurosurgical care. They gain further experience in stereotactic radiosurgery.

Scheduled carotid endarterectomies are coordinated with the Hand Surgery Service. The residents coordinate with the Neurosurgery Chief Resident and the Program Director when he/she participates in those surgeries under the auspices of the Vascular attending and resident surgeons.

At NSUH, scheduled peripheral nerve operations are coordinated with the Hand Surgery Service. The residents coordinate with the Neurosurgery Chief Resident and the Program Director when he/she will participate in those surgeries under the auspices of the Hand Surgery attending.

Endovascular surgery – is performed at NSUH by Dr. Avi Setton  He is an interventional neuroradiologist who is fellowship-trained and has had extensive experience as an attending before joining Northwell Health He has a joint appointment in the Departments of Neurosurgery and Radiology. Dr. Setton has trained neurosurgeons in endovascular surgery in numerous well-recognized fellowship programs. At NSUH, residents participate in endovascular neurosurgery one half day a week. He/she learns the basic principles of catheter selection and indications for endovascular treatment of cerebral aneurysms, arteriovenous malformations, tumors and stroke. Endovascular treatments are done as part of the Cerebrovascular Surgery program.

PGY-4 / NS-4: Research

Residents are encouraged to pursue basic or clinical research at the Feinstein Institute for Medical Research (FIMR), within the hospital setting, or at the Hofstra Northwell Medical School campus.

All research proposals are submitted to the PD and the Education Committee for approval by the end of the PGY-2 year, so as to ensure that they are scientifically rigorous and that the resident can submit the project for external funding or research award. 

Residents will take a limited amount of call during their research experience to ensure that clinical skills are maintained.

PGY-5 / NS-5: Research or In-Folded Fellowship

Residents have the option of continuing their research for a second year. In certain cases, when planned from the start, they may be able to complete the work needed towards a PhD from the Elmezzi Graduate School of Molecular Medicine (based at the Feinstein Institute for Medical Research).

Residents who choose to pursue an in-folded clinical fellowship this year will train as fellows in the field of their choice, including cerebrovascular, functional, neurooncology, neurotrauma/critical care, pediatrics, spine or skull base surgery. Resources for training in these subspecialty areas currently exist at Northwell Health.

PGY-6 / NS-6: Senior Resident North Shore University Hospital and Lenox Hill Hospital

Residents play a key role in managing the inpatient service and in the instruction of junior residents. They are expected to take a proactive role in surgical education and must demonstrate a readiness to assume greater surgical responsibility. The PGY-6 residents are in charge of making rounds and leading the house staff team when the Chief Resident on the service is not available. They also have a senior position in the pediatric and adult neurosurgery clinics at Long Island Jewish Medical Center. This year will allow residents to mature in their clinical and operative skills in preparation for their Chief Resident year.

At NSUH, the senior resident coordinates with the Vascular Surgery service regarding scheduled carotid endarterectomies. He/she coordinates with the Neurosurgery Chief Resident and the Program Director when he/she participates in those surgeries under the auspices of the Vascular attending and resident surgeons.

The senior resident also coordinates with the Hand Surgery service regarding scheduled peripheral nerve operations. The resident coordinates with the Neurosurgery Chief Resident and the Program Director when he/she participates in those surgeries under the auspices of the Hand Surgery attending.

The senior resident increases his/her experience in stereotactic radiosurgery. The resident takes the lead in treatment planning and defines the use of single or multiple session treatments for patients with various intracranial and intraspinal lesions.

The resident gains further experience in endovascular surgery at North Shore University Hospital. He/she will is a part of the team performing procedures, and gains increased understanding of the techniques of angiography and endovascular treatments. The resident learns the risks involved in these procedures and strategies to avoid complications.

PGY-7 / NS-7: Chief Resident NSUH

The chief residents are responsible for the clinical and administrative management of the neurosurgical services at NSUH. This includes overseeing resident preparation for conferences, assigning surgical cases to the other residents and finalizing the resident call schedule. They are expected to have mature clinical and surgical judgment and to use this year to refine these skills in preparation for neurosurgical practice or post-residency fellowship training

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