Neurological Surgery Residency Curriculum

Through a carefully designed program curriculum with scheduled rotations at five affiliated hospitals, our residents are exposed to the full range of neurosurgery, including: cerebrovascular, endovascular, epilepsy, skull base surgery, movement disorder, neurosurgical oncology, pediatric neurosurgery, peripheral nerve, complex spine, trauma, and pain specialties. The extensive surgical and patient facilities provide an excellent environment for training, and offer exposure to state-of-the-art neuroendovascular suites with three-dimensional reconstruction of angiography, intraoperative MRI and CT scanners, adult and pediatric level 4 epilepsy monitoring units, intraoperative microelectrode recordings, and many other technologies.

In addition to PGY-level specific curriculum, residents have the opportunity to participate in lecture and lab dissection courses with neurosurgical teaching faculty. Topics for each course can range from the study of skull base surgery, spinal neurosurgery, and neuroendoscopy. The lecture and dissection courses are a monthly series held in the neurosurgical labs at the main Baylor College of Medicine campus.

The first year internship is highly oriented to didactic and clinical education relevant to neurosurgery. The PGY-1 year is comprised of six months of structured education in general patient care, three months of basic clinical neuroscience, and three months of critical care education applicable to the neurosurgical patient. During the internship year, residents will rotate through Ben Taub Hospital, Michael E. DeBakey Veterans Affairs Medical Center, Baylor St. Luke’s Medical Center, and the MD Anderson Cancer Center.

The second year provides the resident with an overview of neurological history-taking and examination, the spectrum of neurosurgical disease, the indications and contraindications for surgery, and operative techniques. During four-month rotations at Ben Taub Hospital, Texas Children's Hospital, and MD Anderson Cancer Center, the resident encounters distinct patient populations and institutional structures. By the conclusion of the second year, the resident should have learned the workup of neurosurgical conditions, mastered a variety of bedside neurosurgical procedures, and gained experience performing significant portions of cranial and spinal surgeries.

During the third year, the residents refine their diagnostic, clinical and operative skills during four-month rotations at Ben Taub Hospital, Baylor St. Luke’s Medical Center, and Texas Children’s Hospital. The resident will be provided with increasing responsibility in the operating room, and should gain competence in a number of neurosurgical procedures, such as the resection of superficial brain tumors and simple spine surgeries.

The fourth year is divided into four-month rotations at Ben Taub Hospital, Baylor St. Luke’s Medical Center, and the MD Anderson Cancer Center. At Ben Taub, the fourth-year resident takes a leading role in a variety of intracranial and spinal procedures, and assists the chief resident in more complex cases. At MD Anderson, the resident learns from neurosurgical faculty specialized in the treatment of brain, spine, and skull base tumors. The residents are also trained in modern concepts of tumor biology, peripheral nerve tumor surgery, pain control, stereotactic radiosurgery, and adjuvant therapy for cancer. At Baylor St. Luke’s Medical Center, residents have the chance to work with both academic and private neurosurgeons, receiving special training in vascular neurosurgery, complex spinal disorders, and epilepsy.

The entirety of the fifth year is dedicated to research, during which the resident pursues a project in an area of academic interest. This project can range from basic neuroscience to clinical research. Residents will have the opportunity to have their laboratory research projects funded through the department's NIH R25 Grant.

Baylor College of Medicine has a remarkable environment for research, both within the Department of Neurosurgery as well as in other departments which also offer opportunities for resident research. In 2014, Baylor's Department of Molecular and Human Genetics ranked first in the nation in NIH funding, while its Department of Neuroscience ranked seventh. Furthermore, The University of Texas MD Anderson Cancer Center is nation's leading center for NCI grants and its laboratories also serve as outstanding sites for our residents to carry out laboratory research. For residents who choose to pursue clinical research projects, there are abundant opportunities for clinical research throughout the program's five affiliated hospitals and residents are welcome to pursue these opportunities.

During the sixth year of training, residents rotate on a four-month basis between the Michael E. DeBakey Veterans Affairs Medical Center, Baylor St. Luke’s Medical Center, and Texas Children’s Hospital. The sixth-year resident functions as chief resident at Texas Children’s Hospital and the Veterans Affairs Medical Center, and as senior resident at Baylor St. Luke’s Medical Center. At Texas Children’s, the resident works with six faculty neurosurgeons and has primary operative responsibility for a wide range of pediatric neurosurgical cases, including brain tumors, spinal dysraphism, craniofacial surgery, and epilepsy surgery. At the VA Hospital, the sixth-year resident takes on primary administrative and operative responsibilities for the service, and oversees training of the PGY-2 resident. The residents perform a variety of intracranial and spinal cases, as well as functional and peripheral nerve surgery. At Baylor St. Luke’s Medical Center, the resident takes on two rolls: senior resident of the neurosurgical service, and chief resident of the endovascular service, where they will have the chance to participate in basic neurosurgical procedures as well as extracranial vascular procedures.

The seventh year is spent as chief resident for four months each at Ben Taub Hospital, Baylor St. Luke’s Medical Center, and MD Anderson Cancer Center. By the beginning of the chief year, the resident has already gained considerable operating experience and can focus on honing skills in complex cases and on particular areas of interest. At Baylor St. Luke’s Medical Center, the chief resident performs surgeries for aneurysms and vascular malformations, minimally invasive and endoscopic spine surgeries, and epilepsy surgery. At MD Anderson Caner Center, the resident operates with specialists in brain tumor, skull base, and spine tumor surgery. At Ben Taub Hospital, the chief resident guides junior residents through simpler cases, while perfecting skills in more complex cases. Once the seventh year of training is completed, the resident will be proficient in surgery for aneurysms, tumors of the cranial base, transsphenoidal surgery, and spinal reconstruction for tumor or trauma.