The rotations in the neurosurgery residency program are designed to optimize resident education. A great strength of the program is that residents train at five renowned hospitals within the Texas Medical Center, and encounter five distinct patient populations and institutional structures. Twenty-five faculty neurosurgeons train our residents in every area of neurosurgery at these five hospitals.
At St. Luke’s Episcopal Hospital, residents learn from a variety of adult neurosurgical cases, with special emphasis on cerebrovascular surgery, degenerative spine (including minimally invasive and endoscopic approaches), epilepsy, and functional neurosurgery. Ben Taub Hospital is the neurosurgical referral center for the Harris Health System, and receives a large volume of aneurysms, brain and spine tumors, neurotrauma, and degenerative spinal disease. The Veterans Affairs Medical Center is the federal neurosurgical referral center for the South and Southwest, and residents there perform a wide range of cranial and spinal procedures, including deep brain stimulation for Parkinson’s Disease. At both Ben Taub and the VA, residents are expected to take a leading role as surgeons, with outstanding faculty supervision. Texas Children’s Hospital is the largest pediatric hospital in the U.S., and surgeries are routinely done for pediatric brain and spine tumors, craniofacial reconstruction, and epilepsy. The MD Anderson Cancer Center is a world leader in the treatment of brain and spine tumors, receives an unparalleled spectrum of pathology, and offers the most cutting edge technology for use by specialists in every area of neurosurgical oncology.
Residents in our program are encouraged to develop a progressive level of responsibility in the operating room, beginning at an early stage in training. The schedule allows for a full year of research during which residents do productive academic work in an area of their choosing. We are committed to training exceptionally competent, confident neurosurgeons and leaders in our field. A sample outline of each year is provided below.
The one-year internship is highly oriented to didactic and clinical education relevant to neurosurgery. The internship is comprised of a three months of general surgery rotations with an emphasis on surgical critical care and trauma; rotations in clinical neurosciences, including rotations in neurology, neuroradiology/neuro-ophthalmology, and neurosurgical critical care. Training in neuropathology is integrated into the clinical neurosciences block through required readings, lectures and practical exposures.
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 three hospitals (Ben Taub Hospital, Veterans Affairs Medical Center, St. Luke’s Episcopal Hospital) 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, have mastered a variety of bedside neurosurgical procedures, and have 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 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. In a four-month research rotation, third-year residents are expected to formulate a research agenda for the upcoming year.
The fourth year is a full year of research, during which the resident pursues a project(s) in a particular area of academic interest. There are a large number of basic science and clinical research opportunities in the neurosurgery department.
The fifth year is divided into four-month rotations at Ben Taub, St. Luke’s, and the MD Anderson Cancer Center. At Ben Taub, the fifth-year resident takes a leading role in a variety of intracranial and spinal procedures, and assists the chief resident in more complex cases. A high volume and wide spectrum of neurosurgical disease is treated at Ben Taub, which is the neurosurgical referral center for the Harris Health System. At MD Anderson, the resident learns from neurosurgical faculty specialized in the treatment of brain, spine, and skull base tumors. MD Anderson is a world leader in neurosurgical oncology, and residents learn the most advanced treatments in intracranial and spinal cancer pathology. The residents are also trained in modern concepts of tumor biology, peripheral nerve tumor surgery, pain control, stereotactic radiosurgery, and adjuvant therapy for cancer. The fifth year resident also completes a rotation at St. Luke's, working with both academic and private neurosurgeons, and gains special training in vascular neurosurgery, complex spinal disorders, and epilepsy.
The sixth-year resident functions as chief resident at Texas Children’s Hospital and the Veterans Affairs Medical Center. At TCH, 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 VA Hospital receives a large volume of neurosurgical referrals from the South and Southwest. Residents perform a variety of intracranial and spinal cases, as well as functional and peripheral nerve surgery. The third rotation of this year is an elective slot for a focused clinical experience linked to a clinical research project, or for completion of the project undertaken in the previous year.
The seventh year is spent as chief resident for four months each at Ben Taub, St. Luke’s, and MD Anderson. 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 St. Luke’s, the chief resident performs surgeries for aneurysms and vascular malformations, minimally invasive and endoscopic spine surgeries, and epilepsy surgery. At MD Anderson, the resident operates with specialists in brain tumor, skull base, and spine tumor surgery. At Ben Taub, the chief resident guides junior residents through simpler cases, while perfecting skills in more complex cases. The resident will become facile with surgery for aneurysms, tumors of the cranial base, transsphenoidal surgery, and spinal reconstruction for tumor or trauma.