The Neurosurgical Residency Program at Yale-New Haven Hospital is a seven-year program under the direction of the Department of Neurosurgery. Dr. Murat Günel is the department chair, and Dr. Charles Duncan is program director for the residency.
The Neurosurgical Residency Program gives residents a broad neurosurgical background. It exposes them to subspecialty neurosurgery and gives them a chance to engage in basic and clinical research.
Appointments to the program are for one year with advancement based on performance. Residents are evaluated continuously by the faculty and senior residents in accordance with the General Competencies. The department expects residents to contribute to their own education through active interaction with faculty. Faculty evaluations are based on residents’ performance in seminars, on the wards, in the OR, in clinics and in the laboratory.
The epilepsy surgery program offers a flexible experience in the diagnostic and therapeutic approaches to medically intractable seizures. A single position for six months to one year is available either following completion of neurosurgical training or embedded within the residency. A Yale-New Haven Hospital resident may elect to concentrate within this specialty for six months to one year and, if choosing this path, may combine clinical experience with ongoing research related to epilepsy.
For individuals choosing the one-year course, either during or following neurosurgery training, the year begins in July and the first three months are spent in Neurology. Here the fellow works with the medical epileptologists attending outpatient clinics, evaluating patients for the surgical program, learning about the appropriate selection of anticonvulsants, and studying both scalp and intracranial electroencephalography. The surgical fellow rotates with the neurology fellows supervising the audiovisual monitoring (AVEEG) of Phase-1 patients (24-hour scalp monitoring selection for surgical candidacy) and caring for the patients undergoing chronic intracranial study (Phase 3). The fellow is supervised in the AVEEG monitoring suite by an epileptology faculty and is then responsible for presenting these patients at the weekly Monday epilepsy surgery conference. The next nine months are then spent in the surgical arm of the program where they take part in both diagnostic and therapeutic surgical procedures. There is a close interaction with the other residents who also take part in the surgical procedures assuming the role of assistant or primary surgeon, depending on year of training and ability. The fellow is expected to carry out at least one clinical research project during this year, attend twice weekly clinics, present at monthly Journal Club, and at the end of the year prepare an abstract for the yearly meeting of the American Epilepsy Society.
An infolded fellowship in endovascular neurosurgery is available through the Neurovascular Section. Furthermore, opportunities for further developing Cerebrovascular and skull base microsurgical skills is also available through the Cerebrovascular/Skull Base microsurgical dissection laboratory through the Neurovascular Section.
The department is used for undergraduate teaching by the Yale University School of Medicine. During their laboratory experience residents participate in the neuroanatomy course as lecturer and laboratory supervisor. In this course the neurosurgery resident acts both as teacher and student. This role has been extremely well received and according to the medical student reviews accounts for much of the enthusiasm for neurosurgery. One to 4 students will be on the clinical service at one time
Third year medical students have a four week Clinical Neurosciences Rotation with a choice of adult neurology, pediatric neurology, neurosurgery or outpatient experience. The student who chooses neurosurgery works closely with the residents and attendings as an integral member of the team. Fourth year medical students may elect a subinternship in neurosurgery and similarly be an integral part of the service. There is a surgical intern on the neurosurgery service at YNHH at essentially all times. The residents have responsibility for teaching these students and interns. These interactions with students are an important guide to mentoring for the residents. There is a noon conference each Friday where the medical students present selected educational cases. The residents prepare the students and question them during the conference. Similarly, students present at other general conferences and chief’s rounds.
Each year a number of students complete their medical school thesis in the Department and a number of others will do shorter projects as well.
Residents teaching residents is an important aspect to neurosurgical education. The faculty makes every effort possible to assure this is well supervised and appropriate. Some of the best-received teaching conferences are those were resident present topics to their peers. Additionally, the residents have an opportunity to teach general surgery, neurology, and pediatric house staff about surgical diseases of the nervous system.