The PGY-3 year continues to be a heavy clinical year. They are the workhorses of the clinical service. More time is spent in the OR as a PGY-3 resident, participating as an assistant or actively observing the critical portions of complex neurosurgical procedures. During the PGY-4 year, as residents transition from junior to senior years, they are provided more time to define and strategize their individual plans for professional development as frontline clinical responsibilities begin to ease. A dedicated block of research is undertaken in the PGY-4 year. “Research” time may be utilized for basic / translational research, clinical / population health research, a clinical intensive (mini-fellowship), or pursuing a professional graduate certificate. Exposure to pediatric neurosurgery is usually achieved during these formative years in training, in addition to continued rotations at OUMC and the VA.
Pediatric neurological surgery is an important area of subspecialty knowledge and practice, both for general neurosurgeons with comprehensive practices and for those who will concentrate their practice on children. Pediatric neurosurgery includes care of infants, children and adolescents and comprises medical and surgical care of the central and peripheral nervous system, their dural and bony coverings, intracranial and cervical extracranial cerebral vasculature, and function. Pediatric neurosurgeons also offer counseling to families with in-utero diagnoses of congenital nervous system malformation. Pediatric neurosurgeons may also care for some patients with congenital nervous system disease into adulthood. Thus, many disease conditions and decisions faced by pediatric neurosurgeons. Residents rotating on the pediatric neurosurgery service have already obtained a foundation in basic neurosurgical procedures.
During that time, they will work with the attending pediatric neurosurgeons as well as myriad other clinical services in Oklahoma Children’s Hospital (OCH).
The service includes general pediatric neurosurgical clinic and multidisciplinary clinic, during which the resident may be involved in the evaluation of new referral patients and will follow-up with patients they have previously managed or operated on. The resident may also see all new consults during the day and may assume care of consults from the covering night resident each weekday morning, under the supervision of the attending surgeon. The resident will also attend didactic conferences geared towards pediatric neurosurgery.
The resident will scrub on all operative neurosurgical cases in OCH and perform all ICU and bedside procedures while in the hospital. Participation in the cases will be dictated by resident ability, case complexity, patient safety, and learning experience. It represents a significant opportunity to gain skill and confidence with complex and microsurgical cases, including craniotomy for tumor, epilepsy, vascular and other problems, endoscopy, intradural spinal operations, and hydrocephalus management.It also allows residents who do not plan to care for children upon entering practice to have some expertise in caring for adults with congenital neurosurgical disease.
The resident will be expected to continue self-directed learning, especially as related to relevant current cases.
The resident will continue to participate in department teaching conferences.
Pediatric neurosurgery raises particularly salient issues of ethics, complex systems based care, and delicate family communications.