Neurological Surgery Residency Program
At UT Southwestern Medical Center

Department Overview

The UT Southwestern Neurosurgery Department consists of ten faculty dedicated to the various neurosurgical subspecialties. Three cerebrovascular faculty contribute to an internationally recognized expertise in cerebrovascular and endovascular neurosurgery. Complex spine, skull base surgery, functional neurosurgery and trauma are also well developed as is our neuro-oncology center. The Neurosurgeons For Children at Children's Medical Center of Dallas contribute an additional five faculty to an intensive pediatric experience.

The goal of the residency program is to provide strong clinical training and foster good judgment in the field of neurosurgery in preparation for an academic career or an exemplary private practice. Emphasis is on a practical, patient-centered approach to the field with superlative technical training.  Most residents also are involved with ongoing clinical or basic science research.  Strong leadership abilities are also sought and cultivated.

Residency Overview 

The Neurological Surgery Residency at The University of Texas Southwestern Medical Center at Dallas is seven years in length including one introductory year of general surgery at our institution.  Two residents are appointed each year of the six neurosurgical years for a total of twelve residents in the training program. 

The initial two years of neurosurgery (PGY-2 and PGY-3) are devoted to mastering patient and critical care skills. Basic operative approaches, patient selection and surgical skills are also emphasized.  Rotations for the PGY-2 and PGY-3 years are primarily at Parkland Memorial Hospital and the Zale Lipshy University Hospital. The third year also includes time for the micro-dissection laboratory with participation as an instructor in our cerebral aneurysm course at the annual Congress of Neurological Surgery meeting. Development of a basic science research project also takes place.

For those residents who are considering a career in academic neurosurgery or in a subspecialty practice setting, the PGY-4 year should be devoted to implementing laboratory or clinical research plans developed in the third year. For those planning to become general neurosurgeons this year may be spent on various clinical rotations including the spine service, the tumor service and at the Children's hospital. When sufficient competence is demonstrated, PGY-4 and PGY-5 residents rotate at the Veteran's Hospital where higher levels of autonomy and decision-making are developed.

The final two years (PGY-6 and PGY-7) are spent in chief resident rotations at Parkland Memorial Hospital and Zale Lipshy University Hospital and on senior resident rotations or mini-fellowships in various subspecialty areas. To a degree these years are tailored to the individual resident's educational needs to fulfill both board requirements and ultimate career goals. Trauma and critical care, complex spine, skull base surgery and functional neurosurgery are among the options for mini-fellowship experiences. Residents with an interest in cerebrovascular surgery may elect for an intensive experience in micro-neurosurgery or may have access to an introductory experience in endovascular surgery.

During these final two years some time is spent as the Chief Resident at Parkland and on the cerebrovascular service at Zale Lipshy. These rotations allow development of teaching and leadership skills and include training on how to organize an academic or private neurosurgery practice. Basic surgical skills are expected to be in place prior to these rotations so that the focus can be on surgical nuances.

Detailed Residency Information for POST GRADUATE YEARS (as of Jan 1, 2008)

 The PGY-1 resident will spend twelve months on the surgical services within the Department of General Surgery, including surgical critical care, trauma, the emergency department, and the neurosurgery service.  At least two months of neurology are also completed.

The PGY-2 year, the first year of full-time neurosurgery residency, consists of rotation segments alternating between Parkland Health & Hospital System (PHHS) and Zale Lipshy University Hospital (ZLUH).  During this time, you are introduced to the broad spectrum of neurosurgical patients.  In conjunction with the critical care team, hospitalists, pulmonologists and cardiologists you will develop facility in patient management decisions at the critical care level.  The resident also is responsible for knowing the patients from the time of admission to the time of their discharge. During this time you will develop increasing competence in neuroradiological interpretations, neurological diagnosis, patient assessment, and patient management.  Resident operative time at this level has been greatly enhanced by the addition of new faculty dedicated to this aspect of resident education.  By the end of this year you should be familiar with all the steps of some neurosurgical procedures as well as the positioning, opening and closing of most neurosurgical operations.  Immediate supervision is provided by the chief resident and by the faculty attending at both institutions.

The PGY-3 year is an expansion of the PGY-2 year.  Clinical care continues with a greater emphasis on surgical skills and decision-making. The resident will be directed toward developing and expanding knowledge in basic neuroscience and selected lab techniques as well as the core of closely-aligned clinical areas, such as neuro-imaging, cerebral blood flow, neuropathology, etc.  Residents take and usually pass the written neurosurgical board exam during this year. A dedicated introduction to microsurgery is incorporated into a block of  the lab experience.  You will spend several weeks performing craniotomy and spine approaches on cadavers. Similar sessions can be devoted to upper and lower extremity peripheral nerve anatomy, spine exposure including cadaver and skeletal bone for complex instrumentation.  A three-month angiography rotation has been added.

During the PGY-3 year the resident is encouraged to work with a member of the neurosurgery faculty either in a research laboratory or on the preparation of a clinical research paper.   More specific research opportunities available to residents include:  the Mobility Foundation Center Laboratory where Dr. Jon White directs studies of cerebrovascular and disease and the skull base and neuro-oncology laboratory under the direction of Dr. Babu Welch and Dr. Bruce Mickey.  A data base with over a decade of aneurysm and AVM outcomes are also available. 

The two Senior Resident years are spent rotating on the Tumor Service, Spine Service, VeteransHospital and Children's Medical center.  These rotations are organized around the task of developing the residents' operative abilities in these various subspecialties of neurosurgery.   Each of these rotations also includes time in the ambulatory care center with one-on-one instruction from a faculty member.  This is designed to provide greater understanding of patient selection and outcomes.

A newly implemented Advance Study year is incorporated into the residency.  This is a year of intensive training designed to add depth to the neurosurgical training and will be tailored to individual resident goals.  Residents interested in basic research will develop their projects during the PGY-3 year and use this additional year to implement their design. Those interested in pursuing additional clinical training may participate in two six-month or a one year sub-specialty experience in neurosurgery.  Complex spine, functional, epilepsy, trauma, skull base surgery, neuro-oncology are among the options.  Completion of a portion of an interventional neuroradiology fellowship is also an option.

As Chief Resident you will assume additional clinical responsibility for the patients under your care and it is here that maximum operative and independent decision-making experiences are attained. During this period the resident rotates on three-month blocks between Parkland and the Zale Lipshy cerebrovascular services. These experiences complement each other well, with the Parkland experience being that of an active Level 1 neurotrauma patient load, combined with a general neurosurgical service having large amounts of spine, cerebrovascular, and brain tumor patients.   The Parkland service is maintained as a chief resident-run service although direct faculty involvement and supervision is always present, on the wards, in the ICU, and especially in the operating room. The chief resident is in charge of the Parkland outpatient clinic. Alternatively, the rotations on the ZLUH cerebrovascular service expose the chief resident to a large operative case load of simple and complex vascular patients.  Aneurysms, AVMs, cerebral ischemic disease, and microvascular decompressions are all referred to the facility.  The PGY-6 resident will attend Aston outpatient clinic with these faculty members,  evaluating patients preoperatively and following them postoperatively. 

BENEFITS    (information detailed in the Parkland Health & Hospital System Benefit Book)
 1.         Vacation

 All residents from the PGY-2 through PGY-7 Chief Resident will have two week vacations during these years in addition to the Christmas/New Year seasonal break.   The PGY-2 and PGY-7 vacation will come in one week segments during the August-November and February-May periods.

 2.         Hospitalization Insurance - coverage provided through PHHS.

Group hospitalization insurance is provided at a nominal cost to residents with the remainder of the cost paid by Dallas County Hospital District.  Enrollment of the resident's spouse and/or dependents in the group plan is available at his/her expense.  Benefits payable under this plan are subject to any changes made in the program during the course of the year. 

3.         Disability - coverage provided through PHHS.

The Long-Term Disability Plan is designed to help replace the resident's earnings if he/she is unable to work because of an illness or injury that lasts longer than three consecutive months.  Parkland Memorial Hospital pays the entire cost of this protection that assures the resident's receipt of up to 60% of his/her basic monthly earnings during times of being totally disabled. 

4.         Subscriptions

            a.   Journal of Neurosurgery - individual subscriptions provided through American Association of Neurological Surgery

            b.   Neurosurgery - individual subscriptions provided through Congress of Neurological Surgeons (with resident membership of $25.00)

5.         Computer - Access and support is provided. Individual programs are available for each neurosurgery resident to document training and experience. 

6.         Neurosurgery Meetings and Conferences

Each resident above the PGY-2 level will be sent to one major neurosurgical meeting or course per year. This is commonly one of the sectional meetings during their more junior years, although the PGY-3 resident will be urged to attend one of several neurosurgical courses during this year.  In addition, any resident will be sent to at least one other major neurosurgical meeting per year if he/she is presenting at that meeting.

ON-CALL COVERAGE

At PHHS, on-call coverage is provided by a neurosurgery chief resident, two neurosurgery junior residents and two general surgery PGY-1 residents.  At the junior level, the neurosurgery residents share coverage with the two general surgery residents rotating on the service at any one time, resulting in the neurosurgical resident rotating on a every third to fourth night.   The chief resident is off every other weekend.  Each PGY-2 and PGY-1 resident is off two weekends/month.

At ZLUH the chief resident, two senior residents and a junior resident, provide the coverage. Since this institution does not have an emergency room, no in-house coverage is required.  The residents cover evenings alternatively on a  weekly basis.  Again, the chief resident is off every other weekend with the PGY-2 neurosurgery resident off two weekends/month.  Senior residents are also off every other weekend.

The VA resident takes home call during the week and has every other weekend off.  The resident at CMC, provides coverage  every third week alternating with the two pediatric fellows.   The resident is off-call two out of three weekends. 

The call schedule and coverage is designed to be in compliance with ACGME guidelines for an 80-hour workweek. 

Didactic Conferences

Several mandatory didactic conferences take place weekly and monthly throughout the year. The conferences are mandatory in order to protect the resident's ability to attend. Monthly morbidity and mortality conference features resident presentation of each month's cases, with emphasis on identifying management decision-making processes. Each week surgical spine, tumor and cerebrovascular conferences are held. Residents and faculty bring their challenging cases to discuss operative planning and to participate in resident, student and nurse education. Journal Club occurs monthly and is devoted to a general overview of the month's new literature with focused debate over timely issues.

A visiting professor conference is conducted bi-monthly in which a distinguished professor with national acclaim is featured. Elective surgical activities are suspended to allow for this half-day of lectures. Two lectures are delivered by the guest and additional current topics are presented by the local faculty or senior residents. A few times a year an afternoon session occurs consisting of hands-on training in spine instrumentation with "saw bones" exercises or endovascular training using simulators.

Supervision Policy

please click here to read the updated (03/20/2009) supervision policy (hit back button when finished)

Resident Program Objectives and Goals

please click here to read the updated (03/20/2009) Resident Program Objectives and Goals (hit back button when finished)

Application Process

Medical students interested in obtaining information about or applying for the neurosurgery program at UT Southwestern should contact Ms. Mary Cook at mary.cook@"nospam"utsouthwestern.edu.  (Please remove "nospam" from email address: this is to prevent spiderbots from gathering and using this email address.)

All  applications and related documents must be processed through the Electronic Residency Application Service (ERAS).

Welcome To Our Newest Residents
We are pleased to announce that Dr. Daniel Klinger (UT Southwestern) and Dr. Adam Griffith (UTHSC-San Antonio) have matched with our residency program.  They will begin their residency training in July 2008, by starting their PGY-1 year in general surgery. 

We have accepted Dr. William "Chip" Scott as a PGY-2 resident beginning July 2008.

Fellowships
Fellowships (post-residency additional training) are occasionally offered in cerebrovascular surgery (neurovascular and combined neurointerventional/neurovascular) and in spinal neurosurgery. Interested parties should contact Ms. Cook (mary.cook@"nospam"utsouthwestern.edu) for details. (Please remove "nospam" from address....)

Electives and Preceptorships
Medical students interested in an elective at UT Southwestern in 2004 should apply beginning in March. A copy of your transcripts and CV are required. Space is limited. Contact Mary Cook (mary.cook@"nospam"utsouthwestern.edu) for details. (Please remove "nospam" from address...)
 

UT Southwestern Neurosurgery Residents  -  June 2003

Graduating Residents: Richard Stovall and Vinay Deshmukh
Front Row (L to R): Josheph Beshay, Zeena Dorai, Richard Stovall, Vinay Deshmukh,
Beth Allen, Kelly Schmidt, Debra Steele
Back Row (L to R): Sam Barnett, Talmadge Trammell, Chris Lothes, Atif Haque,
Steve Brown, Shawn Moore, Armen Choulakian

UT Southwestern Neurosurgery Residents  -  June 2002

Front Row: Kevin Morrill, MD, Lee Kern, MD, Sanjay Misra, MD
Back Row: Josh Goldstrich, MD, Chris Lothes, MD, Talmadge Trammell, MD,
Kelly Schmidt, MD, Richard Stovall, MD,Shawn  Moore, MD, Samuel Barnett, MD,
Zeena Dorai, MD, Jeffrey Drees, MD, Tom Psarros, MD
Not Pictured: Vinay Deshmukh, MD,  Debra Steele, MD

last updated: Mar 20, 2009