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, 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. Throughout training, residents will be aided by neurosurgical clinicians at Parkland Hospital, Zale Lipshy University Hospital, Children’s Hospital and the VA.