Curriculum Overview/Rotations Over the last five years, with the re-invigoration and growth of the Department, there has been a concerted effort on the part of the Chair and the Program Director, Dr. Howard Silberstein, to restructure and expand the didactic curriculum. This has lead to the designation of Friday as the Resident Academic Day each week. Throughout the morning, different rotating conferences are scheduled, and attendance for residents and faculty is mandatory. Major topics include: 1) Clinical lectures by neurosurgery faculty on topics of interest, including the "How I Do It" describing the favored approach to patient assessment, diagnosis and treatment (surgical or otherwise) of different neurosurgical conditions. 2) Translational research conferences to review a topic of basic science research with direct translational relevance. 3) Neuropathology case conferences to review notable neuropathological cases from the past month's citywide neurosurgical service (important teaching points for the written Boards). 4) Neuroradiology/Neuropathology unknowns: an opportunity for "Socratic" learning of two topics commonly encountered on the written Boards. 5) Clinical neuroanatomy, including hands-on cadaver dissection focusing on peripheral nerves and skull base approaches. 6) Resident clinical lectures, focused on neurosurgery "fundamentals", that allow a resident to delve in depth into a topic and to develop a review resource for all residents in preparation for the Boards (presentations are archived and maintained on a central server). 7) Combined Neurosurgery/Ortho conference. The Departments of Neurosurgery and Orthopaedics Spine Specialists review new initiatives and successes in the management of Spinal tumors, spine and pain disorders. This is an opportunity for the Department, and the residents, to interact and engage in case review and didactic sessions. Highland Hospital Currently an ACGME approved participating site located less than 2 miles from Strong Memorial Hospital, the sponsoring institution. In addition, Highland Hospital is the site for ACGME approved residency programs in Neurology, Medicine, and other supporting disciplines. As dictated in the Program Requirements for Neurological Surgery, (I.B.2. – I.B.3) Highland Hospital functions as a single neurological surgery service under the direction of Dr. Kevin Walter, University of Rochester Medical Center (URMC) faculty member and Chief of Service at Highland Hospital. Dr. Kevin Walter performs surgery at both Strong Memorial Hospital and Highland Hospital and is overseen in his role as local training director by Dr. Howard Silberstein. The PGY-4 neurosurgical resident completes a 6-month rotational block, the resident would be the only resident on service for a smaller community neurosurgery service with three operating faculty members. The resident at Highland Hospital will supervise four PA’s who help with patient rounds, inpatient consults, emergency department consults, and coverage of operating rooms. This resident will also be responsible for taking “home call” on evenings when a department faculty member is on call. This will be very strictly monitored for duty hour compliance by both the local Program Director and the Program Director. Further, weekend call is routinely covered every-other week by a private neurosurgery group and, therefore, will not need to be covered by the Highland Hospital resident. Residents will be able to attend routine conferences and grand rounds both at Highland Hospital and Strong Memorial Hospital. Rochester General Hospital As acknowledged by the RRC in 2006, the program has developed a 6-month PGY-6 rotation at RGH. Rochester General Hospital has busy clinical neurosurgery and neurology programs. Dr. James Maxwell is currently the local PD, with Dr. Silberstein (who also practices at RGH) providing oversight. The resident “runs the team”, performing rounds in the morning and overseeing new inpatient and ED consults with two surgical PA’s who have worked with the neurosurgery service at RGH for over 10 years. This amounts to an additional 6 months of “chief year”, but in a very different environment from the academic medicine environment of URMC; this enriches the perspective that our residents acquire during their training. Rochester General Hospital has 528 acute beds, this teaching hospital offers an array of services provided by a highly trained, dedicated staff. Members of the Department of Surgery and the Division of Neurosurgery work closely with primary care physicians and specialists in other disciplines to effectively manage patients with various diseases and conditions. Department members are also involved in a wide range of clinical research projects and trials. Unity Hospital Unity Hospital is currently an ACGME approved participating site located 8 miles from Strong Memorial Hospital, the sponsoring institution. The faculty in Medicine, Neurology, and other supporting disciplines maintain faculty appointments at URMC, and Unity Hospital participates in training of URMC medical students in neurology and medicine. Unity hospital is a 256-bed full service community hospital located on the “west side” of Rochester, only 12 minutes away from URMC (equivalent in resources and distance from the main training hospital as RGH). Unity has undergone significant renovations within the last two years, with a rebuilt emergency room, a completely new inpatient hospital tower, and expanded capabilities in the OR including new microscopes, frameless navigation, intra-operative monitoring, and endoscopic instruments. Special clinical programs include the newly created Unity Spine Center codirected by Dr. Paul Maurer, Chief of Neurosurgery at Unity and Dr. Mary Dombovy (a Professor of Neurology at URMC with a joint appointment in our Department), an extensive orthopedics joint program, and well established cardiology and interventional cardiovascular services. Unity Hospital is also home to the St. Mary’s Brain Rehabilitation Program, the largest brain rehabilitation program in Monroe County, with extensive connections to URMC (which is the level 1 trauma center for Monroe County). During the 6-month rotation, the PGY-6 resident at Unity would be the only resident on service for a busy community neurosurgery service with three operating faculty members (Drs. Maurer, Girgis and Wensel). The resident at Unity Hospital will work with two nurse practitioners and supervise four PA’s who help with patient rounds, inpatient consults, emergency department consults, and coverage of operating rooms. The Unity resident will also participate in weekly clinic is Dr. Maurer on Thursdays and Fridays, providing the exposure to continuity of care through experience in Dr. Maurer’s clinic. This resident will also be responsible for taking “home call” on evenings when a department faculty member is on call. This will be very strictly monitored for duty hour compliance by both the local site Director and the Program Director. Weekend call is routinely covered every-other week by a private neurosurgery group that has also been present at Highland Hospital (one of our other training sites) and, therefore, will not need to be covered by the Unity Hospital resident. The Unity resident will be able to attend conferences and grand rounds both at Unity Hospital and Strong Memorial Hospital. Visiting Professors The Department sponsors a number of different visiting professors throughout the year. This is a chance for our residents to interact with neurosurgeons of national stature outside of the department, giving them fresh knowledge and perspectives gained from decades of surgical experience and thoughtful inquisition. It is also an opportunity to interact with "big names" socially, at sporting events and dinners scheduled while our visitors are in town.