What Makes us Unique? Our vision of residency training in Neurosurgery incorporates four components: (1) Acquisition of core technical operative skills in the early years of residency. Over the past five years, our department has recruited eight new clinical faculty and now covers all areas of general and subspecialty neurosurgery practice. (2) Research at the frontiers of translational Neurosurgery made possible by research faculty recruitment, which has brought to our Department leaders in the search for new therapies for Neuroscience diseases. (3) Creation of a positive educational experience based on a new core educational and didactic curriculum, which addresses all of the competencies of Neurosurgical practice over the six years of residency, as well as a collegial training environment that fosters resident growth and maturation. This has included a restructuring of the entire service to embrace the 80-hour work week. (4) Preparation for practice and leadership in the evolving arena of Neuroscience Medicine. The future of neurosurgery will embrace multidisciplinary disease management approaches, will emphasize measures of quality and cost effectiveness of neurosurgical care, and will irrevocably transform current practice models in our specialty. Our Department has already created programs and partnerships which will serve to help residents preparing for change.