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http://my.clevelandclinic.org/neurological_institute/education/neurosurgery_overview.aspx
Introduction
The neurosurgical residency program of the Cleveland Clinic is located at the hospital’s main campus, an 1100-bed hospital, just east of downtown Cleveland, Ohio. The Cleveland Clinic serves as a major tertairy-care referral center for Northeast Ohio and Western Pennsylvania, as well as for patients from around the country and world. The Clinic is one of the largest nonprofit hospital systems in the country, with over 30,000 employees at a number of hospitals, and revenues of nearly $5 billion per year.
The teaching faculty includes 18 neurosurgeons, 1 orthopedic spine surgeon, and 2 interventional neuroradiologists. We have a 16-bed dedicated neurological/neurosurgical ICU and a 12-bed stepdown unit. In 2006, the service performed over 4,500 major procedures (including angio).
Program Structure
The residency program has full RRC accreditation and accepts 3 residents per year.
PGY-1: Beginning with the 2007-08 academic year, the Department of Neurosurgery is assuming full control of the intern year from the Department of General Surgery. As an intern, you will complete a 3-month rotation on the neurosurgery service, as well as the surgical and ICU rotations which have consistently had the highest educational value in recent years (as determined by our interns).
PGY 2-3-4: As a junior resident, you will rotate through the 7 inpatient neurosurgical services at the CCF main campus. You will assume significant responsibility for the management of floor and ICU patients. Additional rotations include:
-NICU service (with the four attending neurointensivists who participate in management of all NICU patients)
-MetroHealth (Cleveland’s only ACS level 1 trauma center)
-night sweeper (see below)
PGY 5-6: Traditionally these are the research years, but there is considerable flexibility in the curriculum. See below.
PGY 7: As a chief resident, you will have a supervisory responsibility for several services, and generally spend 4 days per week operating. The chief residents are also responsible for assigning cases and supervising the residents and clinical fellows.
Academic Niche Development
In an effort to allow residents to create a unique area, or ‘niche’ within the neurosurgical community, the AND program was introduced several years ago. The assumption is that some, but not all, residents will ultimately benefit from participation in basic science research. Several residents have elected to complete the first year of an endovascular fellowship during PGY-5 and the second year during PGY-7, and the chief year as a PGY-6. This has allowed them to finish a neurosurgical residency and train fully as endovascular neurosurgeons in 7 years. Other in recent years have done the following:
-Tumor biology/basic science research (2 years)
-Political fellowship in Washington DC (1 year)
-Ortho/neuro spine fellowship (1 year) and biomechanics research (1 year)
-epilepsy fellowship (1 year) and epilepsy research (1 year)
-traveling spine fellowship (3 months) and spinal cord injury research (21 months)
Other allowable uses include the pursuit of an advanced degree (MBA, JD, etc.). Basic and clinical research opportunities are available in all areas of neurosurgery as well.
Call
We have received the ACGME 10% extension to allow an 88-hour workweek. In order to meet this, we have implemented a nightsweeper system. You will spend a total of 4 months on this rotation during the PGY 2-4 years (generally not consecutively). The nightsweeper is on duty from 5PM to 7AM, Sunday through Thursday, and off-duty from 7AM Friday to 5PM Sunday.
Weekend junior call is assigned with a bias toward PGY-2’s taking more and PGY-4’s taking less. All residents have (at least) two full weekends per month free of call.
Chief call is shared among the chiefs. The research residents are expected to take 3-4 weekends of chief call per year, and this is compensated at $600 per weekend.
Benefits
The department will buy your loupes at the end of PGY-1 (generally about $1500). Beginning in 2007, several books will be provided to all entering interns (the list is not yet finalized, but will likely include Greenberg, and Osborne’s DCA). An escalating book allowance provides over $500 to the junior residents per year, and over $1000 to the research and chief residents per year.
Meetings
At the PGY-3 level or higher, the department will pay for one meeting per year. The department will pay for any meeting at which a resident is presenting a poster or talk. Our residents attend the RUNN course at Woods Hole as juniors as well.
Vacation
Three weeks per year, plus an additional several days off over Christmas or New Year’s. Residents in their final year of training receive an additional 5 business days for interview time.
Visiting subinternships
We offer a visiting subinternship geared towards 4th-year medical students planning on a career in neurosurgery. This visiting sub-i is not required to interview or match at the program, but historically many of our residents have rotated here as medical students. If you are interested, please contact Rodina Bizri, the medical student coordinator, at bizrir@ccf.org or (216) 444-6632.