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Each resident is required to spend a minimum of 42 months in clinical neurosurgery throughout the six-year program. The typical rotation sequence is listed below.

Postgraduate Year 1 (PGY-1)

PGY-1 neurosurgery residents spend three months on the medical neurology service and three months on the neurology and neurosurgery intensive care service. Additionally, residents spend five months of structured education in general patient care, including rotations on the neurology and neurosurgery intensive care service (three months), otorhinolaryngology surgery (one month) and plastic surgery (one month). The final four months of PGY-1 involve two months of neurosurgery with the department chair and two months of spinal neurosurgery. Additionally, during the PGY-1 year residents are required to complete basic bronze-level training in the Mayo Quality Academy.

By the end of the first year, residents should have a basic understanding of neurological disease and be competent to perform a neurological history and examination. Residents should also have a strong knowledge base for evaluating and caring for critically ill patients in the intensive care unit. During PGY-1, residents also perform basic neurosurgical procedures, including placement of external ventricular drains, laminectomy exposures and basic craniotomies. The first year lays the foundation for the knowledge and basic skills required for a successful career in neurosurgery.

Postgraduate Year 2 (PGY-2)

During the second year, neurologic surgery residents spend two months on the medical neurology intensive care service. One month includes training in electroencephalography (EEC) and electromyography (EMG). Residents spend nine months working one-on-one with staff neurosurgeons as first assistant in the operating room and caring for patients in the inpatient and outpatient settings on the neurosurgical spine service (three months), neurosurgical cranial service (three months) and neurosurgical cerebrovascular service (three months). During the cerebrovascular service rotation, residents participate in neurosurgery endovascular procedures.

During PGY-2 and PGY-3, residents take the American Board of Neurological Surgery (ABNS) written examination for practice.

Postgraduate Year 3 (PGY-3)

During the third year, residents spend two months in neuroradiology and one month in neuropathology, followed by nine months assigned to quarterly rotations on the neurosurgical services of various consultants. The subspecialty neurosurgery groups of spine (three months), cranial (three months) and cerebrovascular (three months) offer the opportunity for strong teaching relationships, as residents work with no more than three neurosurgeons during each rotation.

During PGY-3, residents' surgical skills advance significantly as they perform critical parts of operations with staff neurosurgeons.

A didactic neuroscience course held January through April helps residents prepare to take and pass the ABNS written examination during PGY-4.

Postgraduate Year 4 (PGY-4)

During PGY-4, residents receive four months of training in pediatric neurosurgery at Wolfson Children’s Hospital in Jacksonville, Fla. Two months are available for elective rotations in neurosurgery based on individual clinical or research interests. Additionally, PGY-4 residents participate in neurosurgical trauma and peripheral nerve surgery during a six-month rotation to Mayo Clinic in Rochester, Minn.

Postgraduate Year 5 (PGY-5)

During PGY-5, residents may tailor their neurosurgical experience based on their clinical and research interests. A minimum of three to a maximum of nine months are available for elective rotations on neurosurgical services or research projects with an identified mentor, approved by the department chair. Residents may choose clinical research projects that allow them to pursue a clinical-investigator training program or a master's degree.

Post-Graduate Year 6 (PGY-6)

During the final 12 months of the Neurologic Surgery Residency, chief residents have responsibility for managing their own clinical service as junior faculty members. They perform the role of primary surgeon with their own roster of complex elective cases. Chief residents are also given the opportunity to rotate for three to six months with senior faculty to acquire additional expertise in areas of subspecialty training such as spine, cerebrovascular, endovascular, tumor, epilepsy, skull base or stereotactic surgery.

Rotation schedule

  • Adult neurology (1 mo.)
  • Pediatric neurology (1 mo.)
  • Neuro-ophthalmology (1 mo.)
  • Neurology critical care in the ICU (3 mo.)
  • ENT (1 mo.)
  • Plastic surgery (1 mo.)
  • Spine neurosurgery (2 mo.)
  • Cranial neurosurgery with the department chair (2 mo.)
  • EMG and EEG (1 mo.)
  • Neurology critical care in the ICU (2 mo.)
  • Cerebrovascular neurosurgery (3 mo.)
  • Spine neurosurgery (3 mo.)
  • Cranial neurosurgery (3 mo.)
  • Neuroradiology (2 mo.)
  • Neuropathology (1 mo.)
  • Spine neurosurgery (3 mo.)
  • Cranial neurosurgery (3 mo.)
  • Cerebrovascular neurosurgery (3 mo.)
  • Pediatric neurosurgery (4 mo.)
  • Elective (2 mo.)
  • Neurotrauma neurosurgery (3 mo.)
  • Peripheral nerve neurosurgery (3 mo.)
  • Spine neurosurgery (3 mo.)
  • Cranial neurosurgery (3 mo.)
  • Cerebrovascular neurosurgery (3 mo.)
  • Elective neurosurgery (3 mo.)
  • Chief resident of neurosurgery (12 mo.)

Didactic training

Required neurosurgery conferences are held twice a week. They include:

  • Neurosurgery spine
  • Neurosurgery cranial
  • Journal club
  • Morbidity and mortality
  • Neurovascular
  • Neuropathology
  • Neuroradiology
  • Epilepsy

In addition to these teaching conferences, residents attend a basic neuroscience course that provides additional didactic neuropathology training, offered January through April during PGY-3.

Research training

There is sufficient elective time for residents to participate in research projects of interest. During PGY-2, PGY-3, PGY-4 and PGY-5, residents are required to submit one manuscript for publication a year. Residents are encouraged to submit abstracts for oral presentations at national neurosurgical meetings, as well. The department supports a minimum of one trip a year for each resident for presentations at national neurosurgical meetings.

Call frequency

Resident in-house call coverage is limited to a maximum of one in-house 24-hour coverage every two weeks.


Quality of didactic and clinical education is monitored in several ways. First, all conference attendees are asked to complete an email survey evaluating the conferences. Second, residents complete a structured evaluation of their educational experience on a quarterly basis.

During resident orientation, the program director reviews the performance criteria on which residents are evaluated. Throughout the residency, the program director meets with residents individually each quarter to review ongoing performance expectations and criteria used to evaluate performance, and to review their educational experience.

The program director meets annually with evaluators (faculty and support staff) to review the program's competencies, goals, objectives and curriculum. The program director outlines the criteria used to evaluate residents, the tools and resources to be used for each assessment method, and provides support and feedback during the evaluation process. Evaluators use an automated, Web-based Integrated Scheduling and Evaluation System (ISES) to provide resident evaluations.

  • Feb 3, 2012
  • ART150745