Curriculum

Each resident is required to spend a minimum of 54 months in clinical neurosurgery throughout the seven-year Neurologic Surgery Residency. Our academic year follows a four-week, 13-month block rotation schedule.

Rotation schedules

PGY-1

RotationLength
Adult medical neurology 1 month
Chief Resident Service 1 month
Neuro-ophthalmology 1 month
Neurology critical care (ICU) 3 months
ENT 1 month
Plastic surgery 1 month
Spine neurosurgery 2 months
Cranial neurosurgery (with department chair) 3 months
Any neurosurgery service 1 month

Additionally, during the PGY-1 year, residents complete basic bronze-level training in the Mayo Clinic Quality Academy.

In July, PGY-1 neurosurgery residents are required to attend a two-day Intern Bootcamp course put on by the Society of Neurological Surgeons (SNS). The SNS has created these training courses to take place at six different sites and the standard curriculum is approved by the ACGME and also serves as models in training for all medical specialties. This course addresses ACGME Level 1 and 2 Milestones for residents to ensure PGY-1 residents achieve these needed milestones and beyond. Through didactic sessions in small groups and practical hand-on simulations, you are exposed to a variety of bedside procedures essential for their basic training.

By the end of the first year, you should have a basic understanding of neurological disease and be competent to perform a neurological history and examination. You should also have a strong knowledge base for evaluating and caring for critically ill patients in the intensive care unit. The residents are also required to attend a two-day Junior Bootcamp course put on by the SNS. Junior Bootcamp: Introduction to the Operating Room and Leadership and addresses Level 1 and 2 Milestones for Residents to ensure PGY-1 residents achieve their Milestones. Using specimens, simulators, and didactic lectures, the course will teach the following competencies: professionalism and leadership, communications, patient care, technical skills, basics of cranial and spinal neurosurgery, and system-based practice/practice-based learning: quality improvement.

During PGY-1, you 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.

PGY-2

RotationLength
Clinical neurophysiology 2 months
Neurology critical care (ICU) 1 month
Cerebrovascular neurosurgery 3 months
Spine neurosurgery 3 months
Cranial neurosurgery 3 months
Any neurosurgery service 1 month 

During the second year, you 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, you participate in neurosurgery endovascular procedures.

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

PGY-3

RotationLength
Neuroradiology 2 months
Neuropathology 1 month
Spine neurosurgery 4 months
Cranial neurosurgery 3 months
Cerebrovascular neurosurgery 3 months
Any neurosurgery service 1 month

During the third year, you spend two months in neuroradiology and one month in neuropathology, followed by rotations in the subspecialty neurosurgical services of various consultants.

The subspecialty neurosurgery groups of spine, cranial, and cerebrovascular offer the opportunity for strong teaching relationships, as you work with no more than three neurosurgeons during each rotation.

During PGY-3, your surgical skills advance significantly as you perform critical parts of operations with staff neurosurgeons.

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

PGY-4

RotationLength
Pediatric neurosurgery 4 months
Neurotrauma neurosurgery 5 months
Peripheral nerve neurosurgery 3 months
MCF neurosurgery service 1 month

During PGY-4, you receive training in pediatric neurosurgery at Wolfson Children's Hospital in Jacksonville, Florida. You participate in peripheral nerve neurosurgery during a rotation to Mayo Clinic's campus in Rochester, Minnesota, and participate in a neurotrauma rotation at UF Health Jacksonville.

During PGY-4, residents take the American Board of Neurological Surgery (ABNS) written examination for credit with a minimum of 70% passing rate or higher before being qualified for the chief resident year.

PGY-5

RotationLength
Enfolded fellowship, research, elective 13 months

During PGY-5, you may tailor your neurosurgical experience based on your clinical and research interests. A minimum of three to a maximum of 13 months are available for elective rotations on neurosurgical services or research projects with an identified mentor, approved by the department chair.

You may choose clinical research projects that allow you to pursue the Clinician-Investigator Training Program or a master's degree.

PGY-6

RotationLength
Enfolded fellowship, research, elective 13 months

PGY-6 is dedicated entirely to your electives.

PGY-7

RotationLength
Chief resident in neurosurgery 13 months

During the final 13 months of the Neurologic Surgery Residency, you have responsibility as chief resident for managing your own clinical service as junior faculty members. You perform the role of primary surgeon with your 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.

Call frequency

Your in-house call coverage is typically one in-house 24-hour coverage shift every two weeks. Mayo Clinic follows the recommendations of the Accreditation Council for Graduate Medical Education (ACGME).

Didactic training

Required neurosurgery conferences include:

Every day:

  • Morning chief rounds

Monday:

  • Neuroscience-Neurosurgery Lecture Series 
  • Epilepsy Case Conference
  • Spine Working Conference
  • Neuro-Oncology Working Conference

Tuesday:

  • ABNS Board Review

Wednesday:

  • Words of Wisdom - Case Discussions

Thursday:

  • Neurovascular Stroke Education Lecture Series

Friday:

  • Neuro-Oncology Skull Base Multimedia Teaching Series

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

Research training

During your residency, you have sufficient elective time to participate in research projects of interest. During PGY-2, PGY-3, PGY-4 and PGY-5, you are required to submit one manuscript for publication a year. You 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.

Teaching opportunities

Neurosurgery residents have the opportunity to teach Mayo Clinic Alix School of Medicine students and visiting student from other medical schools, through bedside instruction, formal didactic lectures, and voluntary participation in the anatomy curriculum.

Evaluation

Quality of didactic and clinical education in the Neurologic Surgery Residency is monitored in several ways. You complete a structured evaluation of your educational experience on a quarterly basis.

During resident orientation, the program director reviews the performance criteria on which you are evaluated. Each resident is assigned a faculty mentor who has volunteered to help guide the resident through their residency. In addition, the program director meets with you individually each quarter to review ongoing performance expectations and criteria used to evaluate performance, and to review your 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 MedHub to provide resident evaluations.