Clinical training
As a resident, you will be required to spend a minimum of 54 months of clinical neurosurgery training prior to graduation. A unique feature of the neurosurgery training at Mayo Clinic is our mentorship model, in which residents complete dedicated clinical rotations working one-on-one with each faculty member for two-month intervals. This provides for the development of a longitudinal relationship between the resident and staff, as well as an opportunity for true immersion in a particular practice model, and complete continuity of care for the patients and families on those services.
The typical rotation sequence for junior residents is:
PGY-1
The first year is expected to lay the foundation of knowledge and skills required for a superlative career in neurosurgery. You will rotate with the medical neurology services, neurosciences ICU, critical care service ICU, and neuro-anesthesia service. You’ll also spend ample time in the OR as second assistant on the neurosurgery chief resident service and the combined services of Jamie Van Gompel, M.D. and Frederic Meyer, M.D., the executive dean of education for Mayo Clinic College of Medicine and Science.
By the end of this first year, you will have a basic understanding of neurological disease and be competent to perform a neurological history and examination. You will have a strong knowledge base for evaluating and caring for critically ill patients in an intensive care setting. In addition, you will have performed basic neurosurgical procedures including intracranial pressure (ICP) monitor placement, external ventricular drain, laminectomy exposures, and basic craniotomies.
PGY-2
During this year, you will spend additional time in the ICU as well as serve a junior role on the neurosurgery chief resident service. You will also work one-on-one with staff neurosurgeons as a first assistant for stereotactic, functional, and peripheral nerve procedures.
PGY-3
You are assigned to rotations on the clinical neurosurgery services of the various neurosurgery consultants during your third year. It is expected that during this time, depending on your individual skill set, you will perform critical portions of each operation with the staff surgeon serving as an assistant and coach. Therefore, your surgical skills improve dramatically during this year. It is also expected that you will better define your clinical interests and begin to formalize your career goals. PGY-3 rotations concentrate on spine, intra-axial brain tumors, peripheral nerve, and epilepsy.
PGY-4
Over the course of fourth year, residents typically complete additional rotations on complex cranial, complex spine, cerebrovascular, skull base, and endovascular surgery.
A formal, required curriculum of skull base, microvascular, and peripheral nerve techniques is simultaneously completed, both to facilitate anatomic study and to prepare you for senior-level roles. Final planning decisions are made for upcoming career development years.
Elective time
Two years of dedicated elective time are afforded for research and career development during senior residency (PGY-5, PGY-6, PGY-7). Dedicated laboratory research, enfolded fellowships, visiting electives, and the acquisition of advanced degrees are common academic pursuits during this time. Flexibility and adaptability to the needs of each individual resident's career are emphasized.
For residents who are pursuing a one- or two-year research block, application for a Neurosurgery Research and Education Foundation (NREF) training grant is highly encouraged. If basic research is chosen, a research plan should be developed the preceding year with a mentor identified. Clinical research projects also may be chosen, and potentially pursued, via the Clinician Investigator Training Program or a master's degree. Additional provisions are allowed for residents desiring to expand their training by an additional year or longer to obtain a doctorate in neurosciences through Mayo Clinic Graduate School of Biomedical Sciences.
The emphasis during the research year is on the development of critical scientific methodology and the production of meaningful contributions to basic science or clinical knowledge. For those pursuing additional clinical neurosurgery training, the goal is to develop advanced surgical training in a subspecialty area of interest.
Within these two years, both research and advanced clinical training can be combined. Furthermore, you are strongly encouraged to rotate to Mayo Clinic in Jacksonville, Florida, or Phoenix/Scottsdale, Arizona, for advanced clinical training, notably in endovascular surgery, complex adult spine surgery, or minimally invasive spine surgery.
External Rotations
Another key aspect of our program is the ability to rotate at other sites during your time in the program. We have ACGME-approved rotations established at Phoenix Children's Hospital, Wolfson Children’s Hospital, and both Mayo Clinic campuses in Arizona and Florida. Mayo Clinic fully funds all incumbent costs, including travel, housing, automobile rental, and licensure fees for these rotations.
You can also pursue elective rotations at non-Mayo affiliated programs/sites. Program support is provided to assist you in coordinating these rotations with ACGME and the ABNS to ensure the rotation provides significant educational merit and qualifies for credit toward board certification.
Enfolded Fellowships
Opportunities for enhanced training in a subspecialty area can be enfolded within the curriculum during PGY-7. Affiliated programs within Mayo Clinic's Department of Neurologic Surgery in Rochester, Minnesota, include the following:
- Complex Spine
- Oncology
- Peripheral Nerve
- Critical Care
- Skull Base Oncology
Chief residency
The capstone of our program is the chief resident experience. Trainees spend 12 months during either PGY-6 or PGY-7 running an independent service in a transition-to-practice role taking on the privilege of responsible patient management and patient care in a one-to-one relationship with the patient.
The chief residency allows senior trainees to function as junior faculty with the privileges of an autonomous starting operating room in which they are the primary surgeons. Chief resident cases are booked on an elective basis from their own active clinical practices. Further, the chief residents manage all emergency neurosurgery cases and in-house consultations, providing for consultant-level decision-making and management across the full breadth of neurosurgery. This experience is unique among training programs and is perhaps the greatest strength of our singular training program.