Residency Program Curriculum

As a PGY-1, you will spend nine months on the Neurosurgery service and three months on electives, which include Neurology, Neuroradiology, and Physical Medicine & Rehabilitation. During this year, one of your main focuses will be building a strong foundation in neurosurgical education. While on service, you will cover inpatient and emergency consults, develop familiarity with the fundamentals of neurosurgical procedures, and participate in caring for operative and non-operative patients. You will also spend significant time in the Neuro ICU, where you will gain experience in neurocritical care and perform key procedures such as placement of external ventricular drains, intracranial pressure monitors, central and arterial lines, intubations, and bronchoscopy. In addition, you will begin your operative training by participating in various neurosurgical operations. The overall goals for your intern year are to develop foundational knowledge of neurosurgical diseases and complications, establish sound surgical judgment, learn pre- and post-operative care principles, and acquire essential early skills in surgical techniques.

As a PGY-2, you will spend the whole year at the University Hospital, where the emphasis is on advancing your fundamental surgical skills, clinical management of neurosurgical patients, and critical care expertise. During this year you transition into the role of an operative resident, gaining early exposure to a broad spectrum of cases in the operating room while learning the core principles of how an OR flows and the neurosurgeon's role beyond ‘cutting and tying.’ You will also begin taking independent in-house call, during which you are responsible for evaluating consults and managing emergent neurosurgical issues (with backup from the on-call Chief Resident). In addition, you will be responsible for covering the Neuro ICU, where you will refine your ability to care for critically ill neurosurgical patients and build confidence in independent decision-making. The year aims to provide an immersive operative and critical care experience that prepares you for progressively greater surgical and clinical responsibility.

The Third year begins the transition to middle-level residency, highlighted by exploring the various neurosurgical subspecialties and significant steps up in independence and responsibility. Over these two years, you will rotate at our internationally recognized Children's Hospital of Colorado (CHCO), the Rocky Mountain Regional Veterans Affairs (VA) hospital, and Denver Health Hospital, Denver’s safety net hospital. You will spend up to six months at CHCO, working alongside the fellow to run the service. You will gain exposure to the full spectrum of pediatric neurosurgery, including fetal surgery, tumors, epilepsy, craniofacial, and spine deformity. Your time at the VA is marked by one-on-one mentorship in spine surgery fundamentals and independently running the service. The VA rotation is typically the first rotation of residency where you are “the Chief” of a neurosurgical service.

During the PGY-4 year, you will spend significant time running a high-volume neurosurgery service at Denver Health. This rotation broadens your horizons to encompass some of the most severe cases of neurotrauma and polytrauma while providing an excellent elective case volume. The rest of the intervening months will be spent at the University, solidifying the fundamentals of neurosurgery while progressively earning more independence and mentoring junior residents. Overall, this curriculum continues the progression of neurosurgical skills and autonomy, exposing you to the breadth of neurosurgery and helping cement your career interests heading into the elective year.

PGY-5 is our dedicated elective year, where residents are encouraged to pursue their academic interests. You will have worked with your mentor and program leadership during the preceding years to develop a plan for this crucial time in your career. We do not believe that residents should be forced into a binary choice of “research or clinical” tracks. In the past, our program has been very flexible in how residents utilize this time. We have supported residents while they pursued advanced degrees (ex, MBA) or clinical training (the first year of an endovascular fellowship), and we were delighted to support a recent graduate - interested in healthcare policy - who obtained a White House Fellowship. We have developed a physician-scientist track (PST) for this academic year. Residents will declare their intent to pursue this during the PGY-3 year and lay the groundwork for a robust research experience during the PGY-5 year. Residents in the PST will work with the department to maintain the momentum of this research year while they complete the PGY-6 Chief Resident year and plan to continue the PGY-5 scholarly work as a PGY-7. We are also incorporating our long-standing collaboration with neurosurgical leaders in Tanzania to develop a global health track within the residency. The University of Colorado also has robust opportunities for device development and healthcare innovation through collaborations on our Anschutz Medical Campus and the ‘mothership’ up in Boulder, where nationally renowned engineering programs are eager for collaboration with physicians.

Whether you want to become a physician-scientist, global health advocate, leader in quality improvement, resident educator, or master surgeon, this is a dedicated year to help you advance your career toward your desired path.

As a PGY-6, you will spend 12 months at the University Hospital acting as Chief Resident. Your responsibilities include staffing consults, mentoring junior residents, making the weekly resident OR schedule, and managing the inpatient service. You will be given significant operative and clinical autonomy as the faculty allows you to ‘run the service.’ Chief residents spend time managing the Cranial, Spine, Vascular, and Functional services throughout the year.

Our PGY-7 year allows residents to develop their niche within neurosurgery further. We call this the ‘Transition to Practice’ year. Residents may choose (in consultation with their mentors and program leadership) to complete an enfolded fellowship or to continue clinical work in areas of interest. Those residents on the ‘Physician Scientist Track’ will continue the scholarly activities from their elective year in a hybrid fashion alongside clinical responsibilities. As we continue to develop residency tracks such as physician-scientist, global health, or healthcare innovation, the PGY-7 year will represent a key opportunity to build your particular interest within neurosurgery further. We believe this will allow every resident to graduate poised to become a leader in the field.