Curriculum in Detail

Important note: There is a degree of flexibility within the curriculum, so changes may be made to best suit each individual resident.

Year 1: General Surgical Internship

The first year of postgraduate training in spent under the auspices of the department of general surgery. For 10 months the trainee functions as a surgical intern on services such as vascular surgery, general surgery, hepatobiliary surgery, trauma/emergency surgery, urology, head and neck surgery, and plastic surgery. Rotations are conducted at UCLA-Westwood campus, UCLA-Santa Monica campus, West LA-Veterans Administration, and LA County-Olive View Medical Center. Time is spent managing surgical inpatients, conducting outpatient evaluations in clinic, and performing as first-assistant in general surgery operations. Skills learned during the year include the management of the critically ill/ICU patient, trauma management and assessment, and basic surgical technique. Two months during the internship are spent on the neurosurgery service, both at the Westwood and VA campuses. Acceptance into the internship is automatic with acceptance into the neurosurgery program.

Year 2: Clinical Neurosurgery Junior

The second year of postgraduate training is spent entirely at the UCLA-Westwood campus, where the trainee functions as the neurosurgery junior resident under the supervision of the chief resident, two senior residents, and the faculty. Responsibilities include performing histories and neurological exams on all newly admitted patients and consultations, performing ICU/Critical Care related activities (central venous access, arterial lines, Swan-Ganz catheterization, ventriculostomy, bedside subdural drain placement), and assisting in the operating room in neurosurgical operations. Junior residents typically have 2-3 days a week assigned to the OR to do cases with attendings. Due to the high caseload, double-scrubbing is relatively uncommon and the junior resident acts as first assistant on the majority of assigned cases. Skills attained throughout the year include the management of the critically ill neurosurgical patient, performance of all bedside procedures, basic operative neurosurgical technique, development of neurological diagnosis and formulation of treatment plans for all new consultations and ED admissions.

Year 3: Clinical Neuroscience and Neurosurgery Electives

The third year of postgraduate training is spent rotating through various electives in both clinical neurosurgery and the neurosciences. During this year the neurosurgical written boards are taken for practice.

Two months are spent on the neuropathology service, where responsibilities include attending all signout sessions of slides, attending relevant autopsies and brain cutting sessions, and attending neuropathology lectures. During this time experience is developed in identifying gross and microscopic neuropathologic specimens, and an emphasis is placed on reviewing neuroanatomy. At the end of this rotation a short lecture is given by the neurosurgery resident on a neuropathology area of interest.

Two months are spend on the neuroradiology service, where responsibilities include attending all reading sessions. Ample time is given during this rotation for self-study of neuroradiology and neuroanatomy.

Two months are spend on the endovascular service, where responsibilities include attending and participating in diagnostic angiography as well as interventional therapy for aneurysms, AVMs, AV fistulas, and stroke. Lectures are frequent and emphasis is placed on learning the art of reading and interpreting diagnostic angiograms.

Three months are spend on the neurology service, where responsibilities include issues related to the assessment and management of the patient with non-surgical neurological disease.

The remaining three months are spent on the functional/stereotactic surgery and radiosurgery service under Dr. Antonio DeSalles, where responsibilities include managing the clinical functional/stereotactic service, planning and performing all radiosurgery, and planning and performing functional/stereotactic procedures including but not limited to deep brain stimulation, motor cortex stimulation, stereotactic surgery and biopsy, and single electrode stimulation. Dr. DeSalles is currently involved in cutting edge functional procedures for behavioral modification as well.

Throughout the year, surgical skills are kept well honed through coverage at Harbor-UCLA 3-4 shifts a month. This experience provides the developing resident to manage complex patients with increasing autonomy, to sharpen clinical skills and to better understand the decision making process.

Years 4-5: Clinical Neurosurgery Senior

The fourth and fifth years of postgraduate training are spent as senior clinical resident on the three major neurosurgical services at Harbor, UCLA-Westwood, and UCLA-Santa Monica. Responsibilities include supervision and education of junior residents and interns, supervision of the management of neurosurgical patients in the ICU and on the wards, and performing all major neurosurgical operations (both elective and emergent) under attending supervision. Extensive experience is gained in neurosurgical trauma operations during rotations at Harbor and UCLA-Westwood. All aspects of neurosurgical operations are learned during the year, including tumor, vascular, skull base, peripheral nerve, spine, epilepsy (adult and pediatric) and pediatric. A dedicated four-month rotation is spent performing all aspects of advanced spine surgery at UCLA-Santa Monica. Key skills attained during this time include all aspects of management of the neurosurgical patient, the ability to supervise other residents and run a clinical service, and the ability to function as an autonomous surgeon in the operating room. During this time the neurosurgical boards are taken for credit.

Year 6: Academics (Research, Elective)

The sixth year of postgraduate training in spent during research in one of the many neuroscience laboratories throughout UCLA. The neurosurgical program has particularly strong ties to neurotrauma and neuro-oncology research, so many residents elect to spend their time in one of these labs. That being said, UCLA has an extremely large neuroscience community with all aspects of neuroscience represented. The purpose of this time is to develop a relevant research interest to the resident's career plans and learn the techniques necessary to carry out the research beyond residency. Faculty mentors are available to help the resident model an academic career. The ability to write grants and achieve autonomous funding is also developed during this time.

Year 7: Clinical Neurosurgery Chief Resident

The final year of postgraduate training is spent rotating through the VA hospital, Harbor, and UCLA Westwood as administrative chief resident. The responsibilities include education of the other residents, overall supervision of the neurosurgical service, all administrative duties related to the residents, and performance of all advanced neurosurgical cases (with an emphasis on vascular and skull base surgery).

Additional Benefits

The Ronald Reagan UCLA Medical Center provides you and your family with medical, dental and vision insurance plans at no cost to you. In addition life and long-term disability insurance is provided to UCLA House Staff residents at no cost.

Health plan: With few exceptions, all healthcare you need during your residency is covered by UCLA. All prescriptions are free for residents as long as they are obtained through the UCLA pharmacy. Typically, any additional medical bills received are submitted to the UCLA postgraduate education office where they are reimbursed.

Dental plan: Residents are covered the Prudent Buyer Dental plan, with $50 deductible and coverage of 50-100% of all participating dentists' bills (most are 80-100% except for orthodontics and prosthedontics).

Vision plan: VSP has made arrangements with numerous optometrists and ophthalmologists (who are called "VSP Panel Doctors") to provide certain vision care services to the resident and their covered dependents. Panel doctors bill VSP directly, so you have limited out-of-pocket costs for covered services and materials (except for the $10 deductible and an additional $25 if the doctor prescribes lenses or frames, or both; contact lenses will cost more).

Meals: Each resident is given an amount of money on their meal card proportional to the amount of in-house call they are taking. Usually this money is sufficient to allow residents to purchase all of their meals during the academic year.

A yearly book fund is typically provided for the residents around the holidays. In the past, several board-review books and Youman's Neurological Surgery have been bought for the senior residents as well. UCLA also provides residents with pagers, laboratory coats, scrubs, and prescription surgical loupes. A private, 2-bed call room for neurosurgery with private bathroom is adjacent to the neurosurgery offices. The neurosurgery resident office contains 7 networked computers as well as a neurosurgical library and private chief resident's office.

UCLA Neurosurgery

UCLA Neurosurgery