Cleveland Clinic has a long history of Neurosurgical training, first established in 1929 by Dr. W. James Gardner
A diverse and internationally recognized faculty. The program is a unique, multidisciplinary, completely subspecialized arrangement. This permits resident exposure to both Neurosurgical and non-Neurosurgical expertise with more than 80 full-time neurologist and neurosurgeons. Organized into multi-specialty teams, the center provides comprehensive medical and surgical care for a wide range of neurological based concerns in adults and children, including cerebrovascular disease (stroke, aneurysms and arteriovenous malformation), epilepsy, movement disorders such as Parkinson’s disease and dystonia, metabolic disease, pituitary disorders, brain tumors and spinal concerns. The breadth of Neurosurgery is represented with programs that include Cerebrovascular/Neuro-Endovascular, Complex Spine, Skull-base, Neuro-oncology, Pediatric/congenital/endoscopic, Functional-Restorative, Pain, Peripheral Nerve, and Epilepsy Surgery.
Diverse group of fellows allows support and cross training for residents, while maintaining a strict Resident's first/non-compete operative policy.
All residency training (except a 4-month Neuro-trauma rotation at the PGY 3 level) is completed at a single institution, Cleveland Clinic.
Cleveland Clinic offers one of largest Neurosurgical caseload in the United States. Annual caseload exceeds 4,500+ surgical procedures. This permits a significant resident operative experience, beginning at the PGY-2 level. Residents at all levels typically operate 4 days/week with 1-day spent in a subspecialty clinic specific to the rotation.
Research and Education
Two years of research are required during the PGY-5 and 6 years. This can be used to prepare for a life in a clinical, academic or subspecialty focused neurosurgery. Each individual can use these years to focus on their ‘niche’ in neurosurgery. Cleveland has one of the largest and most diverse conical and research program in the United States.
Part of resident responsibility within the neurosurgery program is to engage in teaching and mentoring of medical students. In addition, residents are given the opportunity to help create the program curriculum.
A unique "Niche-Development" program that allows facilitation and career planning, beginning at the junior resident level, to help residents focus and plan their research and careers.
Cleveland Clinic is on the cutting edge of technology development. New and exciting innovations and technologies are continuously being implemented. Examples include state of the art intraoperative robotics, neuro-endovascular labs, intraoperative MRI, Gamma-Knife, computer assisted surgery including navigation and neuroendoscopy.
Length of Training
The Internship year (PGY1) consists of 6-months of Neurosurgery, 3-months of Neurology, 1-month of Trauma, 1-month of NeuroAnesthesia and 1-month of Plastic Surgery. Of the 6 remaining years, two are focused on research.
Three residents per year are matched. Currently the program has 21 residents and a Non-Categorical Intern program consisting of 3 interns.
- Three chief residents are each responsible for a designated clinical service(s) for a period of 4-months simultaneously.
- Eleven residents are on clinical service during any given month.
- Residents at the PGY2 through PGY4 levels will rotate through the six clinical services:
- Neuro-oncology (tumor)/Skull-base
- During the PGY3 year a resident will rotate through Neuro-Intensive Care Unit and 4-consecutive months at MetroHealth Medial Center (the only regional level-one trauma center). The PGY5 and PGY6 years are spent doing research. The PGY7 year is the Chief (administrative) year.
The main site is Cleveland Clinic (Cleveland, Ohio). It is a 1,130 bed tertiary care, international referral facility. The secondary site is Metro Health Medical Center (Cleveland, Ohio), which is the region's only Level-1 trauma center.
The Department of Neurological Surgery has approximately 19 surgeons on staff. As previously mentioned, the group practice is completely subspecialized. For example, all aneurysms are treated by the cerebrovascular faculty. The staff is actively engaged in basic or clinical research, with the majority having their own basic science laboratory staffed with project scientists, technicians, and/or fellows. Each faculty member has his/her own nurse clinician, nurse practitioner, or physician assistant. The nurses or physician assistants/aid the staff in their individual practice and in the clinic; they do not participate in the operating room. The Department of Neurosurgery and the Neuroscience Nursing Unit jointly employ a full-time certified nurse practitioner (CNP). The CNP role is to aid the residents in admissions, discharges, and daily inpatient management, which are performed on the neuroscience hospital floor.
The "Night Sweeper" is a one-month rotation in which all junior residents rotate through. It covers in-house nightly call (5pm-7am) Sunday (beginning at 5pm) through Thursday. The eleven on-service residents cover Friday through Sunday (until 5pm) on a rotating basis. The result is 2-3 calls per month by each clinical resident. The "Night Sweeper" is a seperate rotation without any daytime responsibility.
- Breakfast and dinner are available for the on-call resident Monday through Friday.
- During the weekend, breakfast, lunch, and dinner are provided while on-call.
- Main cafeteria
- Doctors Dining Room
- Au Bon Pan
- Table 45
- Citrus Room
Table 45 and the Citrus Room are located in the Intercontinental Hotel, which is attached to Cleveland Clinic.
88-Hour Work Week
We are in full compliance with the 88-hour work education week (averaged over 30-days) as mandated by the ACGME. Residents track hours daily in an internet web-based program required by the Graduate Medical Education.
The PGY1 (Internship year) is administered by the Neurosurgery Residency Program. The rotations consist of 3-months of Neurology (NICU and stroke), 6-months of Neurosurgery, 1-month of NeuroAnesthesia, 1-month of Plastic Surgery and 1-month of Trauma (MetroHealth Health Center, level 1 Trauma Center).
Approximate Case Volume
- Spine service: 2000+/year
- Neuro-oncology service (Brain Tumor/Skull-base): 650+/year and 300+/yr gamma knife cases.
- Functional service: 500+/year
- Pediatric service: 150+/year (does not include hydrocephalus cases)
- Epilepsy service: 200+/year (dedicated surgical epilepsy cases).
- Vascular service: 230+/year aneurysms/year (coils and clips).
- Neuro-Endovascular procedures: 400+/year
- Neuro-Cognitive procedures: 250+/year
In 2007, residents assisted approximately 3,000+ cases. As one can see, there are more than enough cases for each resident. Cleveland Clinic is unique in the breadth of Neurosurgery as represented by its faculty. Cleveland Clinic is a tertiary and international referral center and attracts a wide variety and complexity of cases.
Intensive Care Units
Dedicated Neurosurgical Intensive Care Unit and a dedicated Neurosurgical Step-down Care Unit staffed by three full-time Neuro-Intensivists. Neurosurgery patients are cared for on a Neuroscience nursing floor by Neuroscience nurses.
In addition to various weekly conferences, a newly developed didactic lecture series occurs every Friday from 1-4pm. This is time protected for board review, faculty lectures, journal club, resident lectures, resident meetings and skills based lab off site at our Lutheran Hospital spine lab.
Full coverage health and dental insurance are provided. Disability insurance is also included. Scrubs and white coats are provided free of charge. A book fund allowance is provided by the department to all neurosurgery residents. Surgical Loupes are also provided (one time purchase) for the each resident during his/her PGY-1 year. Residents are able to attend one conference if presenting each year funded by Graduate Medical Education (up to $1200.00). The Neurological Institute will fund any conference in which the resident presents clinical or basic research with advanced program approval.
Cleveland Clinic offers a Health Fitness Center on campus at employee reduced rates. The on-campus Library is open 7 days/week. References include 8000+ clinical texts, 900+ journals. Study rooms and computer lab are also available. On-campus parking is available to all Cleveland Clinic medical providers.
Cleveland Clinic is located within 5 minutes of downtown, 10 – 15 minutes from the eastern suburbs and 20 – 30 minutes from most western suburbs (includes airport). Cleveland represents a city that is growing and is an exciting area for young professionals to live. Cleveland has the largest performing arts center in the world outside of New York City. We are fortunate to have University Circle with several museums within walking distance of each other, including the Cleveland Museum of Art. Cleveland is the home of The Rock and Roll Hall of Fame and Museum. The well-known Cleveland Orchestra plays at Severance Hall, which is located only one mile from Cleveland Clinic. We have one of the best park systems in the countries National Park & Recreation Association. Cleveland Browns ‘Fans’ are #1 in pro football and Progressive Field is ranked the #3 ball park in major league baseball.
Cleveland Clinic was ranked among the best in the Nation (#4), U.S.News and World Report.
Created by the Neurosurgery Residents and Staff of the Cleveland Clinic...7/08