Thread Rating:
  • 0 Vote(s) - 0 Average
  • 1
  • 2
  • 3
  • 4
  • 5
PGY2/3 Operative Experience
#1
How is everyone's junior operative/call experience organized? Split between OR and taking the consult pager, independence in OR, etc?
Reply
#2
(07-23-2020, 01:49 PM)Guest Wrote: How is everyone's junior operative/call experience organized? Split between OR and taking the consult pager, independence in OR, etc?

Not sure about everyone else, but we have our PGY2 with 12 months of consults (6-5) split evenly between the 2nd years (4 months each), of which the rest of the year you are in the OR. Overnight cases that come in you do alone with the attending which is nice, we get comfortable pretty quickly in the OR. Daily PGY2 cases would be a double scrub you and the chief alone doing simple to complex spine/cranial tumor/skull base. 2s generally have battery changes, DBS, and shunt revisions to themselves with attendings alone. We also cover the translabrynthines/middle cranial fossas for acoustics, and the endovascular suite which is pretty busy (but mostly getting access, then standing around while the adults work lol).

We are encouraged on the simple operative cases to become independent early, with the idea that they are an introduction to the OR. As the year goes on you get to do more and more by yourself. The consensus has been that the most terrifying but fastest experience progression for us have been the overnight cases - 2s take the most overnight call, and operative cases that come in overnight you do with just you and the attending, chiefs do not come in for cases unless you have multiple going simultaneously. Hematoma evacs, multilevel spine traumas, acute paralysis from a spine tumor -> Transpedicular decompression, instrumentation, fusion with just the attending is really nice for getting good, quickly. 

3rd year we are the floor chiefs, and we do not take consults during the day. 3rd year is about independence in the OR. No double scrubbing as a 3 which is nice. Primary cases are ACDFs, posterior cervicals, laminectomies, TLIFs, ALIFs, Laterals, hematomas, and craniotomies depending on the chiefs' interests (can be awake glioma/oligo craniotomy with the attending vs simple extra-axial meningiomas). Again, none of these are doubled. VA is split between the 3s as well, and you do it in a block. VA is the VA, attendings don't scrub in with the point being to make you really struggle so that you become comfortable.
Reply
#3
(06-21-2021, 05:24 PM)Blue Fire Wrote:
(07-23-2020, 01:49 PM)Guest Wrote: How is everyone's junior operative/call experience organized? Split between OR and taking the consult pager, independence in OR, etc?

Not sure about everyone else, but we have our PGY2 with 12 months of consults (6-5) split evenly between the 2nd years (4 months each), of which the rest of the year you are in the OR. Overnight cases that come in you do alone with the attending which is nice, we get comfortable pretty quickly in the OR. Daily PGY2 cases would be a double scrub you and the chief alone doing simple to complex spine/cranial tumor/skull base. 2s generally have battery changes, DBS, and shunt revisions to themselves with attendings alone. We also cover the translabrynthines/middle cranial fossas for acoustics, and the endovascular suite which is pretty busy (but mostly getting access, then standing around while the adults work lol).

We are encouraged on the simple operative cases to become independent early, with the idea that they are an introduction to the OR. As the year goes on you get to do more and more by yourself. The consensus has been that the most terrifying but fastest experience progression for us have been the overnight cases - 2s take the most overnight call, and operative cases that come in overnight you do with just you and the attending, chiefs do not come in for cases unless you have multiple going simultaneously. Hematoma evacs, multilevel spine traumas, acute paralysis from a spine tumor -> Transpedicular decompression, instrumentation, fusion with just the attending is really nice for getting good, quickly. 

3rd year we are the floor chiefs, and we do not take consults during the day. 3rd year is about independence in the OR. No double scrubbing as a 3 which is nice. Primary cases are ACDFs, posterior cervicals, laminectomies, TLIFs, ALIFs, Laterals, hematomas, and craniotomies depending on the chiefs' interests (can be awake glioma/oligo craniotomy with the attending vs simple extra-axial meningiomas). Again, none of these are doubled. VA is split between the 3s as well, and you do it in a block. VA is the VA, attendings don't scrub in with the point being to make you really struggle so that you become comfortable.

Thanks for sharing. Who takes day call if the pgy2s take nights and PGY3 only do floor?
Reply
#4
(06-21-2021, 07:07 PM)Guest Wrote:
(06-21-2021, 05:24 PM)Blue Fire Wrote:
(07-23-2020, 01:49 PM)Guest Wrote: How is everyone's junior operative/call experience organized? Split between OR and taking the consult pager, independence in OR, etc?

Not sure about everyone else, but we have our PGY2 with 12 months of consults (6-5) split evenly between the 2nd years (4 months each), of which the rest of the year you are in the OR. Overnight cases that come in you do alone with the attending which is nice, we get comfortable pretty quickly in the OR. Daily PGY2 cases would be a double scrub you and the chief alone doing simple to complex spine/cranial tumor/skull base. 2s generally have battery changes, DBS, and shunt revisions to themselves with attendings alone. We also cover the translabrynthines/middle cranial fossas for acoustics, and the endovascular suite which is pretty busy (but mostly getting access, then standing around while the adults work lol).

We are encouraged on the simple operative cases to become independent early, with the idea that they are an introduction to the OR. As the year goes on you get to do more and more by yourself. The consensus has been that the most terrifying but fastest experience progression for us have been the overnight cases - 2s take the most overnight call, and operative cases that come in overnight you do with just you and the attending, chiefs do not come in for cases unless you have multiple going simultaneously. Hematoma evacs, multilevel spine traumas, acute paralysis from a spine tumor -> Transpedicular decompression, instrumentation, fusion with just the attending is really nice for getting good, quickly. 

3rd year we are the floor chiefs, and we do not take consults during the day. 3rd year is about independence in the OR. No double scrubbing as a 3 which is nice. Primary cases are ACDFs, posterior cervicals, laminectomies, TLIFs, ALIFs, Laterals, hematomas, and craniotomies depending on the chiefs' interests (can be awake glioma/oligo craniotomy with the attending vs simple extra-axial meningiomas). Again, none of these are doubled. VA is split between the 3s as well, and you do it in a block. VA is the VA, attendings don't scrub in with the point being to make you really struggle so that you become comfortable.

Thanks for sharing. Who takes day call if the pgy2s take nights and PGY3 only do floor?

One of the other two PGY2s will then take the pager for the day shift while the designated pager PGY2 is post call. Night call is split to be mostly PGY2s (60+ overnights and all Saturday 24hr call shifts) which decreases to about 1/3rd of that as a PGY3.
Reply
#5
(07-23-2020, 01:49 PM)Guest Wrote: How is everyone's junior operative/call experience organized? Split between OR and taking the consult pager, independence in OR, etc?

Is there any benefit to choosing a residency where they start to operate as a PGY-1?  I hear at places like BNI and Mayo that you get to operate as an intern.  Oviously would be thankful to match anywhere but just saying when it comes to surgical skill.
Reply
#6
(08-27-2021, 08:41 PM)Guest Wrote:
(07-23-2020, 01:49 PM)Guest Wrote: How is everyone's junior operative/call experience organized? Split between OR and taking the consult pager, independence in OR, etc?

Is there any benefit to choosing a residency where they start to operate as a PGY-1?  I hear at places like BNI and Mayo that you get to operate as an intern.  Oviously would be thankful to match anywhere but just saying when it comes to surgical skill.
Early operative exposure makes residency more enjoyable and takes you out of doing scut work but i dont think theres advantage to starting to operate as pgy1,2 and early pgy3. Whats more important is learning to do the basic skills well and not building bad habits. Neurosurgery is a lifelong learning career so in the long run a few years dont matter. Its important to be humble when your teachers criticize and give you tips. Graduated autonomy to independence as a chief is ultimately the goal which doesnt require u to start operating as a pgy1
Reply
#7
(06-21-2021, 05:24 PM)Blue Fire Wrote:
(07-23-2020, 01:49 PM)Guest Wrote: How is everyone's junior operative/call experience organized? Split between OR and taking the consult pager, independence in OR, etc?

Not sure about everyone else, but we have our PGY2 with 12 months of consults (6-5) split evenly between the 2nd years (4 months each), of which the rest of the year you are in the OR. Overnight cases that come in you do alone with the attending which is nice, we get comfortable pretty quickly in the OR. Daily PGY2 cases would be a double scrub you and the chief alone doing simple to complex spine/cranial tumor/skull base. 2s generally have battery changes, DBS, and shunt revisions to themselves with attendings alone. We also cover the translabrynthines/middle cranial fossas for acoustics, and the endovascular suite which is pretty busy (but mostly getting access, then standing around while the adults work lol).

We are encouraged on the simple operative cases to become independent early, with the idea that they are an introduction to the OR. As the year goes on you get to do more and more by yourself. The consensus has been that the most terrifying but fastest experience progression for us have been the overnight cases - 2s take the most overnight call, and operative cases that come in overnight you do with just you and the attending, chiefs do not come in for cases unless you have multiple going simultaneously. Hematoma evacs, multilevel spine traumas, acute paralysis from a spine tumor -> Transpedicular decompression, instrumentation, fusion with just the attending is really nice for getting good, quickly. 

3rd year we are the floor chiefs, and we do not take consults during the day. 3rd year is about independence in the OR. No double scrubbing as a 3 which is nice. Primary cases are ACDFs, posterior cervicals, laminectomies, TLIFs, ALIFs, Laterals, hematomas, and craniotomies depending on the chiefs' interests (can be awake glioma/oligo craniotomy with the attending vs simple extra-axial meningiomas). Again, none of these are doubled. VA is split between the 3s as well, and you do it in a block. VA is the VA, attendings don't scrub in with the point being to make you really struggle so that you become comfortable.
If your PGY2s are taking consults what the hell are your interns doing?
Reply
#8
(06-21-2021, 05:24 PM)Blue Fire Wrote:
(07-23-2020, 01:49 PM)Guest Wrote: How is everyone's junior operative/call experience organized? Split between OR and taking the consult pager, independence in OR, etc?

Not sure about everyone else, but we have our PGY2 with 12 months of consults (6-5) split evenly between the 2nd years (4 months each), of which the rest of the year you are in the OR. Overnight cases that come in you do alone with the attending which is nice, we get comfortable pretty quickly in the OR. Daily PGY2 cases would be a double scrub you and the chief alone doing simple to complex spine/cranial tumor/skull base. 2s generally have battery changes, DBS, and shunt revisions to themselves with attendings alone. We also cover the translabrynthines/middle cranial fossas for acoustics, and the endovascular suite which is pretty busy (but mostly getting access, then standing around while the adults work lol).

We are encouraged on the simple operative cases to become independent early, with the idea that they are an introduction to the OR. As the year goes on you get to do more and more by yourself. The consensus has been that the most terrifying but fastest experience progression for us have been the overnight cases - 2s take the most overnight call, and operative cases that come in overnight you do with just you and the attending, chiefs do not come in for cases unless you have multiple going simultaneously. Hematoma evacs, multilevel spine traumas, acute paralysis from a spine tumor -> Transpedicular decompression, instrumentation, fusion with just the attending is really nice for getting good, quickly. 

3rd year we are the floor chiefs, and we do not take consults during the day. 3rd year is about independence in the OR. No double scrubbing as a 3 which is nice. Primary cases are ACDFs, posterior cervicals, laminectomies, TLIFs, ALIFs, Laterals, hematomas, and craniotomies depending on the chiefs' interests (can be awake glioma/oligo craniotomy with the attending vs simple extra-axial meningiomas). Again, none of these are doubled. VA is split between the 3s as well, and you do it in a block. VA is the VA, attendings don't scrub in with the point being to make you really struggle so that you become comfortable.

It’s seems like neurosurgery programs put little emphasis on patient wellbeing. Letting residents operate unsupervised and letting them “figure it out” on a living patient? I am thinking of surgery but I don’t want a guilty conscience
Reply


[-]
Quick Reply
Message
Type your reply to this message here.

Image Verification
Please enter the text contained within the image into the text box below it. This process is used to prevent automated spam bots.
Image Verification
(case insensitive)

Forum Jump:


Users browsing this thread: 1 Guest(s)