Fletcher Allen, a Vermont university hospital and medical center, serves all of
Vermont and the northern New York region. Located in Burlington, Fletcher Allen is a regional, academic healthcare center and teaching hospital in alliance with the University of Vermont.
Curriculum - Neurosurgery Residency
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Rotations
PG1 year
The first year consists of a six-month general surgery rotation, followed by electives in neurology, neuroradiology, and neuropathology. General surgery rotations include months with trauma and intensive care, among others. In-hospital call during these rotations will be with the general surgery service. During the latter six months of the first year, in-house call with the neurosurgery service commences. Following the PG1 year residents should feel comfortable performing arterial line, central line, lumbar drain, ventriculostomy.
PG2 year
The second year resident is the junior resident on service, and along with the intern on service is the primary consulting resident for inpatient and emergency consultations. This resident performs bedside procedures and assists senior residents and attendings in the operating room when available. Weekly outpatient clinic requirement averages one day weekly. In-hospital call averages 8-9 monthly, including weekends. Following the PG1 year residents should feel comfortable performing of external spine fixation devices, stereotactic frame biopsy, ventriculo- or lumbo-peritoneal shunt, assisting on basic craniotomy and spine procedures. Cases average approximately 100 as primary resident, 100 as secondary resident.
PG3 year
The third year resident functions as the research fellow. This resident takes in-hospital call on average 6-7 monthly. Residents are encouraged to partake in basic science and clinical research projects. Recent laboratory projects include study on cerebral vasospasm using an animal model, retrospective studies regarding trauma and cerebral vasospasm prediction models, and cadaveric minimally invasive skull base approaches. For more information on neurosurgical research at the University of Vermont, see our Research Page.
PG4 year
The fourth year resident spends six months on service and six months with elective time. This resident acts as a junior resident on the neurosurgical service. Duties with inpatient care are shared with the PG2 resident on service. This resident averages one day in outpatient clinic weekly. Primary objective of this year in residency is honing clinical and surgical skills working with the other junior resident and senior residents on service. The second six months of the year are elective time. Residents may schedule additional time with Neurology, Neuropathology, or Neuroradiology rotations, including interventional Neuroradiology. Extramural activities are considered on a case-by-case basis; this resident must fulfill a 4-5 in-hospital call requirement monthly. Following the PG4 year, residents should feel comfortable performing basic spine and cranial procedures. Cases average 200 as primary resident, 100 as secondary resident.
PG5 year
The fifth year resident works with a private-practice neurosurgery group at Maine Medical Center in Portland, Maine. This resident works as the lone neurosurgery resident at Maine Medical Center, with floor coverage by physician assistants. During this year, the resident gains confidence and experience in surgical skills. One day weekly is spent in pediatric neurosurgery clinic. In-hospital call is sporatic. Housing in Maine is arranged through the Department of Surgery at Fletcher Allen. Cases average approximately 500 as primary resident.
PG6 year
The senior resident on service operates with the attending surgeon in the second room operating daily. This resident in addition is responsible for coordination of the academic calendar as well as instruction and oversight of junior residents in patient care. One day weekly is devoted to outpatient clinical duties. In-hospital call is minimal, with an average of two monthly. Weekend home call is split between the senior and chief resident. Cases average approximately 400 as primary resident.
PG7 year
The chief resident is the primary operating neurosurgical resident. This resident overlooks the care of patients on service and operates daily. Following the PG7 year, the chief resident is comfortable performing most neurosurgical procedures. Cases average approximately 500 as primary resident.
Case Experience
Yearly Neurosurgery cases at Fletcher Allen average approximately 1,200. The PG5 resident operates as the sole neurosurgery resident at Maine Medical Center in Portland, Maine. An estimate of case experience based on recent years is delineated below.
Average case load as first assistant:
- PG2, Junior Resident - 100
- PG4, Mid-Level Resident - 200
- PG5, Maine Medical Center - 500
- PG6, Senior Resident - 400
- PG7, Chief Resident - 500