New Application: Neurological Surgery
Review Committee for Neurological Surgery
ACGME
515 North State Street, Suite 2000, Chicago, Illinois 60654  312.755.5000  www.acgme.org
INSTITUTIONS
Sponsoring Institution
Identify the ACGME-accredited programs available at either the primary clinical site or a participating
site. [PR I.A.2.]
Anesthesiology
Diagnostic Radiology
Internal Medicine
Neurology
Pediatrics
Surgery
Site #1
☐
☐
☐
☐
☐
☐
Site #2
☐
☐
☐
☐
☐
☐
Site #3
☐
☐
☐
☐
☐
☐
Site #4
☐
☐
☐
☐
☐
☐
Site #5
☐
☐
☐
☐
☐
☐
Site #6
☐
☐
☐
☐
☐
☐
Site #7
☐
☐
☐
☐
☐
☐
Site #8
☐
☐
☐
☐
☐
☐
Participating Sites
Describe how the program director will ensure peer interaction and regular attendance of residents at
joint conferences and other activities regardless of the location of their assigned rotations. [PR I.B.3.]
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PROGRAM PERSONNEL AND RESOURCES
Program Director Responsibilities
For each participating site, list the site director and briefly describe their clinical responsibilities at that
site. [PR II.A.4.b).(1-2)]
Site
Site Director Name
#1
Name
#2
Name
#3
Name
#4
Name
#5
Name
#6
Name
#7
Name
#8
Name
Other Program Personnel
Site Director Clinical Responsibilities
Responsibilities
Responsibilities
Responsibilities
Responsibilities
Responsibilities
Responsibilities
Responsibilities
Responsibilities
Is there a designated program coordinator with financial support from the sponsoring institution?
[PR II.C.1.] ......................................................................................................................... ☐ YES ☐ NO
Resources
Neurological Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
Page 1 of 15
1. Describe the inpatient facilities available to the program. [PR II.D.1]
Click here to enter text.
2. Describe the outpatient facilities available to the program. [PR II.D.2.]
Click here to enter text.
3. Describe the research facilities available to the program. [PR II.D.3.]
Click here to enter text.
Neurological Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
Page 2 of 15
4. Are there clinical services available to the program in the following specialties? [PR II.D.4.]
Anesthesiology
Site #1
☐Y☐N
Site #2
☐Y☐N
Site #3
☐Y☐N
Site #4
☐Y☐N
Site #5
☐Y☐N
Site #6
☐Y☐N
Site #7
☐Y☐N
Site #8
☐Y☐N
Critical Care
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
Emergency Medicine
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
Endocrinology
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
Ophthalmology
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
Orthopaedic Surgery
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
Otolaryngology
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
Pathology
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
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☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
☐Y☐N
Psychiatry
If no to any of the
above, describe the
resources for
education of
neurological surgery
residents
5. List the number of procedures performed by the neurological surgery service during the most recent academic year for each participating
site. [PR II.D.5.]
Site #1
DC1 Adult craniotomy-brain tumor
Extra-Axial
#
Biopsy
#
Intra-Axial
#
Skull Base and Other
#
TOTAL Adult Craniotomy#
brain tumor
DC2 Adult craniotomy-trauma
Other
#
Cranioplasty
#
Site #2
Site #3
Site #4
Site #5
Site #6
Site #7
Site #8
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Neurological Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
Page 3 of 15
Site #1
Site #2
Site #3
Depressed Skull Fracture
#
#
#
or Extra-Axial Hematoma
Craniectomy for Abscess,
Contusion or
#
#
#
Parenchymal Hematoma
TOTAL Adult
#
#
#
craniotomy-trauma
DC3a Adult Craniotomy for Intracranial Vascular Lesion
Other
#
#
#
AVM
#
#
#
Aneurysm
#
#
#
TOTAL Adult craniotomy
for intracranial vascular
#
#
#
lesion
DC3b Endovascular Therapy for Tumor or Vascular Lesion
AVM
#
#
#
Aneurysm
#
#
#
Tumor Embo,
Thrombectomy,
#
#
#
Vasospasm and
Intracranial Stenting
TOTAL Endovascular
therapy for tumor or
#
#
#
vascular lesion
DC4 Adult craniotomy-pain
#
#
#
DC5 Adult cranialtranssphenoidal#
#
#
sellar/parasellar tumors
DC6 Adult cranial-extracranial vascular procedures
Bypass, CEA, Ligation
#
#
#
Endovascular (CAS)
#
#
#
TOTAL Adult cranialextracranial vascular
#
#
#
procedures
DC7 Adult radiosurgery
#
#
#
Neurological Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Site #4
Site #5
Site #6
Site #7
Site #8
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Updated 5/2015
Page 4 of 15
Site #1
Site #2
DC8 Adult functional procedures
Vagal Nerve Stimulation
#
#
Stimulation for Pain
#
#
DBS or Lesioning
#
#
Cordotomy/Rhizotomy
#
#
Sympathectomy
#
#
Intrathecal and
#
#
Implantable Pumps
Other Adult Functional
#
#
Procedures
TOTAL Adult functional
#
#
procedures
DC9 Adult VP shunt
VPS
#
#
ETV
#
#
Other CSF Diversion
#
#
TOTAL Adult VP shunt
#
#
DC10 Adult spinal-Anterior
Cervical Approaches for
#
#
Decompression/Stabilizati
on
DC11 Adult spinalPosterior Cervical
Approaches for
#
#
Decompression/Stabilizati
on and Craniocervical
Junction
DC12 Adult spinal-lumbar
#
#
discectomy
DC13 Adult spinalthoracic/lumbar
#
#
instrumentation fusion
DC14 Adult spinal-peripheral nerve procedures
Neurolysis/Transposition
#
#
Neurological Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Site #3
Site #4
Site #5
Site #6
Site #7
Site #8
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Updated 5/2015
Page 5 of 15
Site #1
#
#
Nerve Repair
Peripheral Nerve tumor
Other Peripheral Nerve
#
Procedures
TOTAL Adult spinalperipheral nerve
#
procedures
DC15 Pediatric
#
craniotomy-brain tumor
DC16 Pediatric craniotomy-trauma
Other
#
Cranioplasty
#
Depressed Skull Fracture
#
or Extra-Axial Hematoma
Craniectomy for Abscess,
Contusion or
#
Parenchymal Hematoma
TOTAL Pediatric
#
craniotomy-trauma
DC17 Pediatric spinal
#
procedures
DC18 Pediatric VP shunt
#
DC19 Adult and pediatric
#
craniotomy-epilepsy
DC20 Minor
procedures/critical care#
ICP monitor placement
DC21 Minor
procedures/critical care#
external ventricular drain
DC22 Minor
procedures/critical care-VP
#
shunt tap/programming
Site #2
#
#
Site #3
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Site #4
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Site #5
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Site #6
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Site #7
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Site #8
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Neurological Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
Page 6 of 15
DC23 Minor
procedures/critical carecervical spine traction
DC24 Minor
procedures/critical carestereotactic frame
placement
DC25 Minor
procedures/critical careCVP line placement
DC26 Minor
procedures/critical careairway management
DC27 Minor
procedures/critical carearterial line placement
DC28 Minor
procedures/critical carearteriography
TOTAL DEFINED CASE
CATEGORY
PROCEDURES/SITE
Craniofacial
Spinal Tumor/AVM
Spinal Tumor Resection:
Primary and Metastatic
Spinal Vascular Lesion
Resection
Reconstructive
Secondary Procedures
TOTAL Spinal tumor/AVM
Miscellaneous/Unclassified
TOTAL Reportable, nontracked procedures/Site
Site #1
Site #2
Site #3
Site #4
Site #5
Site #6
Site #7
Site #8
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Neurological Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
Page 7 of 15
Appointment of Fellows and Other Learners
Will the program sponsor or participate in any clinical fellowship taking place within sites participating in
the program? [PR III.D.2.] ................................................................................................... ☐ YES ☐ NO
If yes, describe the fellowship's relationship to and impact on the residency. [PR III.D.2.b)]
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EDUCATIONAL PROGRAM
Conferences
1. Provide a schedule of the planned required didactic sessions, including teaching conferences,
rounds, journal club and other educational activities in which program faculty and residents will
participate. The schedule should include the type, frequency, and duration of the topic, the name of
the individual responsible for oversight of the session, and the name of the individual presenting the
session. Add rows as necessary.
Type
Name of
Name of
Individual
Individual
Presenting
Duration / Responsible
the
Frequency
hours
for Oversight Conference
Required to Attend
Faculty Residents
2. Describe how conferences will be organized and monitored to ensure (a) coordination among
participating sites, and (b) faculty and resident attendance and participation.
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Patient Care and Procedural Skills
Indicate the settings and activities in which residents will develop competence in each of the following
areas of patient care. Also indicate the method used to evaluate competency.
Competency Area
Gathering essential patient
information in a timely manner
[PR IV.A.5.a).(2).(a)]
Synthesizing and properly
utilizing acquired patient data
[PR IV.A.5.a).(2).(b)]
Settings/Activities
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Method(s) Used to Evaluate
Resident Competency
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Neurological Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
Page 8 of 15
Competency Area
Generating a differential
diagnosis and properly
sequencing critical actions for
patient care, including managing
complications and morbidity and
mortality
[PR IV.A.5.a).(2).(c)]
Generating and implementing an
effective management plan
[PR IV.A.5.a).(2).(d)]
Prioritizing and stabilizing
multiple patients simultaneously
[PR IV.A.5.a).(2).(e)]
Performing neurosurgical
operative procedures, including:
[PR IV.A.5.a).(2).(f)]
Adult cranial procedures, to
include:
[PR IV.A.5.a).(2).(f).(i)]
Craniotomy for brain
tumors
[PR IV.A.5.a).(2).(f).(i).(a)]
Craniotomy for
intracranial vascular
lesions
[PR IV.A.5.a).(2).(f).(i).(b)]
Craniotomy for pain
[PR IV.A.5.a).(2).(f).(i).(c)]
Craniotomy for trauma
[PR IV.A.5.a).(2).(f).(i).(d)]
Endovascular/intervention
al procedures for
intracranial
cerebrovascular and
neuro-oncologic
conditions
[PR IV.A.5.a).(2).(f).(i).(e)]
Extracranial vascular
procedures (open surgery
and endovascular)
[PR IV.A.5.a).(2).(f).(i).(f)]
Functional procedures
[PR IV.A.5.a).(2).(f).(i).(g)]
Radiosurgery
[PR IV.A.5.a).(2).(f).(i).(h)]
Transsphenoidal
sellar/parasellar tumors
(endoscopic and
Settings/Activities
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Method(s) Used to Evaluate
Resident Competency
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Neurological Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
Page 9 of 15
Competency Area
microsurgical)
[PR IV.A.5.a).(2).(f).(i).(i)]
Ventriculoperitoneal (VP)
shunt
[PR IV.A.5.a).(2).(f).(i).(j)]
Adult spinal procedures, to
include:
[PR IV.A.5.a).(2).(f).(ii)]
Anterior cervical
approaches for
decompression/
stabilization
[PR
IV.A.5.a).(2).(f).(ii).(a)]
Posterior cervical
approaches for
decompression/
stabilization
[PR
IV.A.5.a).(2).(f).(ii).(b)]
Interventional procedures
for spinal conditions
[PR
IV.A.5.a).(2).(f).(ii).(c)]
Lumbar discectomy
[PR
IV.A.5.a).(2).(f).(ii).(d)]
Peripheral nerve
procedures
[PR
IV.A.5.a).(2).(f).(ii).(e)]
Thoracic/lumbar
instrumentation fusion
[PR IV.A.5.a).(2).(f).(ii).(f)]
Pediatric procedures, to
include:
[PR IV.A.5.a).(2).(f).(iii)]
Craniotomy for brain
tumor
[PR
IV.A.5.a).(2).(f).(iii).(a)]
Spinal procedures,
including Chiari
decompressions,
laminectomy for
dysraphism, laminectomy
for spinal tumors,
laminectomy for
syringomyelia, and
Settings/Activities
Method(s) Used to Evaluate
Resident Competency
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Neurological Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
Page 10 of 15
Competency Area
correction of spinal
deformity
[PR
IV.A.5.a).(2).(f).(iii).(b)]
VP shunt
[PR
IV.A.5.a).(2).(f).(iii).(c)]
Craniotomy for epilepsy for
adult and pediatric patients
[PR IV.A.5.a).(2).(f).(iv)]
Assessing postoperative
recovery, recognizing and
treating complications,
communicating with referring
physicians, and developing the
physician-patient relationship
[PR IV.A.5.a).(2).(g)]
Analyzing patient outcomes
[PR IV.A.5.a).(2).(h)]
Providing health care services
aimed at preventing health
problems and maintaining health
[PR IV.A.5.a).(2).(i)]
Settings/Activities
Method(s) Used to Evaluate
Resident Competency
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Medical Knowledge
Indicate the activities (lectures, conferences, journal clubs, clinical teaching rounds, etc) in which
residents will demonstrate competence in their knowledge of the following areas. Also indicate the
method(s) that will be used to evaluate resident competency in each area.
Competency Area
Neurosurgical emergencies;
[PR IV.A.5.b).(1)]
Treating neurosurgical
conditions, including:
[PR IV.A.5.b).(2)]
Cerebrovascular disorders
[PR IV.A.5.b).(2).(a)]
Functional neurosurgery
[PR IV.A.5.b).(2).(b)]
Neurocritical care
[PR IV.A.5.b).(2).(c)]
Neurooncology
[PR IV.A.5.b).(2).(d)]
Pain
[PR IV.A.5.b).(2).(e)]
Settings/Activities
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Method Used to Evaluate
Resident Competency
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Neurological Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
Page 11 of 15
Competency Area
Pediatric neurological surgery
[PR IV.A.5.b).(2).(f)]
Peripheral nerve disorders
[PR IV.A.5.b).(2).(g)]
Spinal disorders
[PR IV.A.5.b).(2).(h)]
Trauma
[PR IV.A.5.b).(2).(i)]
Different medical practice models
and delivery systems and how to
best utilize them to care for an
individual patient; and,
[PR IV.A.5.b).(3)]
Study design and statistical
methods.
[PR IV.A.5.b).(4)]
Settings/Activities
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Method Used to Evaluate
Resident Competency
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Practice-based Learning and Improvement
Describe the planned settings/activities in which residents will demonstrate competence in
incorporating evidence-based principles in their clinical practice. Also indicate the method(s) that will be
used to evaluate resident competency. [PR IV.A.5.c).(9)]
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Systems-based Practice
Describe the planned settings/activities in which residents will demonstrate competence in accessing,
utilizing and evaluating the effectiveness of the resources, providers, and systems necessary to provide
optional neurosurgical care. Also include the method(s) that will be used to evaluate resident
competency. [PR IV.A.5.f).(7)]
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Curriculum Organization and Resident Experiences
1.
Briefly describe the planned settings/activities in which PGY1 residents will demonstrate
competence in the following fundamental skills: [PR IV.A.6.a)]
a) Develop the knowledge, attitudes, and skills needed to formulate principles and assess, plan,
and initiate treatment of patients with surgical and medical problems [PR IV.A.6.a).(1)]
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b) Be involved in the care of patients with surgical and medical emergencies, multiple organ
system trauma, and nervous system injuries and diseases [PR IV.A.6.a).(2)]
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Neurological Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
Page 12 of 15
c) Gain experience in the care of critically-ill surgical and medical patients; [PR IV.A.6.a).(3)]
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d) Participate in the pre-, intra-, and post-operative care of surgical patients; and, [PR IV.A.6.a).(4)]
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e) Develop basic surgical skills and an understanding of surgical anesthesia, including anesthetic
risks and the management of intra-operative anesthetic complications. [PR IV.A.6.a).(5)]
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2. If the program will have more than one resident per year, describe how the program will ensure that
each resident has a full 12-month chief resident experience. [PR IV.A.6.b).(3)]
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a) Describe how the chief resident will have major or primary responsibility for patient management
with faculty member supervision. [PR IV.A.6.b).(3).(a)]
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b) Describe how the chief resident will have administrative responsibility as designated by the
program director. [PR IV.A.6.b).(3).(b)]
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3. Will resident experiences include: [PR IV.A.6.d)]
a) Participating in the management (including critical care) and surgical care of adult and pediatric
patients, which should include the full spectrum of neurosurgical disorders; [PR IV.A.6.d).(1)]
................................................................................................................................ ☐ YES ☐ NO
b) Evaluating patients referred for elective surgery in an outpatient environment; [PR IV.A.6.d).(2)]
................................................................................................................................ ☐ YES ☐ NO
(1) Describe how the program director will ensure that this experience will include obtaining a
complete history, conducting an examination, ordering (if necessary) and interpreting
diagnostic studies, and arriving independently at a diagnosis and plan of management.
[PR IV.A.6.d).(2).(a)]
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c) Making pre-operative decisions and participating in procedures, including surgical,
endovascular, interventional, and radiological procedures; [PR IV.A.6.d).(3)] ......... ☐ YES ☐ NO
(1) Describe how the program director will ensure each resident will record, in the ACGME
Case Log System, the number and type of each procedure he or she performs as either
assistant resident surgeon, senior resident surgeon, or lead resident surgeon.
[PR IV.A.6.d).(3).(a)]
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(2) Describe how the program director will ensure that resident participation in and responsibility
for procedures increases progressively throughout residency. [PR IV.A.6.d).(3).(b)]
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d) Post-surgical care and follow-up evaluation of patients; and, [PR IV.A.6.d).(4)]....... ☐ YES ☐ NO
e) Clinical experience in neuroradiology, including endovascular surgical neuroradiology, and
neuropathology designed specifically for neurological surgery residents. [PR IV.A.6.d).(5)]
................................................................................................................................ ☐ YES ☐ NO
(1) Describe how the program director will ensure such experience takes place under the
direction of qualified neuroradiologists and preferably endovascular neurosurgeons, and
neuropathologists. [PR IV.A.6.d).(5).(a)]
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Residents’ Scholarly Activities
Describe how the program director will ensure residents participate in the development of new
knowledge, learn to evaluate research findings, and develop habits of inquiry as a continuing
professional responsibility. [PR IV.B.2.a)]
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RESIDENT FORMATIVE EVALUATION
List the frequency with which the program director will review the ACGME case log data with each
resident and how the program director will ensure the balanced progress of each resident towards
achieving experience with a variety and complexity of neurological surgery procedures. [PR V.A.1.d)]
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RESIDENT DUTY HOURS IN THE LEARNING AND WORKING ENVIRONMENT
Clinical Responsibilities
1. Describe how the program director will ensure that residents practice across a diversity of care
settings with varying degrees of primary care responsibility. These situations may vary from first call
cross-coverage on the floors to possible interaction with a primary intensivist, pediatric, or
hospitalist service. [VI.E.1.]
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2. Describe how the program director will ensure peri-operative inpatient care will be further balanced
with resident participation in the operating room, including how the program director will consider
adequate coverage and provision of patient care; sufficient inpatient clinical responsibility to allow
resident progression along clinical care milestones; and, meaningful insulation of operative
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experiences from inpatient care to allow technical progress and facilitate resident development of
organizational and triage skills, when assigning patient loads: [PR VI.E.2.]
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Maximum Frequency of In-House Night Float
What is the maximum number of months in each year that a resident will be assigned night float?
[PR VI.G.6.] ....................................................................................................................................... [ # ]
If assigned night float exceeds four months per year, what is the rationale?
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