During this year, each intern will rotate on a variety of services, including six months of Neurosurgery, three months in the Neuro ICU at University Hospital, and three months of electives. While on the neurosurgical service each intern will learn and become more experienced with basic management of the neurosurgical patient. A lot of time will also be spent in the Neuro ICU where the intern will learn the basic procedures necessary for the proper care of neuro-critical patients. These procedures include placement of external ventricular drains, intracranial pressure monitors and central/arterial lines. The intern will also begin their surgical experience by participating in a variety of neurosurgical operations. The goals of the neurosurgery intern are to develop knowledge of surgical diseases and complications, develop surgical judgment, learn basic pre- and post-operative care, and develop elementary skills in surgical technique.

During the second year of residency, training emphasis is placed on enhancing fundamental surgical, clinical care of the neurosurgical patient and on critical care skills. The goal of the year is to provide experience in which the resident learns how to care for neurosurgical patients regardless of the magnitude of the clinical problem. This goal is achieved by rotations at all four hospitals including UCH, DH, TCH and VAMC.

The goal of the third clinical year of training is to provide the resident with more surgical skills, clinical skills, knowledge base and technical experience in common neurosurgical problems. Rotations are spread across the four hospitals.

The goal for the fourth year of neurosurgery training is to further develop surgical skills, clinical skills, knowledge base and surgical techniques. Rotations are spread between the four affiliated hospitals. A three month elective is taken as well with options available in neuropathology, neuroradiology, interventional radiology or stereotactic radiosurgery.

The PGY5 year is entirely devoted to mentored research. There is, intermittent on-call clinical responsibility. The resident may choose with the help of their research mentor from a variety of basic science or clinical research projects to develop with the intent of producing publications.

The goal for the sixth year of neurosurgery training is to further develop more complex surgical skills, clinical skills, knowledge base and advanced techniques. Rotations are spent at the University Hospital, where senior residents are involved in more complex cases.

Each resident is placed in a leadership position as the Chief Resident on neurosurgical services, mainly at UCH (12 months). In this capacity, the trainee is given leadership responsibility for the neurosurgical service and coordinates and supervises all clinical and education activities on the service.