Introduction

The Department of Neurosurgery offers a senior year discipline-based pathway in Neurosurgery. The Neurosurgery Discipline-Based Pathway provides basic experience in Neurosurgery, with additional exposure to various subspecialties of Neurosciences. Because Neurosurgery is a field that is integral to almost all of medicine, students will be encouraged to diversify their course selection. Hospital-based, clinic-based, and urgent-care courses are encouraged, as is exposure to both pediatric and geriatric practices where neurosurgical interventions are common. All students must also complete the required Intersession course. Involvement in research in the neurosciences is becoming increasingly important in this highly competitive residency.

The student is encouraged to explore all other fields of medicine since many interface with Neurosurgery
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Sites and Personnel

Pathway Director:
Rudy Rahme, M.D.
Rr999@drexel.edu

Drexel Administrative Coordinator for Neurosurgery:

Linda Greco

Queen Lane, Room C9G

215-991-8520
lag64@drexel.edu

NEUROSURGERY TEACHING SITES

The Neurosurgery course in the discipline-based pathway will be available as described in the course catalogue. Please work with the Pathway Director to determine what rotation would be the best option for you.

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Description of Pathway

Goals And Objectives

The primary goal of the senior year discipline-based Neurosurgery pathway is to provide a framework for students to structure their senior year in preparation for a future career in Neurosurgery. Neurosurgery programs currently range from 5-7 years following an internship year. Neurosurgery is a far-ranging discipline in which the practitioner sees young and old patients with both systemic and localized diseases, as well as patients with conditions necessitating surgery. Therefore, the Departments of Neurosurgery encourage students to take electives that will expose them to the many and varied conditions that they will be encountering in caring for future patients.

The pathway includes the four required courses and several elective opportunities.

Required Courses

Emergency Medicine Subinternship
Emergency Medicine Subinternship is required by the University as a senior year course. During this course we would expect that the student will learn the principles of rapid assessment and stabilization of critically ill and injured patients; learn the initial evaluation and management of the wide range of undifferentiated patient complaints in the Emergency Department; gain skills, specialized examination technique and real-time interpretation of diagnostic studies; participate in common and more advanced procedures.

Required Subinternship Objectives: Neurosurgy Pathway students are required to complete a Surgery Subinternship
By the end of the rotation learners will be able to:

1. Take ownership of their patients and be the primary point person regarding their care.
2. Demonstrate the ability to care for patients with increasing independence while seeking help when appropriate
3. Handle the daily tasks of an intern including preparing for rounds, presenting on rounds, interprofessional knowledge and communication skills, and patient interactions, histories and physicals, note writing of all varieties, and sign-out in a proficient and efficient manner.
4. Apply their knowledge towards diagnosis and management of common acute complaints and chronic conditions, creating care plans and communicating with consultants as necessary.
5. Perform general procedures through demonstration of the necessary preparation and key issues required for the performance of procedures, including understanding patient-specific factors, indications, contraindications, risks, benefits, and alternatives. 
6. Demonstrate reliable mechanical skills in performing procedures in most situations and knows when to seek help for procedures or situations beyond the learner’s abilities.
7. Perform safe transitions of care, coordination of care, and discharge planning.

The Neurosurgery required rotation should be taken early in the year so that the student may acquire some familiarity with the field in order to make an informed choice of professions, as well as for letters of recommendation.

The Pathway recommends that the student selects two additional Neurosurgery Electives. These are listed under "Recommended Elective."

Anesthesia is a discipline which is closely allied to Neurosurgery. The student should be exposed to the techniques of intravenous sedation, regional anesthesia, and general anesthesia. The rotation should provide the student with extensive exposure to airway management and clinical pharmacology.

Infectious Diseases is a medical subspecialty which will familiarize the student with the treatment of sepsis, acute and chronic infections, and surgical infections. The student will become familiar with the use of antibiotics, as well.

Otolaryngology is a rotation where the student should learn to do a proper head and neck examination, and become familiar with complaints and conditions relating to the ears and sinuses, both of which have considerable overlap with the central nervous system.

Endocrinology is a field of medicine wherein the student will become familiar with diseases that also often affect the central or peripheral nervous system. A familiarity with endocrinologic diseases will greatly enhance the students understanding of related neurosurgical diseases.

Radiology is a rotation where the student will become familiar with imaging techniques used in neurosurgical disorders e.g. reading Cat Scans and MRIs as well as plain films. Ability to read and interpret these studies will be very helpful in future neurosurgical training.

Required Rotations In Neurosurgery
This is a four week course that should familiarize the student with the broad scope of neurosurgical practice, both medical and surgical. The student should become familiar with neurosurgical terms and common surgical nervous system diseases, as well as with Neurosurgical findings in systemic diseases. The rotation will be structured as a subinternship so that the students is actively involved in patient care and functions as an integral member of the neurosurgical care team in all settings including critical care units, operating rooms, the emergency department and the outpatient clinics.

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Textbooks And Learning Resources

1. Handbook of Neurosurgery. Greenberg, M (ed) 6^th Edition, Thieme
2. Neurosurgery. An Introductory Text. Black, P (ed.) Oxford University Press
3. Essential Neurosurgery. Kaye, A (ed) 3^rd Edition. Blackwell Press
4. The ICU Book. Marino,P (ed) 2^nd Edition. Williams and Wilkins
5. Clinical Neurology and Neurosurgery. Q&A. Mckhann, G (ed). Thieme

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Evaluation

Evaluation of the Student
The student's performance in each rotation will be evaluated by supervising physicians, and residents when appropriate, using the standard Drexel University College of Medicine clinical evaluation form. Students not receiving a grade of satisfactory or higher will be counseled and provided with remediation.

Evaluation of 4th year Courses
Upon completion of each rotation, students are encouraged to complete the end-of-rotation evaluation form in DOCSS. Students have the opportunity to provide feedback on the rotation as well as on specific faculty (and residents) with whom they worked in DOCSS. All feedback is de-identified.

Evaluation of the Pathway
Students are encouraged to complete an end-of-year Pathway evaluation for the Pathway. The feedback from this evaluation will help in advising future students more effectively.

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The provisions of The Student Handbook of Drexel University College of Medicine are not to be regarded as a contract between any student and the College of Medicine. The College of Medicine may, at any time, change any provisions, curriculum requirements, teaching facilities, affiliated teaching sites and/or their amenities, bylaws, rules, regulations and policies as may be necessary in the interest of the University, Drexel University College of Medicine of Medicine, and its students.

Revised 01/25/2024 -- Specific questions or comments about the content of this page may be directed to the Division of Clinical Education