In the PGY-6 year, each of the 2 residents is stationed for 6 months at the VA Hospital, 3 months on elective and 3 months on the tumor/vascular service at the University Hospital. Throughout this year these residents participate with the 2 chief residents in the senior call pool, taking UW Hospital back-up call from home every 4th or 5th night. The Middleton Veterans Administration Hospital and the UW Hospital are physically joined, have a single neurosurgical faculty, and function as a single unit. While at the VA, the senior residents are responsible for seeing all out patients and urgent care patients, identifying patients needing admission, formulating the evaluation strategy, reviewing findings with the staff neurosurgeon, and making recommendations regarding surgical and nonsurgical management. Although the senior resident’s principal responsibility is to care for veterans hospital patients, he/she also has responsibilities at UW Hospital seeing inpatient consultations, assisting in and performing operations.
This elective rotation functions as a mini fellowship. By the PGY-6 year many residents are seriously weighing the pros and cons of subspecialty interest. The elective rotation allows them to spend a trial period immersed in one subspecialty. In the event that this subspecialty lies in a clinical area shared by two departments, such as spine (shared with orthopedics), skull base (ENT) or neuroendovascular (radiology), we have established precedents for such shared training. Alternatively, some residents may wish to spend this time in further bench research. In either instance, the format is designed on a case by case basis.