Nothing special about hitting the ground rolling. Everyone, for the most part, starts at the same stage. But I think there are things to remember as you go through residency.
You'll find lots of posts about how to be a good intern scattered about SDN. The summary is just be honest, work well with others, call your spouse/girlfriend/mom & dad when you get the chance, don't procrastinate on anything, when you feel uncomfortable about some patient situation it's time to load the boat.
In terms of neurosurgery I think the following are important:
Try to keep a positive attitude. You will get immensely frustrated at times. Try to remember how lucky you are that you were given the incredible opportunity to do what you are doing.
There is no such thing as a "stupid consult". Yes, you work hard (and probably a lot harder than most ER, radiology, IM, family medicine residents that you'll deal with everyday). But, that does not mean when they call you for help you should treat them anything less than what they are: someone asking for your help.
Make sure you learn something new every single day. At first it will seem like you are learning something new every minute. But soon you will get jaded and think you know it all. This is never true. Also, when times are bad, I think about what I learned that day and realize why I'm in this hell of residency...not just to get tortured but actually learn how to be a great neurosurgeon.
Set up a reading scheduling early and stick to it. No matter how tired you are, remember that your attending worked at least 50% more hours per week than you did. Therefore spending 10 to 20 minutes reading something every day should not be a chore for you. As an intern you should be reading the basics...Marino's ICU book; Greenberg's chapters on spinal and cranial trauma. As you get more senior you need to read a text; While long, Youman's would be ideal. Then the operative technique texts, like Schmidek & Sweet.
Neurosurgery is awesome.
