Neurosurgery rotation expectations

[Broccoli3200]

I'm thinking of doing a neurosurgery rotation for 4 weeks as a 4th year, thinking that I'm going into psychiatry, and would love to learn more about neuroanatomy. Question is- will I learn much neuroanatomy, or will I spend most of my time standing around in the OR, working exhausting hours, and doing majority spinal stuff? Could anyone give me an example schedule of when you've done a neurosurgery rotation? Thanks!

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[Anti-PD1]

It really depends on what your home program is like. If you have a strong functional neurosurgery group, I'd recommend spending time with them, for your purposes. DBS is being utilized for a variety of refractory psychiatric conditions, and the functional guys tend to love teaching neuroanatomy. Also spend some time with the pediatrics peeps, at least at my hospital they tended to place shunts for NPH, it's really interesting to see (for the first few times). Finally, you can never go wrong with tumor/vascular, it always requires a conversation about anatomy. Nothing wrong with spine, it might also help you as you'll see chronic pain patients in psychiatry.

For my 4 week rotation, arrive at 5 every day, round on ~3 patients, present at 6 when running the list, finish by 7. Head to the ORs until the room finishes its last surgery. Check in with the residents. Get out by 6-7 usually. We were also there for q3 overnight call. I saw a lot of tumor, spine and trauma, some vascular and an occasional DBS.

It just depends on what your neurosurgery department is heavy in, and also, if they'll let you customize your OR schedule.

 

[TypeADissection]

You're probably better off doing neurology and brushing up on your pharm. Or radiology and getting better at reading CTs. What you're describing is akin to an IM resident who wants to do Cardiology and spends a month on CTS scrubbing in to watch the surgeon sew in valves and do bypasses. Would that be educational? Sure, I guess. But the yield I'd imagine would be low.

 

[CherryRedDracul]

I would say neurosurgery would be low yield compared to neurology or radiology. As a future psychiatrist, I doubt you're going to be finding yourself in the OR much.

This is unless you still kinda miss the OR and don't mind coming in at 5 AM every day.

 

[Anti-PD1]

I agree with the above. Neurology or neuroradiology might be more high yield.

(Then again, could be the last time you get to dig around in someone's skull base )

 

[tiedyeddog]

I will join the chorus here and say don't do a neurosurgery rotation. Neurology, radiology, or neuro-ICU would probably be more educational.

 

[Coupd'Cat]

Learned some neuroanatomy, but comparable to or even less than what I learned on Neurology clerkship. A lot of holding back flaps or irrigating the brain, which is pretty cool. A lot of sitting and watching the surgeon dig for vessels on a screen. A lot of rounding, sternal rubbing, and shouting. A lot of sad cases--30 yo waking up with paralysis or people coming in from car accidents and massive hematomas.