Our seven-year training program maintains and adapts its curriculum and training expectations for our residents based on current requirements as per the Accreditation Council for Graduate Medical Education (ACGME) and the ever-changing field of neurosurgery.

The program embraces a progressive learning experience and responsibility for residents as they advance. 

The program utilizes a monthly night float call coverage, which enables residents to meet the requirements of the ACGME and the New York State Bell 405 duty hour regulations. 

During clinical rotations, the residents are assigned to participate in various specialty clinics that further augment their specific rotational educational experience.

Clinical Education

Intern Level Resident—PGY 1

Your structured first year is designed to prepare you with the clinical and surgical skills needed to begin your neurosurgical training. This year includes two months of general (trauma) surgical service as well as a month of neurology. The remainder of the year is spent on the general neurosurgical service with three months of focused neurosurgical critical care exposure. During this year, you will become acclimated to the neurosurgical service and obtain exposure to all the clinical sites.

PGY 1 residents also attend The Society of Neurological Surgeons (SNS) PGY 1 “Bootcamp,” which is held every July in Boston, Massachusetts.

  • Neurology rotation, 1 month
  • Trauma surgery rotation, 2 months
  • Neurosurgical critical care rotation, 3 months
  • General neurosurgical rotation, 6 months

Junior Level Resident—PGY 2

In the second year of training, residents serve as the true “intern” of the neurosurgical service. They evaluate patients preoperatively and assist in postoperative care. They admit patients from the emergency room and directly from the neurosurgical clinics and handle all inpatient neurosurgical consultations. In addition, they perform neurosurgical operative procedures commensurate with ability.

During this year, residents are encouraged to attend as many operative procedures as possible and to learn the basics of neurosurgical preoperative, operative, and postoperative care. In order to facilitate their ability to attend operative cases, several dedicated neurosurgical nurse practitioners help with basic floor and intensive care duties.

  • General neurosurgical rotation, 12 months

Mid-Level Resident—PGY 3, PGY 4

During the mid-level years, residents are encouraged to focus on improving their operative skills by performing basic cranial and spinal operative procedures in addition to developing an appreciation for more complex procedures and approaches. They are expected to keep abreast of current literature and accrue general knowledge in the field of neurosurgery, all the while providing excellent patient care.

In addition to spending time on the main neurosurgical service at the Buffalo General Medical Center, mid-level residents perform dedicated neuro-endovascular, functional, spine, neuro-oncology and pediatric rotations.

Opportunities to cover cranial and spinal trauma at the Erie County Medical Center are also available during this time.



Senior Level Resident—PGY 5, PGY 6

In accordance with the seven-year resident curriculum as mandated by the ACGME, the fifth and sixth years of residency training are focused on providing the residents with opportunities to engage in research or complete enfolded fellowships whether at home or away institutions. During this time, the resident may also elect to continue on the main neurosurgical service at the Buffalo General Medical Center to further augment their operative skills and to sharpen their clinical acumen.

If the resident choses to pursue basic neuroscience and/or clinical research, they may conduct original research projects and prepare manuscripts summarizing research findings. The resident is expected to produce at least two manuscripts of publication quality during the research rotation. Residents may elect to work under the auspices of a Department of Neurosurgery faculty member or, alternatively, they can work with a member of the University at Buffalo faculty conducting neuroscience research.

The Department of Neurosurgery sponsors laboratories at Buffalo General Medical Center, Roswell Park Comprehensive Cancer Center, University at Buffalo and with the Canon Stroke & Vascular Research Center located at the University’s Clinical and Translational Science Institute.

Completion of CAST (Committee on Advance Subspecialty Training) accredited fellowships during this time at an internal or external institution may also be an option depending upon the resident’s clinical and operative performance.

Before the completion of the sixth year of training, each resident must pass for credit the primary examination of the American Board of Neurological Surgery. Any resident who does not pass the examination for credit will not be able to assume the duties of chief resident.

  • Dedicated research time
  • Enfolded clinical fellowship
  • Clinical electives

Chief Resident—PGY 7

Residents spend their seventh year of training at Buffalo General Medical Center. During this year, they are expected to fine-tune their clinical and operative skills and gain administrative experience prior to completing the training program.

Seventh year residents also serve as chief residents and are responsible for the day-to-day operation of the neurosurgical service, including managing the resident complement and select administrative duties. Opportunities exist for chief residents to gain experience in subspecialty areas such as intracranial and skull base endoscopy, complex spine procedures, and open cerebrovascular procedures as well as more general neurosurgical techniques.

Chief residents attend the chief resident clinic during this year and may attend any neurosurgical conference they feel will be beneficial to their future.

  • Chief Year
  • General neurosurgery rotation, 12 months

Specialized Neurosurgical Clinic Opportunities

  • Pediatric Spasticity
  • Pediatric Neuro-oncology
  • Pediatric Spina Bifida
  • Neuro-endovascular Clinic
  • Functional Neurosurgical Clinic
  • Adult Oncology Clinic
  • Chief Resident Clinic

Resident Evaluation Process

In order for any training program to assess its ability to meet its goals and objectives, it is essential that the program have a comprehensive evaluation process, including formative and summative evaluations of the residents, and an evaluation process of the program and the faculty.

Residents are evaluated in writing at midterm as well as at the conclusion of each academic year. Faculty with whom they rotated during that period will provide ACGME milestone evaluation as gathered through the MedHub system. Faculty will also provide comments regarding strengths, weaknesses and any areas identified as needing improvement and/or continued focus going forward.

Residents’ “professionalism” is evaluated by nursing staff and members of the health care team utilizing 360 evaluations and included as part of the complete evaluation process.  Mock Oral Board sessions are also utilized each term.

Once every six months, each resident receives a formal “summative evaluation” conducted by his/her program director (or designee). Each resident meets individually with the program director or associate program director to review the evaluations. During this meeting, a copy of the evaluations and a written summary sheet detailing the materials reviewed is provided to the resident. The resident’s strengths as well as areas for improvement are noted; any corrective measures are also discussed.