A neurosurgery residency is a seven to eight year training program, completed after college and medical school, to acquire accreditation and experience towards becoming a certified neurosurgeon. The amount and allocation of time spent in the residency will depend upon requirements specific to regional certification standards as well as residency program requirements. In the United States, the American Board of Neurological Survey determines accreditation requirements for qualifying neurosurgery residency programs. A residency includes an initial fundamental skills internship, followed by years of clinical neurosurgery and neurology, culminating with time spent in a leadership position and final specialization within the field.
Typically the first year of a residency is spent focusing on clinical skills practice in general surgery or in fields other than neurosurgery, such as with emergency room experience or anesthesiology. The aim is generally to have a resident gain experience in other fields, as well as to learn the basic fundamentals of neurology and neurosurgery. Medical clinical rounds may be taken with a neurologist or neurosurgeon during this time period.
After the first year of general surgery residency, the actual neurosurgery residency itself begins with a focus on neurosurgery and neurology. Regional accreditation programs may require a set amount time for this stage, although specific requirements, such as how much time must be spent at one institution of residency, may vary. The focus of this time is generally on the diagnosing of issues, followed by the determination of management and treatment. It is also usually within these first few years that a written examination for certification is administered, depending on regional requirements.
Later years during a neurosurgery residency may include time spent earning experience with neurology, neuropathology, or neuroradiology. Time in a leadership position is usually also required for certification, generally in the capacity of experience as a chief resident. The final years of a residency will differ program to program, as some will focus on different sub specialties within the field, such as epilepsy or laboratory research experience. Other sub specialties include pediatrics, endovascular, and complex spine surgery. The final year of a neurosurgery residency will include mostly independent clinical experience and individual focus on a chosen sub specialty field.
Neurosurgery residency programs require admission much the same as medical school, with an application evaluation process that includes submitting letters of recommendation, a personal statement, as well as an interview process. After the completion of the residency, individuals go on to join public and private institutions and hospitals, as well as the option of entering academia for laboratory research or teaching positions. The allocation of time in the residency and the focus of the residency program itself generally determines the outcome of an individual's career future within the field.