As a resident of the Neurosurgery training program, you’ll spend seven years training alongside our excellent surgeons and researchers. Our training program consists of a one-year internship, four clinical training years (this includes neurology, neuropathology, pediatric neurosurgery, endovascular neurosurgery, neuroradiology, and radiosurgery rotations), one year of protected research and a dedicated chief year with a transition to subspecialty neurosurgery practice.
Neurophysiology
All neurosurgical operating rooms have equipment for intraoperative monitoring (IOM) which is used to monitor patients’ sensory and motor evoked potentials. Members of our intraoperative monitoring team perform microelectrode recordings of single units in patients with movement disorders who are undergoing surgery for the implantation of deep brain stimulating (DBS) electrodes. Residents are trained in clinical neurophysiology by our IOM physicians. The IOM program runs a laboratory, housing basic neurophysiological and neurological studies.
Neuroradiology
Morning conferences are held twice per week so that the entire resident and staff group can review all service films. The Neuroradiology Division is equipped with seven clinical magnetic resonance imaging (MRI) scanners, more than eight advanced computerized tomography (CT) scanners, dual bi-plane rotational neuroangiographic suites, and three in-section sites for advanced post-processing of image data.
Endovascular Neurosurgery
Neurosurgery residents are involved in the preoperative and postoperative daily care of all patients, including those with aneurysms, vascular malformations, spinal malformations, intracranial tumors, spinal tumors and spinal compression fractures, acute cerebral infarction, extracranial carotid stenosis, and intracranial cerebral stenosis.
Residents participate in the decision-making process for all endovascular cases—gaining experience in carotid angioplasty, stenting, vertebroplasty, aneurysm embolization, arteriovenous malformations (AVM), spinal tumors, and spinal vascular malformations, as well as treatment for vasospasm and acute ischemic stroke. All residents have access to and can act as first assistant in any endovascular or angiographic procedure. Residents learn the basic skills of cerebral angiography, sharpen their vascular anatomic knowledge, and learn the basics of endovascular decision making. For residents who have further interest in this subspecialty, an opportunity exists to spend a year on the diagnostic neuroradiology service.
Neurosurgical Oncology
Our program provides outstanding patient and family-centered care. We are recognized for our development of innovative therapies and surgical technologies for brain tumors. Neurosurgery residents are exposed to cutting-edge technology for the microsurgical and endoscopic management of brain tumors. Residents learn both endonasal and intraventricular neuro-endoscopic techniques for the management of skull based and intraventricular tumors. Residents also learn from the multidisciplinary management of patients with malignant brain tumors with a weekly Brain Tumor Board held across the three main campuses of the Mount Sinai Health System (Mount Sinai Hospital and Mount Sinai West). Laser interstitial thermal therapy (LITT) is now available within the Mount Sinai Health System for the treatment of certain brain tumors that have relapsed despite surgery, radiation, and chemotherapy.
The skull base program is a multidisciplinary group of neurosurgeons and ENT surgeons offers a new and less invasive form of surgery to patients who require surgery for skull base tumors. Neurosurgery residents learn this approach and are taught the surgical approaches and treatments necessary for skull base surgery including minimally invasive microsurgery, endoscopy, and neuronavigation.
The Pituitary and Parasellar Tumors Treatment Program is a multi-disciplinary group of neurosurgeons and endocrinologists that specialize in caring for patients with pituitary tumors. Residents learn advanced surgical and medical techniques for treating pituitary and parasellar tumors.
In the Spine Tumor Program, complex instrumentation and minimally invasive procedures are used to treat patients with metastatic spine tumors. Neurosurgery residents participate in the individualized surgical care of each patient and are exposed to all spine techniques and technologies to provide state-of-the art care for spine tumor patients.
Functional and Restorative Neurosurgery
The Center for Neuromodulation focuses on the treatment of medically refractory movement disorders with Deep Brain Stimulation (DBS). Vagus Nerve Stimulation (VNS) is also performed for the treatment of generalized epilepsy and chronic depression. Mount Sinai physicians are pioneering the use of DBS for obsessive-compulsive disorders, chronic depression, Tourette syndrome, and epilepsy. They are also using motor cortical stimulation to enhance motor recovery after stroke and treat atypical facial pain and secondary dystonia. Programs in neural transplantation and in vivo gene therapy are in their planning stages.
Neurosurgery residents are intimately involved in the pre- and postoperative daily care of all inpatients. They gain an understanding of advanced stereotactic techniques including the use of frameless DBS lead implants and intraoperative single-cell microelectrode recording. Residents participate in all aspects of the DBS procedures including frame application, surgical planning, patient positioning, and the interpretation of physiological parameters.
Stereotactic Radiosurgery
The Stereotactic Radiosurgery Service collaborates with the Departments of Radiation Oncology and Medical Physics, as well as the Cancer Center. This multidisciplinary program provides state-of-the-art minimally invasive comprehensive treatment to patients with brain and spine tumors. Our brain tumor neurosurgeons are actively involved with the stereotactic radiosurgery program. The program employs the Novalis shaped beam surgery technology, allowing delivery of fine field shaping stereotactic radiation to cranial and extracranial nerves.
Neurosurgery residents are encouraged to participate in the frame placement, treatment planning, treatment administration, and clinical and radiographic follow up of these patients, as well as in post treatment care.