Graduate Medical Education

Neurosurgery Residency

Moreno Valley, CA

12 Positions per year

Matched via NRMP

ACGME Accredited

100%

Residents that pursued subspecialty fellowship training after graduation

Welcome Curriculum Faculty Residents Salary & Benefits

Letter from the Program Director

Welcome and thank you for your interest in the Neurosurgery Residency Program at Riverside University Health System Medical Center. The RUHS ACGME Neurological Surgery Program sole objective is to train the complete neurosurgeon who is exceedingly competent in academic and clinical neurosurgery, who practices medicine with kindness and compassion, who communicates with respectful logical actions and words, who integrates Osteopathic philosophy into the care of not only the nervous system but also the entire person, who progressively improves the individual and societal practice of medicine fostering education, camaraderie and cooperation, who excels in the business and professional aspect of medicine nurturing growth, research, teaching, and best standards of practice, and who can solidify the many facets of medicine leading to improved patient and public instruction and confidence. The program has incorporated within it and mandates that the six core competencies and osteopathic recognition of the ACGME be measured and mastered. These measured “Core Competencies” are medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, systems-based practice, and Osteopathic principles and philosophy. The program also provides the potential for individualization in several areas including basic sciences, clinical electives, and research. The program is designed to provide residents with a thorough grounding in fundamental knowledge of neuroscience, as well as to develop diagnostic and therapeutic judgment along with the requisite surgical skills needed to practice neurological surgery. As a Level I trauma center and safety-net academic medical center, RUHS is deeply committed to equitable, high-quality care. Additionally, we have added multiple hospitals to which our residents provide patient care and gain holistic neurological surgery experience. We also emphasize research and active academic pursuit in neuroscience, general neurosurgery, as well as all neurosurgery subspecialties. While the training emphasizes mainstream general neurosurgery, residents are exposed to significant volumes of brain tumors, complex spine instrumentation, vascular neurosurgery, craniospinal trauma, and neuro-intensive care. All residents are encouraged to pursue subspecialty fellowship training after graduation, and thus far 100% of our graduates have gone on to sub-specialization. Preparing future physicians to meet patients’ expectations for optimal care requires that they learn in clinical settings epitomizing the highest standards of medical practice. Our faculty are committed as role models for residents, nurture both the intellectual and the personal development of residents, foster academic excellence, exemplary professionalism, cultural sensitivity, and maintain competence through life-long learning. In alignment with the Mission of our sponsoring institution, our Program’s endeavor to educate exceedingly competent academic and clinical neurosurgeons that are dedicated in mind and body to the excellence of patient care; improve the quality of health and well-being of the most affected of the patient population at the stage in which they may be at their most critical and vulnerable; and practice medicine with kindness and compassion, integrating the Osteopathic philosophy into the care of not only of the nervous system, but also the entire patient, family and community.

Dan Miulli, DO

Program Director

Residents per Year

2000

Year Established

Active Residents

Curriculum

Year-by-year training structure and rotation schedule

Rotations providing well-rounded exposure: ½ day/week neurosurgery outpatient clinic (46 weeks); 1 mo general internal medicine; 1 mo SICU; 2 mo MICU; 1 mo anesthesia; 1 mo emergency medicine; 1 mo general surgery; 3 mo neurology; 3 mo neurosurgery. Academic Skills Reading and lectures on general postgraduate clinical knowledge in medicine, women's health, surgery, pediatrics, neuroanatomy, and neurophysiology. Attend basic science lectures through GME office. Attend neurosurgery Grand Rounds covering applied neuroanatomy, cerebral metabolism, CBF dynamics, ICP management, and basic neuropharmacology. Learn to write a scientific paper using the Case Report format — outline due by December. Present articles at monthly Journal Club and oral case presentations at weekly Case Management Conference. Clinical Skills Obtain proficiency in relevant history-taking and examination on each rotation. Assist senior residents and attendings. Read about specific disease processes encountered. Function as surgical assistant beginning to develop wound opening/closing, burr holes (power and manual), and ICP monitoring device insertion skills. Participate in outpatient clinic, ER evaluations under guidance, and in-patient care of both pediatric and adult patients.

9 months Neurosurgery + 3 months Research Academic Skills Continue reading on neuroanatomy, neurophysiology, cerebral metabolism, CBF dynamics, ICP management, craniospinal trauma, cerebral neoplasms, and spine disorders. Present articles at Journal Club; prepare oral case presentations for Case Management Conference. Case Report outline due by December. Clinical Skills Improve proficiency in neurologic history and examination. Learn neurosurgical instrumentation (headrests, retractor systems, stereotactic frames, surgical microscope, frameless stereotaxy). Function as surgical assistant; develop skills for opening/closing wounds, creating burr holes, inserting ICP monitoring devices. Begin neuroradiology rotation — attend neuroimaging conferences, become proficient in interpreting all contemporary neuroimaging. Participate in outpatient clinic and ER evaluations.

9 months Neurosurgery + 3 months Research Academic Skills Expand neurosurgical knowledge base with broader reading. Case management discussions expected to deepen; decreasing reliance on chief and attending for day-to-day direction. Complete Neurology rotation requirements this year. Annual paper of greater substance than a case report — outline due by December. Clinical Skills Continue as first assistant; begin performing more surgical procedures under supervision — opening, exposing pathology, assisting in removal, and closing cranial and spinal cases. Demonstrate improved ER diagnosis and management skills. More familiar with outpatient management. During Neurology rotation: evaluate and manage patients with neurological disorders and develop thorough understanding of neurologic examination, case management, and clinical neurology.

3 months Neurosurgery + 6 months Pediatrics + 3 months Research Academic Skills Broaden reading beyond standard references. Directly responsible for medical students on elective rotations. Annual paper must be more sophisticated; must submit a paper for publication — outline due by December. Poster session for ACOS Annual Meeting may substitute. Clinical Skills Assume greater role in outpatient and office population management. Evaluate new patients and discuss diagnosis and management options. In the OR, performing more surgical procedures under supervision with attending acting as first assistant during resident-performed phases. Advanced neurosurgical operating skills expected. Neuropathology rotation: actively review histological specimens, attend brain-cutting conferences, assist in the neuropathology laboratory.

3 months Elective or Neurosurgery + 6 months Neurosurgery + 3 months Research Academic Skills Continue expanding knowledge and assume responsibility for more junior resident education. Complete and publish research projects; extensive peer-reviewed paper required — outline due by December. Eligible for out rotations in areas of specialization as approved by Program Director. Clinical Skills Continue expanding surgical independence and clinical leadership. Manage in-patient care including pediatric and adult patients. Demonstrate consistent expertise in neurological management of all conditions. Coordinate junior resident activities including academic programs, call and vacation schedules.

12 months Neurosurgery (can include elective) Academic Skills Assume management of the Neurosurgical service. Expected to lead junior resident education, coordinate academic programs, call and vacation schedules, and administrative activities. Read assigned journals and present at Journal Club; prepare case presentations for Case Management Conference. Complete and publish extensive peer-reviewed papers. Clinical Skills Demonstrate progressive advancement of clinical and technical skills culminating in completion of residency. Take more active role in outpatient and office activities. Demonstrate consistent expertise in all areas of neurosurgical management. Lead junior resident teams. Eligible for out rotations in subspecialty areas.

CHIEF — 12 months Neurosurgery Academic Skills Assume management of the Neurosurgical service. Expected to lead junior resident education, coordinate academic programs, call and vacation schedules, and administrative activities. Read assigned journals and present at Journal Club; prepare case presentations for Case Management Conference. Complete and publish extensive peer-reviewed papers. Clinical Skills Demonstrate progressive advancement of clinical and technical skills culminating in completion of residency. Take more active role in outpatient and office activities. Demonstrate consistent expertise in all areas of neurosurgical management. Lead junior resident teams. Eligible for out rotations in subspecialty areas.

Didactics & Academic Activities

Grand Rounds — Mondays 1pm–6pm (Thursdays when a Monday holiday falls). 1st & 3rd Mondays in person at KP Fontana; 2nd, 4th, & 5th Monday in person at RUHS.. Each session includes two lectures, a quiz, rotating activities, case presentations, and a simultaneous Skills Day lab.

Social Events — Jun-Meet and Greet

Aug-Barbeque Throw down

Aug-Team Building

Oct-Halloween Party

Nov-Thanksgiving Dinner

Dec/Jan-Holiday Dinner

Jan-New Year’s Eve

Jan/Feb-Retreat

Mar-Post In-service Party

Apr-Holiday Dinner

Jun-Graduation, Graduation, Graduation

Jun-Social Event Hello & Goodbye