Neurosurgery Residency Program

PGY-7 Chief Neurosurgery Residents

PGY-6

PGY-5

PGY-4

PGY-3

PGY-2

PGY-1

Thank you for your interest in the Neurosurgery Residency Program at Barrow Neurological Institute.

We accept four PGY-1 residents per year through the Electronic Residency Application Service/National Resident Matching Program only. All of our PGY 2-7 positions are currently filled.

Key Dates for 2023

September 2023: 

Applicants may begin submitting applications to residency programs Sept. 6, 2023 at 9:00 AM EST
MSPEs are released to residency programs Sept. 27, 2023 at 9:00 AM EST

October 2023: Residency program begins reviewing applications and MSPEs

Application Process

Please include the following items in your ERAS application:

• Common application form  
• Personal statement
• Medical school transcript
• Medical Student Performance Evaluation (MSPE)
• Letters of recommendation (maximum of four)
• Photograph
• United States Medical Licensing Examination (USMLE) transcript
• Education Commission for Foreign Medical Graduates (ECFMG) status report (if applicable)

International medical graduates must be able to obtain an ECFMG certificate and J-1 Visa. We do not sponsor visas.

Applicants are evaluated based on multiple criteria, including (but not limited to): personal statement, grades, research experience, USMLE scores, letters of recommendation, and extracurricular pursuits. Applicants will receive notification of their interview status in mid-October.

Interview Dates

Interviews take two full days and are typically held between November and January. Applicants will need to arrive the day before their interview and are expected to be on campus until approximately 5:00 PM on the second interview day.

Learn More on How to Apply to the Neurosurgery Residency Program

For information about how to apply to our program, please contact the National Resident Matching Program at (202) 862-6077 or https://www.nrmp.org.

We only accept applications through ERAS.

If you would like more information about Barrow Neurological Institute or have any questions about the residency program not covered here, contact the Neurosurgery Program Manager at  Neurosurgery@BarrowNeuro.org

Attn: Neurosurgery Program Manager
Barrow Neurological Institute at 
St. Joseph’s Hospital and Medical Center 
350 West Thomas Road 
Phoenix, Arizona 85013 

Neurosurgery Training by Year

Each academic year begins on July 1. That marks the official start date for PGY-1 residents and the graduation date for PGY-7 residents. Residents progress to the next PGY on that date as well. Expand the tabs below for a year-by-year breakdown of the residency program.

PGY-1

• 6 months neurological surgery: Rounding, operating, and participating in neurosurgery call.
• 3 months neurocritical care: Interns are expected to round with the neurocritical intensivists and take ownership of non-surgical aspects of our sickest neurosurgical patients (subarachnoid hemorrhages, complex tumors, etc.), as well as perform various bedside procedures such as intubations, percutaneous tracheostomies, central lines, and lumbar punctures.
• 3 months neuroendovascular surgery: Working with our endovascular fellows, and under the supervision of our faculty, our residents learn to perform angiography, from establishing arterial access to navigating complex aortic arches and third order vessels. Residents on endovascular service manage post-op, ICU, and floor patients, and gain experience with complications associated with endovascular neurosurgery.
• All PGY-1 residents participate in the intern boot camp run by Society of Neurological Surgeons. This will introduce you to the basics of managing neurosurgical patients and procedures.
• Interns on NCC and NEVS do not take call. However, they alternate weekends as weekend-assist, participating with ICU and floor rounding. They generally finish by 11:00 AM.
• During the NCC and NEVS, we ensure that residents have sufficient days off and meet ACGME hour requirements. This typically corresponds to Monday off when following a weekend as the weekend-assist.
• USMLE Step 2 CK must be completed before July 1 of PGY-1.
• USMLE Step 3 must be completed by July 1 of PGY-2 and is often completed during the NCC rotation.

PGY-2

• Junior residents at Barrow, together with chief residents, form the core of our neurosurgical service. PGY-2 residents are responsible for covering primary call, which entails fielding consults from our ER, trauma room, as well as outside hospitals. This exposes our residents to nearly every situation faced by a practicing neurosurgeon.
• Juniors are also responsible for rounding on ICU patients, where they continue to build their  neurocritical care and postoperative management skills.
• This intense year quickly elevates your fundamental clinical skills to a high level, where basic and even complex neurocritical care becomes second nature.
• The call requirement is q6 primary call. The number of consults per call ranges from about 10 to 25 per 24-hour period. The on-call junior resident also performs 1-2 operative procedures—EVDs, subdural drains, halos, etc.—per call. Our residents are treated as neurosurgeons, not labor, during call and normal on-service time. Residents are not involved in placing IVs, A-lines, CT transport, or prepping patients for procedures unless they indicate a desire to do so.
• During rounding, our residents communicate directly with our in-house critical care physicians and internal medicine attending physicians. As well, for management of our floor-status patients, we have 6 nurse practitioners, with 1-2 on weekends, to assist while our residents are operating.
• PGY-2 residents typically perform about 250-300 operative cases, typically involving skill-building cases such as
  • CSF shunt placements
  • Lumbar laminectomy
  • Deep brain stimulation
  • Vagal nerve stimulation
  • Intrathecal pumps
  • Cranioplasties
• It is not uncommon for more complex cases, including brain tumors and cervical fusions, to become available to PGY-2 residents as a first assist. Equally important, there is a strong tradition of resident-to-resident education through double scrubbing with more senior residents on complex cases. This provides opportunities to see once-in-a-lifetime cases, as well as directly model surgical techniques from other residents.

PGY-3

The PGY-3 year is broken down into four different services:

• 3 months Dr. Lawton’s service
• 3 months pediatric neurosurgery at Phoenix Children’s Hospital (PCH)
• 3 months neuro-oncology with Dr. Sanai
• 3 months general service

Lawton’s Service

While on Dr. Lawton’s service, residents are fully responsible for the clinical operations of the chairman. It is a high-intensity experience with superb vascular and skull base exposure wherein residents learn the subtleties of patient management that makes for successful practice. You will learn to manage effectively the various elements of a busy private practice, including:

• Running an outpatient clinic
• Overseeing the care of ICU and floor patients
• Reviewing all radiographic images for consultation
• Post-operative follow-up
• Managing patient phone calls and patient inquiries
• Ensuring that operative cases are scheduled correctly

Pediatric Neurosurgery

For three months, residents rotate at Barrow Neurological Institute (BNI) to work with neurosurgeons in a dedicated pediatric hospital.

• David H. Shafron, MD
• Ruth Bristol, MD 

Residents on pediatric neurosurgical service will gain exposure to:

• Cranial and spinal tumors
• Synostosis reconstructions
• Pediatric trauma
• Endoscopic procedures
• Chiari malformations
• Spine dysraphism including tethered cord and myelomeningocele
• Brachial plexus repair/reconstruction,
• CSF diversion
• Pediatric spinal deformity

While at PCH, our residents are able to choose the cases of their interest, which means that CSF diversion cases comprise 10-15% of their case volume.
The call schedule at PCH is different than that at Barrow, with q2-3 home call with an average of 2-4 consults, which may sometimes be managed through the staff at the hospital. There are great support services at PCH, including multiple nurse practitioners and physician assistants. As at Barrow, residents on pediatric service at PCH serve as neurosurgeons, not support staff.

Neurosurgical Oncology

Barrow residents get early exposure to surgical tenets of neurosurgical oncology with Dr. Nader Sanai. The objectives of this rotation are to:

• develop inpatient and outpatient familiarity with brain tumor patient management
• develop fundamental technical skills and operating room habits for cranial and brain tumor surgery
• understand the principles underpinning a successful academic neurosurgery practice
• develop the professional, clinical, and scientific habits necessary for success in any career in neurosurgery
• learn how to interface with academic multidisciplinary brain tumor patient teams

General Neurosurgery Service

There are also three months of general neurosurgical service, during which residents progressively ascend through cases of increasing complexities.

As a PGY-3, residents are expected to master:

• Anterior cervical fusions
• Lumbar decompression
• Simple cranial cases
• Neurotrauma cases

There is increasing exposure to:

• Spinal deformity correction
• Complex cranial tumors
• Other microsurgical procedures, like Chiari decompression

PGY 4 & 5

The senior operative years at Barrow provide a wealth of advanced oncologic, vascular, and spinal cases. This includes:

• Skull base approaches
• Eloquent tumor resections
• Carotid endarterectomies
• Spinal deformities
• Microvascular decompressions
• Epilepsy surgeries
• Occasional cerebrovascular cases

At this point in training, residents are able to choose increasingly complex cases that facilitate transition to independence upon graduation. Further, the senior call burden lessens each year with PGY-5s averaging one Friday call per month.

Spine Service

Three months during the fourth year is dedicated to learning the management of spinal disorders during an extended rotation with their choice of one of the dedicated spine faculty at SJHMC. This includes:

• Routine out-patient clinic
• Review of films
• Dedicated spinal operative time when not in clinic (Resident is first pick within their class for cases with their spine mentor)

Research

There are six months of elective specialization and research during PGY-5.

PGY 6

The sixth year is dedicated to research and pursuit of elective rotations.

PGY-7 Chief Year

Chief residency at Barrow is a mixture of operative freedom and complexity as well as ultimate responsibility.

Chief neurosurgery residents select the best cases every day, which routinely include:

• Aneurysms,
• AVMs
• Complex tumors
• Skull base approaches
• Complex spinal deformity

Chiefs are also responsible for the operation of the clinical service, which entails:

• Case assignments
• ICU rounds every morning with juniors
• Developing the rules and procedures by which other residents care for patients

During this time, our residents are expected to master complex cases as they take the final steps toward becoming an attending neurosurgeon.

There is a wealth of clinical conferences at Barrow, including multidisciplinary clinical rounds, basic science rounds, and teaching rounds.

For residents, the most important of these opportunities are the teaching rounds held by Dr. Michael Lawton and Dr. Nader Sanai. Commonly referred to as film rounds, this teaching conference represents the ultimate commitment to resident education and have been the way Barrow neurosurgery residents have finished their day for more than 20 years.  Film rounds consist of inquisitive discussion combined with film review.  Questions of diagnosis, anatomy, treatment options, and outcomes are posed to residents, similar to how the ABNS oral boards are performed.

In addition to film rounds, the department’s regularly scheduled conferences include:

• Tumor board
• Morbidity and mortality
• Neuroendocrine
• Journal club
• Board review
• Epilepsy
• Neuropathology brain cutting
• Neurosurgery clinical conferences
• Neuroscience grand rounds

2025 Neurosurgery Sub-Internship Application Process

2025 Sub-Internship Application Requirements

Application Portal: Apply Here

Dates: We will be accepting applications from February 1, 2025 through March 31, 2025.

Materials Required: Medical school transcript, photo, one letter of reference, curriculum vitae, BLS certification, proof of immunizations (including Covid-19 vaccine), letter of good standing, and USMLE Step 1 results.

If you have questions, please contact Neurosurgery@BarrowNeuro.org.

About the Neurosurgery Sub-Internship at Barrow

The essence of the Barrow experience is technical mastery and surgical excellence. As such, the majority of your time here will be spent in the operating room learning surgical fundamentals.

Neurosurgery Residency Program

The neurosurgical service at Barrow is a single service, with one pool of residents independently operating every day in a dedicated 11-room neurosurgical operative suite that contains cutting-edge, state-of-the-art equipment.

The goal of the sub-internship experience at Barrow is to prepare you for residency and to provide you with a very transparent look at our training program. During your time here, you will have exposure to our subspecialty services, clinics, and operating theaters as well as interact on daily basis with our residents, faculty, and staff members.

Neurosurgery Sub-Internship Responsibilities

Your primary responsibility while on service is to learn the surgical fundamentals that will form the foundation of your skills and decision making as a surgeon. With the exception of conferences, afternoon teaching rounds, and clinic, you are expected to be scrubbed in on cases daily.

We make every effort to extend the opportunity to each sub-intern to rotate through 1-3 subspecialty clinics. Scheduling conflicts happen for a variety of reasons, but are typically due to emergency cases.

All neurosurgery sub-interns are required to attend regularly scheduled conferences and to give a 10-minute talk at a conference during their time here.