Brain surgery, science and education

As a pediatric neurosurgeon, neuroscientist, and educator, I come across many interesting bits of information and wonderful people. I will try to share some of this with you here. While the site draws heavily from my experiences as the Campagna Chair of Pediatric Neurosurgery at Oregon Health & Science University, and head of neurosurgery at Doernbecher Children's Hospital, this is a personal blog. My thanks to my wonderful OHSU colleagues, who share this exciting and rewarding work with me.

Friday, July 6, 2012

Making Safety and Education Go Together

I graduated from medical school in the early 1990’s, and went to work in a major US hospital to train as a neurological surgeon. Like my compatriots around the country, within a few weeks of starting training, I began to perform invasive procedures needed by patients in the hospital. The first spinal tap I performed was on an actual patient. The first time I drilled a hole in the skull to relieve pressure … also an actual patient. Passing a catheter deep inside the brain to drain excess fluid? A patient.

Everyone doctor will have to get past his or her first of any procedure they need to perform in practice. And we need to train the next generation of doctors. So how can we do it, without sacrificing patient safety and the highest quality of care?

As the director of residency training in neurosurgery at OHSU, I have thought about this problem a lot. Having residents in the hospital 24 hours a day, seconds away from a patient’s bedside in the intensive care unit, has saved countless lives. But the emergency bedside procedures we do are some of the most impactful and risky in medicine.

In 2009, my colleagues and I hosted a ‘Boot Camp’ for 19 brand new neurosurgical trainees, only a few weeks out from medical school graduation. They came from 5 residency programs in the Pacific NW and California. We used a skills lab to teach, so the first skull drilling, the first lumbar puncture, the first fluid drain, were all carefully taught and mastered in a safe, simulated environment. While we had them all together, we also taught the residents about our perspectives on professionalism, careers, and respectful, effective communications with patients.

Three years later, the descendants of that first effort, the Society of Neurological Surgeons PGY1 Boot Camp Courses, are a universal part of residency training at all 100 neurosurgery training programs in the United States. They are endorsed by the American Council for Graduate Medical Education (ACGME), and they have been funded for 5 years by an unprecedented $1.9 million grant. Six courses are held each July, during the first few days of practice by new residents, at 6 centers around the country. OHSU continues to host the western region course and stay involved in curricular leadership of the courses nationally.

Today, OHSU for the 4th year hosted the Western Region PGY1 Bootcamp. What a great event!

OHSU is proud to share advances in safety and education with our colleagues around the US. Read more about the results at:

Dr. Nate Selden with SNS PGY1 Boot Camp residents

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