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!
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:
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| Dr. Nate Selden with SNS PGY1 Boot Camp residents |
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