Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Department of Neurosurgery

Program Description

The Neurosurgery residency develops neurosurgeons for academic and for practice careers. The residency is seven years in length, including the PGY-1 year.


Due to the change in ACGME program requirements for neurosurgery, the PGY1 year of fundamental skills is now integrated into the neurosurgery program under the leadership and direction of the neurosurgery program director.  The year is spent in rotations in Anesthesiology, ENT, General Surgery, Orthopedic Surgery, Plastic Surgery, Surgical Critical Care, Neuro-Ophthalmology, Neuro Intensive Care, Trauma, and three months of Neurosurgery.


The first full year of Neurosurgery is one of rapid learning of the basics of neurosurgical disease, of operative anatomy and technique, and of patient care.

During the year the resident will perform ventriculostomies, place lumbar drains, open and close craniotomies, perform peripheral nerve explorations, and perform decompressive cervical and lumbar laminectomies and discectomies.

The resident is responsible for the care of patients in the neurosurgical intensive care unit under the direction of neuro-intensivists, Anakara V. Sukumaran, M.D., Michael E. Zwillman, M.D. and Eric A. Bedell, M.D.

By the end of this year, the resident will have experience with the full range of neurosurgical procedures and will be competent to manage critically ill patients.


The year is divided into 4 blocks of three months each, in which competence is gained in the neurosciences on which Neurosurgery depends for making diagnostic and therapeutic decisions.

The rotation in neurology refines the resident’s history-taking and physical examination skills. Experience is gained with electrodiagnostic methods including electroencephalography.

On neuropathology the resident performs the initial reading of frozen and permanent sections and participates in brain cutting. The resident works closely with Dr. Suzanne Powell, Director of Neuropathology, and learns contemporary preparation and interpretation of neuropathological material.

On neuroradiology the resident works closely with Dr. Hani Haykal, Director of Neuroradiology, Dr. Richard Klucznik, Director of Interventional Neuroradiology, and the seven other neuroradiologists. The resident participates in the daily reading of imaging studies.

The resident also participates in diagnostic and therapeutic studies including myelograms, kyphoplasties, vertebroplasties, angiography, and interventional endovascular procedures.

On neuro-ophthalmology, the resident learns the intricacies of the neurological eye examination, and the variety of ways in which CNS disease involves the ophthalmic system. The resident works closely with Andrew Lee, M.D., a neuro-ophthalmologist with extensive training and experience.

During this year the resident takes the Microsurgery Course at TMH, which provides excellent experience in microsurgery of vessels and nerves.


The PGY-4 resident performs more advanced procedures and assumes more administrative responsibility. By the end of this year the resident is able to be the primary surgeon on most neurosurgical procedures.

PGY-5 – Research Year

The research year is dedicated to laboratory or to clinical research. The resident can work in one of the department’s laboratories or elsewhere.

Residents working with our faculty have been able to complete research projects in the areas of intracranial pressure and blood flow monitoring, ischemia protection, brain tumor biology and treatment, and gene therapy for brain tumors. Support is available for study design, biostatistics, and manuscript presentation.


The year is dedicated to gaining greater experience with Neurosurgical subspecialties.

The resident spends four months on the Pediatric Neurosurgical service at Texas Children’s Hospital in Houston, or, because of our affiliation with the Weill Cornell College of Medicine, on the Pediatric Neurosurgical service at Weill College of Medicine of Cornell University Hospital at New York-Presbyterian Hospital.   The rotation at New York Presbyterian Hospital is an option that can be selected by the resident.

Enfolded subspecialty experiences at TMH are taken in two 4-month blocks. Experience is available in the following subspecialties:

  • vascular
  • brain tumors
  • radiosurgery
  • complex spine
  • stereotactic and functional
  • epilepsy
  • interventional neuroradiology

PGY-7 Chief Resident

The chief resident performs all major surgery with the supervision of the attending staff.

The Chief Resident also has responsibility for:

  • supervising senior and junior residents and medical students
  • scheduling all activities of the Neurosurgical Service
  • organizing clinical and basic material presented at conferences, including tracking and presentation of morbidity and mortality data, and selection of articles for presentation at Journal Club.