Community Rotations

Educational Objectives (PGY 3-6)

MEDICAL EXPERT (The below pathologies will present variably to community sites at any given time, therefore the medical expert objectives for this rotation will encompass those pathologies that present during the rotation.)

  • Develop management plan and provide definitive medical management of patients with intracerebral hemorrhage
  • Assess and manage patients with trigeminal neuralgia and other neurovascular compression syndromes
  • Assess and manage patients with disorders of the peripheral nervous system (e.g. entrapment neuropathies, trauma, nerve sheath tumours)
  • Assess and manage patients with intra-axial primary and secondary brain tumours including technical skills of tumour resection
  • Initiate diagnostics and management of the patient with spinal pathology
  • Assess and manage patients with degenerative spinal conditions
  • Assess and manage patients presenting with traumatic spinal emergencies
  • Assess and manage patients presenting with cauda equina syndrome
  • Assess and manage patients presenting with spinal cord compression
  • Assess and manage patients presenting with spinal infections (spinal epidural abscess, osteomyelitis-discitis)
  • Assess and manage patients with Chiari malformation including technical skills of chiari decompression
  • Assess and manage patients with synringomyelia including technical skills of synrinx-shunt insertion
  • Technical skills in the OR including:
    1. Knowledge of surgical anatomy
    2. Skill in use of surgical instruments including using the operating microscope
    3. Skill in registering and utilizing intraoperative neuro-navigation
    4. Perform evacuation of an intracerebral hemorrhage with management of any associated vascular malformation or hemorrhagic tumour
    5. Perform microvascular decompression and/or percutaneous rhizotomy
    6. Perform resection of peripheral nerve tumours
    7. Perform a lumbar laminectomy
    8. Perform a posterior cervical or thoracic decompression
    9. Perform a lumbar discectomy
    10. Perform exposure of the anterior cervical spine
    11. Perform anterior cervical decompression
    12. Perform spinal instrumentation throughout the spinal axis (posterior subaxial, posterior thoraco-lumbar and anterior cervical)
    13. Perform surgical management of intradural spinal pathology including intra-medullary and extramedulallary spinal tumours


  • Establish therapeutic relationships with patients and their families in the clinic, emergency room and on the neurosurgical inpatient units.
  • Present and document the neurosurgical consultations including detailed history, physical exam and findings of investigations and management plan.
  • Document operative and progress notes in the patient chart for patients on the neurosurgical service.
  • Perform/communicate discharge summaries appropriately for patients being discharged from the neurosurgical service
  • Update patients and family relevant information regarding their neurosurgical condition and management plan
  • Obtain consent for neurosurgical procedures


  • Work/collaborate effectively as a member of the interdisciplinary care team on the neurosurgical service
  • Consult other medical and surgical specialities appropriately in the care of the neurosurgical patients
  • Work with other healthcare providers and paramedical personnel on multiple levels in the management of neurosurgical patients
  • Actively participate in educational activities and teaching
  • Listen and respond appropriately to concerns of other health care providers


  • Manage the neurosurgical inpatient service
  • Organize resident call schedule for neurosurgery service (abide by contract and university policies and accommodate requests when able) – recognizing that there will not be complete coverage of the service
  • Effectively utilize and allocate finite healthcare resources
  • Have working knowledge and be able to manage the complete care of patients on the Neurosurgical ward.


  • Recognize and respond to determinants of health in neurosurgical patients.
  • Contribute to overall patient well-being and outcome
  • Facilitate return of patient to community/alternate care
  • Be able to identify and provide community care/resources to support patients


  • Develop and execute scholarly projects in the field of neurosurgery, basic neuroscience and/or medical education
  • Provide teaching to junior learners on the neurosurgery team (bedside and other informal teaching)
  • Identify and seek out personal learning needs related to cases encountered on the neurosurgical service
  • Apply principles of critical appraisal to medical information
  • Facilitate patient, student and peer learning
  • Contribute to development of new knowledge
  • Acquire knowledge in research methods and statistics.


  • Foster collegial relationships with staff and residents, neuroscience nurses and other allied health professionals
  • Develop professional tactics for effective, honest discussion with patients and families with respect to challenging issues including delivery of grave diagnoses, withdrawal of care and disclosure of medical error.
  • Exhibit appropriate professional behaviors in practice (including honesty, integrity, commitment, compassion, timeliness, respect and altruism)
  • Show appropriate respect for opinions of other health care providers
  • Be able to appraise and identify own limits with respect to knowledge and patient care, and when to ask for assistance and consult effectively.
  • Understand and have a working knowledge of ethics in context of clinical care

Expectations of the rotation:

  • Maintain a logbook of all surgical procedures (including insertion of lumbar drains and ICP monitors)