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Neurosurgery Sub-internship - NSUR 548


Successful completion of Junior Internal Medicine and Junior Surgery Clerkships


University of Maryland Medical Center

Description and Goals:

The sub-I works at the intern level in patient care activities on the service, spending four weeks primarily on the inpatient neurosurgery services and, if desired, time can be spent on the Neurotrauma or Veterans Affairs (VA) services. The sub-I participates in the full activities of the Department of Neurosurgery to include daily rounds, clinics, operative cases, and weekly conferences.

The sub-I will attend daily rounds with the residents beginning each day at 5am. They will gather patient data such as vital signs, lab results, intraventricular catheter (IVC) ranges, Ins/Outs, and medications. Additionally, sub-I’s are asked to do minor procedures such as removing sutures, staples and drains. Sub-I’s will also participate in various neurosurgery clinics in the Medical Center, Shock Trauma, and VA to promote continuity of care.

Significant emphasis is placed on participation in operative cases throughout the sub-internship. Cases are chosen by the sub-I based on their interests or assigned to them by a senior resident based on the availability of cases. The majority of cases involve patients with brain tumors, aneurysms, arteriovenous malformations, pediatric neurosurgery problems, spinal disorders and epilepsy. Sub-I’s are expected to follow at least 2-3 patients at any time during their four weeks on service. They will review diagnostic studies, develop management plans with PGY-1’s and PGY-2’s, present them on rounds to senior residents and Chiefs, and do all of the work that needs to be done for the patients that day.

Sub-I’s are expected to participate in weekly neurosurgery conferences. They are held on Thursday mornings:

  • 0700 - 0730: Faculty Case Conference (S9A02)
  • 0730 - 0830: Grand Rounds (1st, 2nd, and 4th) and Morbidity & Mortality (M&M, 3rd Thursdays) (S9A02)

Sub-I’s have the opportunity to formally present a neurosurgical topic of their choosing to the faculty and residents during a designated conference, such as Grand Rounds, or during a more informal setting such as before or after daily rounds or scheduled conferences with the residents and faculty present. It is necessary to plan this well in advance and coordinate the date and time with the academic coordinator (a.k.a. administrative contact). The presentation should be at least 15-30 minutes in length. The sub-I’s presentation will be evaluated by those in attendance and will be used in the grading process.

Number of Students:

Up to 4 per session

Time of Year Available:

Academic weeks 1-48


Monday through Friday - Yes
Shiftwork - No
Evenings - No
Weekends - Yes (Four days total: One full weekend, one day over two weekends, one weekend off)
Call - No

Faculty Responsible:

Francois Aldrich, M.B., Ch.B., M.Med., F.C.S.
(410) 328-0937

Administrative Contact:

Heather Thomas, M.B.A.
Phone: (410) 328-8621
Fax: (443) 462-3051  

Additional Comments:

The course offers a dynamic exposure to surgical diseases of the nervous system on a large neurosurgical service. Diagnostic procedures and neurologic evaluations of patients are stressed. Students with motivation and interest in surgical specialties including neurosurgery, orthopedics, ENT, and general surgery, as well as medical specialties, such as neurology, will find this course rewarding.

Last Revision: April 16, 2013