FREQUENTLY ASKED QUESTIONS ABOUT TEACHING HOSPITALS AND REDISENTS

  1. Aren't residents students?
    No. Residents in neurological surgery have graduated from medical school and completed at least one year of residency training in general surgery. At MUSC residents in neurological surgery are expected to obtain an unrestricted license to practice medicine in South Carolina by the end of their second year after graduation from medical school. They are then fully qualified for the independent practice of medicine. These physicians have chosen to spend a minimum of seven years after completing medical school to obtain specialty training in the field of neurological surgery.

  2. If they haven't completed training in neurological surgery, how can they provide this safety net for patients at MUSC?
    The first neurosurgical problems and treatments that they learn about are the types of emergencies that can require immediate intervention. The life saving procedures needed in this type of emergency are not as complex as major neurosurgical operations and are readily learned early in training. In addition, they are closely supervised by both the chief resident (a neurosurgeon in the final year of training, less than one year from independent neurosurgical practice) and the attending neurosurgeons.

  3. How are neurosurgery residents supervised?
    The neurosurgery resident is never "in charge" of a patient's care. He or she is working under the supervision of the attending neurosurgeon who is a fully qualified independent practitioner of neurological surgery and a member of the faculty of MUSC. The resident and attending neurosurgeons are in close contact every day regarding the patients under their care. They will see each patient together or independently each day, with the attending neurosurgeon directing the patient's care. At night or on weekends and holidays the resident is in phone contact with the attending neurosurgeon who will come to the hospital if necessary. In a very real sense, the resident becomes the eyes, ears and hands of the attending neurosurgeon when the attending is not in the hospital.

    In addition to the attending neurosurgeon, the chief resident in neurosurgery provides supervision to the neurosurgery residents. The chief resident is in the final year of training. In less than a year, the chief resident will be practicing neurosurgery independently. The chief resident is familiar with the management of the full range of neurosurgical diseases and with the practice preferences of the MUSC attending neurosurgeons. The chief resident discusses each patient with the rest of the neurosurgey residents twice each day and with the neurosurgery attendings at least once a day. At MUSC, residents do not perform procedures independently until they have been fully trained and performed the procedures successfully under supervision and to the satisfaction of the attending neurosurgeons. Residents never perform the key portions of operations without the presence of the attending neurosurgeon. Life saving procedures may be performed outside of the operating room by a resident who is trained and approved to do such procedures.

  4. Are teaching hospitals safe?
    Yes! Research has demonstrated that teaching hospitals have better outcomes than non-teaching hospitals when patients with similar severity of disease are compared. Part of this advantage for the patient comes from having a specialist in the hospital at all times. Part comes from having several physicians in the same specialty involved with each patient's care. This means that different points of view are represented, that it is less likely that possible diagnoses or treatments are overlooked and that more attention can be paid to the individual patient's care.

  5. Are there disadvantages to patient care in teaching hospitals?
    When more people are involved in patient care, there is a greater chance that patients and their families may be overwhelmed by the complexity of modern medical care. The may receive explanations of diagnosis or treatment from several different people with different areas of expertise. This can be confusing. Usually, this apparent confusion is simply a matter of the same thing being explained in different ways. However, if at any time during your care you think you are getting different explanations or plans of treatment, ask to speak to your attending neurosurgeon. He or she is the final authority on your care and will clarify any confusion you are experiencing.

    Patient care in teaching hospitals is often thought to be impersonal. This usually results from the need to have several physicians from differing specialties involved to treat the complex diseases that are the special expertise of the teaching hospital. The best way to combat this sense of impersonality is to know who your attending neurosurgeon, resident neurosurgeon, consultants and nurses are and remember that your attending neurosurgeon is the final authority for your care.