Neurosurgery Physician Assistant: A week in the life

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Neurosurgery Physician Assistant (PA)

A Week in the Life of a Neurosurgical Physician Assistant was written by Bianca Belcher, for

What does a Neurosurgery Assistant do?

A day in the life in a Physician Assistant job can vary greatly depending on if you work in inpatient, outpatient, or primarily in the OR. This job is unique because you may work with both neurosurgery and neurosciences. It is easier to understand the role by looking at the schedule for the week. Although each day is very different, my attending and I start each day by rounding on our inpatients and checking the upcoming OR schedule to make sure we have everything we need (equipment, reps, etc) for the surgeries.


Movement disorder clinic day. I see patients in an outpatient setting who have a movement disorder such as Parkinson’s disease or essential tremor that need an evaluation for deep brain stimulation. I also see patients who have already had the implants and are ready for programming. I work closely with movement disorder neurologists to select the appropriate patients and obtain optimal programming results. My day generally runs from 9am- 5pm.


Overflow day. My practice does not routinely schedule any appointments on this day, but we use it to fit in extra OR cases or clinic appointments as needed. I generally see at least 1-2 patients on these days. I use the remainder of the time to catch up on patient phone calls, call referring physicians to update them on their patients, and finish notes.


Neurosurgery clinic day. I see patients both independently and in conjunction with my supervising surgeon. These appointments can range from a new patient coming for an initial evaluation to a post-operative patient that needs their staples/sutures removed. I perform physical exams, review imaging, explain procedures, obtain consent for upcoming surgeries, write notes, and coordinate care with other services such as family medicine, oncology, neurology, and the pain service. A typical clinic day runs from 9am – 5pm. Clinic days are hectic, but they give me a great opportunity to connect with my patients and answer their questions.

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Academic day. Many large teaching hospitals have “Academic Days” in which only urgent or emergent OR cases are scheduled. The purpose of this day is to increase your knowledge about the field and work on academic/scientific projects. These days are designed for the residents, but I try to attend as many sessions as possible. A typical Thursday starts at 7am with Neurosurgery Grand Rounds, then 8am Neuroradiology Grand Rounds, then a noon-time PA Grand Rounds or Resident Teaching Session. Between educational sessions, I am still responsible for rounding on my inpatients and answering calls from my outpatients. In addition, I am a co-investigator on several clinical trials so this is a much needed day to catch up on research.


OR day. Depending on the surgery we are performing that day, we can start as early as 6am or as late as 7am. I visit all patients and their families prior to bringing them back to the OR to answer any last minute questions. I scrub in for the majority of cases and first assist my attending. OR days are a great time to work on surgical technique, see anatomy, and intimately understand the surgeries so you can better explain them to patients and understand potential complications.


Off. As an outpatient Neurosurgical Physician Assistant I do not generally work on holidays or the weekends. The exception is if I need to round on or help discharge a patient on our service, but this is rare.

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