Curriculum

Applicants to the first postgraduate year of training (PGY1) must enter the UMMC neurology residency program through the National Registry Matching Program (NRMP). The department offers 4 (four) positions per year. Applicants to PGY2, PGY3, and PGY4 positions may be hired through special consideration by the chairman and residency program director after a written release from the previous program.

PGY1 (Internal Medicine/Neurology)

Physicians accepted into the neurology residency program perform their PGY-1 year of 8 months of internal medicine and 4 months of neurology. Although the majority of the PGY-1 year is determined primarily by the Department of Medicine, the 4 months of neurology are generally through the Neuroscience Critical Care Unit, Stroke, and General Neurology services.

PGY2 (Second year - junior rotation)

The neurology residency program emphasizes direct care of adult patients with neurologic diseases in the first year of training. First-year residents are the primary caregivers for adult patients on the UMMC and VA hospital wards. A second-year resident (PGY3) or a third-year resident (PGY4) and a faculty member provide close supervision each month.

Many neurologic patients are cared for only in the outpatient setting. Consequently, we believe that a broad outpatient learning experience is essential for the proper education of residents. Therefore, outpatient training begins in the first year and continues throughout the entire three-year residency to ensure a temporal perspective on the management of neurologic diseases.

Each resident runs a continuity of care clinic (COC) which is essentially a "private practice" for the residents, one half-day a week under the supervision of senior residents and neurology faculty. In addition, first-year residents take part in a month-long clinic rotation. During this month, the resident participates in multiple specialty clinics and the general neurology clinics, as well as the COC clinic. The outpatient rotation is considered a primary patient care rotation and does not interfere with the performance of elective rotations. First-year residents work closely with and teach both medical students and physicians rotating from other specialties.

PGY3 (Third year - senior assistant resident)

The third year of training continues to emphasize direct patient care (including pediatrics), supervision and teaching of junior residents and medical students. The PGY3 year is divided as follows:

• 4 months of adult inpatient care. During this time, the second-year resident is responsible for the consult service and for the supervision of the ward teams.
• 3 months of pediatric neurology consult service and inpatient care.
• 5 months of elective rotations. Available rotations include neurophysiology (EEG, Evoked Potentials, EMG), neuropathology, neuroradiology, neurosonology, movement disorders, neuro-ophthalmology, psychiatry, neurorehabilitation, neurosurgery, neuromuscular diseases, epilepsy, cerebrovascular disease, outpatient clinics and neuro-oncology. Residents continue to run their COC clinics under the supervision of the neurology faculty.

PGY4 (Fourth year - senior resident)

The fourth year emphasizes supervision and day-to-day running of the neurology service, teaching of medical students, neurology residents and other rotating physicians. Third-year rotations include 5 months of consults/inpatient ward supervision and 7 months of electives.

Senior residents have much flexibility in selecting elective rotations of their choice. In addition to running their COC clinics, third-year residents are actively involved in the scheduling and overall running of the COC clinics and also supervise junior residents with the assistance of the neurology faculty.

Didactic sessions

Teaching neurology is a high priority of the chairman and each faculty member of the department. Formal teaching is a feature of inpatient rounds, clinics, lectures, conferences and elective rotations.

Lectures primarily aimed at the neurology residents include an annual summer lecture series on the neurologic emergencies and a continuous three-year lecture series. This three-year lecture series is taught in subspecialty blocks. Lectures are given once a week throughout the residency.

Morning sign-in/ teaching rounds

Five days a week, morning sign-in rounds are led by the program director and Neurology residents. These rounds are for all neurology residents, rotating physicians and medical students on the UMMC and VA hospital ward teams. During these rounds, new admissions and consults are discussed in a manner that promotes a basic understanding of the approach to the patient with neurologic disease.

Conferences

Neurology/Neurosurgery Grand Rounds are held weekly throughout the year. Residents are given opportunities to present topics of interest, usually in collaboration with a faculty advisor. Visiting professors, prominent in their fields, are regularly invited to speak at these conferences. Faculty, residents and students from Anatomy, Ophthalmology, ENT, Psychiatry and Pathology actively participate in these conferences. Morbidity/mortality, neuroradiology, neuropathology/brain cutting sessions and journal club are held monthly on a weekly rotating schedule. Resident and faculty "Feedback Rounds" is a monthly forum for "whining while dining."

Library and Learning Resource Center

The department library and UMMC Learning Resource Center has a selection of journals and most recent texts and monographs. A small historical library is also available. Teaching programs are available on computer, videotapes, slide and audiocassettes. The computers also provide access to literature searches, word processing and slide production.

Teaching opportunities

Residents are expected to teach as well as learn. For most of the year, medical students rotate on the Neurology service. Residents are expected to instruct and guide students and physicians who are rotating from other specialties. Senior residents are also responsible for overseeing much of the basic clinical teaching of the junior neurology residents.

Resident's Day Competition

During the spring of each year, there is a Resident's Day Competition in which neurology residents present original papers to the rest of the department. The resident chooses a faculty adviser early in the year to aid in the research project. PGY2, 3, & 4 residents must present a paper each year of the residency. The papers exemplify the case report and literature review, retrospective chart review and prospective approaches to clinical research.