The goals of the intern year are threefold:
- To develop a foundation of internal medicine experience as a prerequisite for studying and practicing neurology
- To begin to develop neurological skills
- To gain experience in some of the fields related to neurology, e.g. psychiatry and neurosurgery
Objectives: During the intern year, residents will
- Evaluate and manage common medical conditions found in patients with neurologic disease. Examples include urinary tract infection, aspiration pneumonia, diabetes mellitus, atrial fibrillation, etc.
- Recognize when a patient has a neurologic disorder, attempt to localize the lesion, and develop a preliminary diagnostic and management plan.
- Recognize when a patient has a psychiatric or neurosurgical emergency and obtain timely consultation.
- Communicate with the various members of the health care team in a respectful and effective manner.
The goals for PGY-2 are
- To become proficient in neurological case formulation
- To learn to rapidly identify and manage neurological emergencies in adults and children
- To learn to evaluate and manage a wide range of neurological conditions in the outpatient setting
- To become proficient in lumbar puncture
- To gain exposure to EEG and EMG
- To appreciate the interdisciplinary nature of neurological care and learn to work as part of a team
Objectives: During the PGY-2 year, residents will
- Formulate cases presented to the attending staff or at educational conferences.
- Evaluate stroke code patients, accurately differentiating acute strokes from mimics and determining tPA eligibility.
- Evaluate and properly manage other acute adult neurological problems such as seizures, headache, multiple sclerosis relapse, Guillain-Barre syndrome, etc.
- Evaluate and manage febrile and other seizures in children.
- Identify normal background rhythms on EEG.
- Explain the role of EMG in localizing neurological disease.
- Evaluate and manage common outpatient problems such as migraine, radiculopathy, polyneuropathy, Alzheimer’s disease, and Parkinson’s disease.
- Lead morning interdisciplinary rounds, interacting with members of the team in a respectful and effective way.
- Teach neurology to, and act as a role model for, medical students on the neurology clerkship.
- Appraise the literature and tailor treatment recommendations based on clinical evidence.
The goals for PGY-3 are
- To develop more refined neurological formulation and management skills
- To start managing complex patients with more independence
- To begin providing supervision to the junior residents
- To become more proficient at EEG and EMG
- To consider clinical care from a systems perspective
Objectives: During PGY-3, residents will
- Consistently and concisely formulate cases presented to the attending staff or at educational conferences.
- Evaluate and manage complex stroke patients requiring endovascular intervention.
- Evaluate and manage inpatient consult service patients with indirect or oversight supervision, including the leading of family meetings.
- Evaluate and manage outpatients with advanced or complex disease, such as severe dementia, late-stage Parkinson’s, and ALS and other uncommon neuromuscular disorders.
- Identify epileptiform discharges and seizures on EEG.
- Perform nerve conduction studies and EMG under direct supervision.
- Model for junior residents the role of consulting neurologist, and specifically the professionalism and communication skills required of such.
- Analyze cases from a systems perspective and present them at systems of care conference.
- Provide care that takes into account cost and other resource limitations.
The goals for PGY-4 are
- To achieve sufficient skill in neurological formulation, diagnostic evaluation, and management sufficient to enter independent practice
- To be a mentor and role model for more junior residents
Objectives: The PGY-4 resident will
- Evaluate and manage patients with complex neurological diseases in a variety of subspecialty clinics.
- Manage the entire spectrum of acute stroke, status epilepticus, and other neurological emergencies
- Identify normal and abnormal background rhythms, epileptiform discharges, and seizures on EEG and compose precise EEG reports.
- Perform nerve conduction studies and low-complexity EMGs.
- Lead morning report and systems of care conferences.
- Lead bedside teaching exercises for neurology clerkship students.
Latest revision: 07/01/18
Justin A. Sattin, MD