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Yale Neurology Residency
PGY2
Overview and Schedule The
first year of neurology training is designed to provide an intensive
clinical
experience in a structured teaching setting. In
parallel with direct care on the inpatient Neurology
Services, PGY-2
residents are assigned to outpatient clinics where they receive
one-on-one
supervision. A large percentage of time
is spent on the The
primary goal of the PGY-2 year is for the resident to achieve a high
degree of
competence in the clinical assessment, evaluation, and treatment of
patients
with neurological disease. Residents
gain experience in the interpretation of neurodiagnostic techniques
including:
EEG, EMG, evoked potentials, carotid and transcranial ultrasound,
angiograms,
computerized tomography, magnetic resonance imaging (MRI), single
photon
emission tomography (SPECT) and positron emission tomography (PET).
As noted below, outpatient as well as
inpatient neurology is emphasized. Beginning
during this first year of neurology training,
residents
establish close working relationships with faculty in the Department.
Collegiality is emphasized, and feedback is
provided throughout the period of residency. The following represents a typical PGY2
schedule. Each block is 4 weeks. Yale Inpatient Wards: 4-5 blocks. Residents work with a team that includes an attending, residents and students. They take primary responsibility for the care of patients on the inpatient ward and the Neuro ICU. Supervision is by a PGY-4 resident and an attending. VAMC Rotation: 2 blocks. Residents work with a team of attendings, residents and students, and care for neurology patients on the neurology ward, and in the ICUs. Residents also have an average of 4 outpatient subspecialty clinics per week, such as epilepsy, stroke, movement disorder, multiple sclerosis and neuromuscular. In addition, residents help provide consults on inpatients for other services and in the ER. Supervision is by a PGY-4 resident and attending physician. Emergency Neurology: 1 block. Residents are stationed full-time in the Yale Department of Emergency Medicine. They function as neurological consultants on all patients with neurological disorders presenting to the Yale Emergency Department. Supervision is by a PGY-4 resident and attending physician. Epilepsy Ward: 1 block. Residents work with a team of fellows and attendings, and care for seizure patients on the epilepsy monitoring unit. Residents attend seizure clinic, participate in epilepsy surgery conference, and read EEGs. Clinical Neurophysiology: 1 block. Residents receive comprehensive full-time exposure to performance and interpretation of EMGs, NCVs, and EEGs. They perform EMGs 4 days per week, and read all EEGs performed at Yale. Supervision is by attendings in the Clinical Neurophysiology lab – usually providing a ratio of 2 attendings to 1 resident, and is thus a highly educational experience for the residents. Residents also attend neuromuscular clinic ½ day per week, and prepare the weekly EEG conference. Night Float: 1 block. The night float resident covers the Yale inpatient neurology service 6 nights per week, responds to inpatient emergencies and provides the initial comprehensive care of newly admitted patients and consults. The night float resident presents newly admitted cases and consults at Morning Report, and then during morning work rounds on the inpatient service before they leave the hospital during the daytime. Daytime activities such as weekly clinic are canceled. Subspecialty Clinic Rotation: 1 block. Residents see patients in a variety of ½-day subspecialty clinics. These clinics are selected based on educational value, and the selection is modified periodically based on feedback from the residents and attendings. The clinics currently are movement disorders, multiple sclerosis, neuromuscular, stroke, neuro-ophthalmology, seizure, and neuro-oncology. Supervision is by attendings who are experts in these subspecialty areas, and teaching is one-on-one. Continuity Clinics: Each resident attends a continuity clinic on average 1 time per week. Continuity clinics are held at the VA ½ day Tuesday, ½ day Wednesday and ½ day Friday. Each resident follows his/her own cohort of patients for 3 years, assuming all responsibility for outpatient care with supervision by an attending, including covering problems that arise between clinic appointments. Night coverage for these outpatients is generally shared between residents.
Last modified: August 2006
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