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Overall Goals and Objectives

PGY-1

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.

PGY-2

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 PG-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.

PGY-3

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.

PGY-4

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