Changing the residency structuregreenspun.com : LUSENET : Residents' forum : One Thread
The Neurology residency's rotation structure, academic schedule, responsibilities of residents and the on-call schedule should be modified for more efficient working and learning. The following is my version of a better-structured program, assuming a total of 18 residents (6 in each year).
4 months as junior resident on ENC floor
4 months as junior resident on VA floor
2 months in New Neurology Clinic at VA
1 month Neuroradiology
1 month vacation
2 months as consult resident at ENC
2 months as consult resident at HAC
2 months as consult resident at VA
3 month Child Neurology
1 month EMG
1 month EEG
1 month vacation
2 months as chief resident at ENC
2 months as chief resident at HAC
2 months as chief resident at VA
1 month Neuropathology
1 month psychiatry
1 month Neurosurgery / NICU / Rehab
2 months elective
1 month vacation
The PGY4 is in overall charge of the floor and consult service. Rounds with the PGY2s on the in-patients and also rounds on the consults that have been seen by the PGY3. Also is in charge of directing and allocating responsibilities to medical students and other rotators on the neurology service.
Two PGY2s are directly responsible for the neurology floor patients. One PGY3 is directly responsible for consults from the ED and other services at ENC.
HAC (no neurology floor service)
The PGY4 is in overall charge of the adult and child neurology consult services. Rounds with the PGY3s (adult and child neurology consult residents) with the respective consult attendings. Also is in charge of directing and allocating responsibilities to medical students and other rotators on the neurology service.
One PGY3 is directly responsible for the adult consults and from the ED, Urgent Care and other services. The PGY3 rotating through child neurology is responsible for the pediatric consults from the ED, Urgent Care and other services.
The structure is similar to that at ENC.
ENC and HAC
1 attending of the month is responsible for morning report, rounding on adult neurology consults at ENC and HAC and the non-stroke patients at ENC floor. Stroke attending and fellow are responsible for all consult and floor stroke patients.
PGY2s will do in-house calls at the ENC and VA and will be responsible for floor patients and consults from the ED and other services. They will call either the stroke beeper (for stroke patients) or the Chief resident on call (for non-stroke patients). PGY3s will do in-house calls at HAC and will be responsible for adult and pediatric neurology consults form the ED and other services. They will call either the stroke beeper (for stroke patients) or the Chief resident on call (for non-stroke patients). One of the Chief residents (PGY4s) will be the second on call for non-stroke patients who are seen by the in-house resident at the ENC, HAC or VA.
7.30 AM - 9.30 AM: Residents' rounds on floor patients
9.30 AM - 10.30 AM: Morning report at ENC with attending of the month (The floor residents, consult residents and Chief residents from ENC and HAC will attend this)
10.30 AM - 11.30 AM: Attending and team rounds on floor patients
12.30 PM - 1.30 PM: Noon conference
3.30 PM - 5.00 PM: Consult rounds with attending
5.00 PM - 5.30 PM: Sign-out to on-call resident
-- Anonymous, February 17, 2000
Shyam, I agree with the structure you have proposed. I think that the PGY3 year should be a year to exposed the variety of cases that are found on the consult service. In addition to the full months of eeg and emg. I also believe with this experience the PGY4 can take on a strong leadership role for the floors. Good plan.
-- Anonymous, February 21, 2000
I feel we deserve more elective time (elective in the real meaning of the word, and not EEG/EMG as a "forced elective"). We should have at least 1 elective as PGY3 and 2 as PGY4, where we choose to do whatever we want. If that is not possible, we should at least have 1 elective as PGY3 and one as PGY4. For eample, I already applied for an elective as PGY3, it was approved by the hospital where I would be going in October and I am waiting for BU to decide wether I can do it or not. Those electives as PGY3 also help us in term of fellowships (which I believe are very important). Finally, when we interviewed in this program, and according to the current manual, we were promised such electives.
-- Anonymous, February 22, 2000