Sample Rotation Schedule

In your first year of internship, you will be rotating at Hartford Hospital, St Francis Hospital, and UConn Health in Farmington. The last block in June is Neurology boot camp, a month full of introductory neurology lectures, simulation training, and shadowing of service and clinic to get interns ready for PGY-2.

Year

Service

Site

Number of Weeks

PGY-1 Inpatient/Ward Medicine HH / SFH / UC 20
ICU/CCU HH / UC 8
Consultative Neurology Service HH 2
Inpatient Neurology Service HH 2
Neurocritical Care HH 4
Ambulatory Service HH 4
Electives/selectives in medicine subspecialties such as: endocrinology; infectious disease; nephrology; pulmonology; rheumatology; or cardiology HH / SFH 4
Neurology Continuity Clinic Weekly
Neurology Boot Camp HH/UC 4

Your three years of advanced neurology training is split between Hartford Hospital and UConn Health. Rotations are also done at the Connecticut Children’s and the Hospital for Special Care, a rehabilitation hospital in New Britain. You also continue your continuity clinic one half day per week throughout the next three years. Below is a sample curriculum.

PGY-2 Inpatient/Ward Neurology HH 16
Consultative Neurology Service HH / UC 12
Day Float HH 2
Night Float HH 4
IR HH 1
Ambulatory Subspecialty Clinics HH / UC 5
Neuro-Radiology and EEG UC 2
Elective 6
PGY-3 Inpatient/Ward Neurology HH 2
Consultative Neurology Service HH / UC 6
Day Float HH 4
Night Float HH / UC 3
Pediatric Neurology CCMC 12
EEG HH / UC 4
EMG HH / UC 8
Ambulatory Subspecialty Clinics HH / UC 4
Elective 5
PGY-4 Inpatient/Ward Neurology HH 6
Consultative Neurology Service HH / UC 10
Day Float HH 2
Night Float HH 2
Psychiatry IOL 4
Neurocritical Care HH 2
Neuropathology HH 2
Neuro-Rehabilitation HH / HSC 3
Ambulatory Subspecialty Clinics HH / UC 5
Elective 12

THE FIRST NEUROLOGY YEAR (PGY-2)

The emphasis in the first year is to develop patient assessment and image interpretation skills as well as a knowledge base of general neurology. To facilitate this, residents spend the majority of the first year providing care for hospitalized patients on the Inpatient/Ward Neurology service at Hartford Hospital and Consultative Neurology services at Hartford Hospital and UConn Health.

The blocks spent on the consultative and inpatient neurology service at Hartford Hospital seeing inpatient and ED consults under the supervision of a senior resident and an attending. On this rotation, the resident is required to remain up-to-date on the status of their consults and follow-up for any pertinent labs and studies and also be responsible for communicating findings and recommendations with the patients’ primary service and writing notes in the chart when appropriate. One block is also spent as consult junior at UConn Health under the supervision of a senior resident and an attending.

On the Neuroradiology/EEG rotation, residents assist in the reading and interpretation of x-rays, MR and CT’s as well as in performing diagnostic procedures. Exposure to other imaging modalities (PET, SPECT, etc) is also provided. Residents will read EEG with attendings on some of the afternoons of this rotation.

The Ambulatory Subspecialty Clinic rotation assures that the residents are exposed to the full range of outpatient neurologic diagnoses consisting of clinics in the subspecialties of stroke, MS, epilepsy, movement disorders, neuro-oncology, cognitive disorders and neuro-ophthalmology.

About 5-6 weeks of elective are completed during PGY-2.

THE SECOND NEUROLOGY YEAR (PGY-3)

The role of a second year resident includes teaching and increased autonomy during the blocks as the Inpatient/Ward service senior as well as the Consultative Neurology service senior at Hartford Hospital and UConn Health.

When in Pediatric Neurology for three blocks, the resident is responsible for overseeing inpatients, inpatient consults and emergency room consults. In addition, outpatient child neurology evaluations are performed in clinics under the presence/supervision of the staff pediatric neurologists. Residents learn to read pediatric EEG’s and are exposed to pediatric neuro-radiology. Sub-specialty clinics at the Connecticut Children’s include muscle disease, epilepsy, and neuro-genetics.

During two blocks of EMG rotation, EMG and neuromuscular disease are taught. The resident will observes EMG studies being performed on patients and practices nerve conduction studies on normal persons then begins to perform NCS on patients under the guidance of an EMG physician. Residents also take part in MDA and ALS ambulatory clinics. During the EEG block, residents will review EEG’s, manipulate digital data to display findings, and learn about recording techniques. Residents will review current records prior to reading them with the electro-encephalographer. Review of our collection of abnormal EEG recordings, evoked potential and sleep records enable residents to learn the pattern recognition required for interpretation. Residents will gain some knowledge of polysomnography.

Another block of Ambulatory Subspecialty Clinic is completed during this year.

One-two weeks of elective are completed during PGY-3. Some elective weeks are scheduled in the beginning of the year to ensure residents have time to explore subspecialty interests before fellowship interviews begin.

THE THIRD NEUROLOGY YEAR (PGY-4)

PGY-4 neurology residents provide leadership and are responsible for overseeing the Inpatient/Ward at Hartford Hospital and Consultative services at both Hartford Hospital and UConn Health. They supervise the junior neurology residents, rotating neurology interns / psychiatry residents, and medical students during these rotations. Clinical, teaching and leadership skills are refined through this process.

In Neuropathology, residents learn the work-up of new autopsy material and assist with microscopic sections and examine slides, review/study sets of microscopic and electron micrograph biopsy material, review current cases, and develop samples and slides for case presentations and CPC’s. They attend adult and neonatal brain cutting.

During Neuro-Rehabilitation, the residents learn and develop skills in the neuro-rehabilitation process including all aspects of specialized clinical assessment, interdisciplinary working and monitoring of structured goals as applied to patients recovering from acute neurological illnesses, especially stroke, traumatic brain injury, and spinal cord injury. They attend rounds on the Inpatient Rehabilitation Unit at Hartford Hospital as well as participate in therapy sessions with the rehab team – physical and occupational therapy, speech/dysphagia therapy, cognitive therapy, rehabilitation nursing, neuropsychology, social work counseling, and prosthetics. Residents also attend the physiatry outpatient clinics and the prosthetic/orthotic clinics.

The Psychiatry rotation teaches the residents medical aspects of psychiatry including the diagnosis of psychiatric syndromes, behavioral neurology, psycho-pharmacology, and how to contend with difficult patients. Under the supervision of the psychiatry attending group and members of the patient’s treatment team, they are responsible for the care of patients including, but not limited to, the initial psychiatric diagnostic evaluation, pharmacologic management, and daily progress notes.

One more block of Ambulatory Subspecialty Clinic rotation is completed during this year.

Several blocks are spent in electives in the last year of residency. Residents generally have a total of 6-7 blocks of electives during their neurology residency.