Program Description
Pediatric Neurology Residency Training
The Division of Pediatric Neurology offers a comprehensive ACGME accredited 3-year training program in child neurology with inpatient and outpatient exposure to various subspecialties. Training involves approximately 12 months in adult neurology (with six months of inpatient training), 12 months in pediatric neurology, and 12 months in subspecialties and electives. Multiple clinical and basic science conferences are an integral part of residency training.
During the 3-year program residents are provided with a broad foundation in general neurology and, specifically, pediatric neurology, thereby preparing them for independent practice or entry into a subspecialty fellowship. Extensive clinical experience with diverse populations and bedside teaching are emphasized and are supplemented with a variety of didactic sessions. Particular attention is given to the humanistic, social and ethical aspects of neurology practice, as well as to the acquisition of academic knowledge and appreciation of the intellectual challenges of the specialty.
YEAR 1
The main goal of training in the first year is for each resident to achieve competence in the performance of the neurological evaluation and the development of management skills on both inpatients and outpatients. Specifically, the resident should show proficiency in collecting the relevant historical information, performing an accurate general and neurological examination, localizing the lesion to the appropriate areas of the nervous system, and beginning to develop differential diagnoses and management skills for the more common neurological entities. This is accomplished through 6 months of supervised experience on the adult neurology ward and consultation services at our University Hospital, at Kings County Hospital Center as well as Maimonides Medical Center. 12 weeks of inpatient pediatric neurology rotations allow the residents to acquire the skills needed to manage pediatric neurology patients. There are months of OPD rotation (one month in 1st, 2nd and 3rd years); this provides an opportunity to concentrate on adult neurology outpatient care. Residents are also assigned to a half day per week in a general pediatric neurology continuity clinic. They attend this continuity clinic all three years. Elective rotations across three years of training (maximum during 2nd and 3rd year) allow the residents to obtain additional training in subspecialties, such as neuroradiology, neuropathology, epilepsy/EEG, neuromuscular/EMG.
Two weeks before the start of the neurology rotations, there is a two-week boot camp, which includes didactic and practical teaching sessions designed to prepare incoming residents for their training.
Each resident is assigned a faculty advisor (mentor). During all three years of training, advisors meet with their assigned residents at least twice a year to review the resident’s performance and address any concerns.
All residents are required to take the in-service exam each year. To prepare for the Board Examination, sessions covering major topics on the in-service exam and Boards are conducted to motivate self-study.
YEAR 2
Pediatric neurology residents spend 6 months of inpatient rotations on pediatric neurology in the second year. During these rotations the residents develop the skills required to lead a team of rotating residents and students and to responsibly monitor the management of inpatients under the supervision of the attending. They also provide consultations in the emergency rooms at UHB and KCH and on inpatients on other services. They learn to manage pediatric neurology emergencies and to communicate with residents and attendings on other services. During the first months of the inpatient rotations, the second year resident is closely supervised by a third year resident. Residents also attend their continuity clinic plus the subspecialty clinics and additional other general pediatric neurology clinic each week.
Residents are also required to spend a full month on child psychiatry. The second month of adult neurology outpatient occurs this year. Three to four months of additional electives or research are available this year. Electives must be approved by the Program Director.
YEAR 3
During their final 4 months of inpatient rotations on pediatric neurology the residents improve the skills required to lead a team of residents as a ward senior. This is monitored closely by the attending. They closely supervise the 2nd year residents during their initial 2-3 months on the pediatric neurology inpatient/consult service and are involved in supervising and teaching rotating residents and students. They also continue to attend the subspecialty clinics and their continuity clinic during this time. As noted previously one month is spent on adult neurology outpatient service.
Six months of elective time allows the resident to pursue other interests, such as neurodevelopmental disabilities, movement disorders, genetic metabolic disorders, neuro-oncology, research and clinical neurophysiology. One-month neurooncology elective is required at the Memorial Sloan Kettering Cancer Center.
Teaching responsibilities for both 2nd and 3rd year residents involve supervision and training of residents and medical students rotating on pediatric neurology. The residents also participate in teaching the medical students' neurology clerkship. Residents are also responsible for preparation of 2-3 case presentation/topic reviews, 1-2 epilepsy reviews, 1-2 journal clubs, and a major presentation to the entire department each year. All these are under the direction of an assigned attending.
At the end of the training the Program Director, along with input from the advisors and the clinical competency committee, provide a final evaluation verifying that the resident has achieved adequate ability to practice competently and independently.
The American Board of Psychiatry and Neurology (ABPM) mandates that demonstration of clinical skills competency is required in order to apply for specialty certification and that this competency should be achieved during residency. Demonstration of competency in evaluating a minimum of five different patients during residency is required. For Child Neurology Residents this involves examination of one adult and four pediatric patients. An ABPN certified faculty member observes the resident's performance and scores the residents interviewing skills; neurological skills; humanistic qualities; professionalism and counseling skills.