Program Description

Department of Neurology residents

Our rotations are divided into four week blocks covering core rotations and electives. We currently have approximately thirteen blocks of elective time during the PGY2-4 years. OHSU neurology is a flexible program offering our residents unique possibilities tailored to meet their education and career goals.

Medicine Preliminary Year (PGY-1)

For residents entering our integrated four-year training program after medical school, the first year of residency training includes an internship year with a strong emphasis in internal medicine. The internship rotations satisfy the requirements of both ACGME and the American Board of Psychiatry and Neurology, and include seven months of internal medicine (including palliative care), one month of emergency medicine. In addition, interns complete two months of neurology, and one month each of stroke, neurosurgery, cardiology, and infectious disease. The neurology residency program director works closely with the internal medicine program director to coordinate the internship year.

At the end of the year, interns emerge with a broad base of knowledge ready to manage medically ill patients. Our residents find this to be a rewarding year where strong bonds are created with other residents and faculty throughout the hospital.

An example schedule

Block 1

Block 2

Block 3

Block 4

Block 5

Block 6

VA Medicine

Palliative Care

MICU

Cardiology

Neurology

Emergency Medicine


 

Block 7

Block 8

Block 9

Block 10

Block 11

Block 12

Block 13

VA   Medicine

Neurology

UH   Medicine

Stroke

VA   Medicine

Neuro- surgery

Infectious Disease

First-Year Neurology (PGY-2)

During the first year of neurology training, the resident develops an understanding of core neurology diseases, localization, and the neurological examination through largely an inpatient setting.

Residents focus on inpatient neurology at the University Hospital and the Portland VA medical center (PVAMC). Ward services at the University Hospital include the general neurology service, stroke service, and the epilepsy monitoring unit. In addition, residents rotate through the neuroscience intensive care unit. At the PVAMC, residents work on the general neurology ward and epilepsy monitoring unit. Medical students and interns from psychiatry, internal medicine and neurosurgery rotate through the neurology inpatient services and work closely with first year neurology residents. Neurology faculty make daily attending rounds and directly supervise neurology residents on the inpatient ward services at the University and the VAMC. 

Rotations are four weeks in length, with a total of three months on the University inpatient neurology service, three months on the inpatient stroke service, three months on the VA inpatient neurology service, two months of neurocritical care, one month of neuroradiology, and one month of epilepsy/ epilepsy monitoring unit.

Residents also begin their continuity care clinics at the University hospital and PVAMC through half day clinics each week. Many of the patients are followed longitudinally throughout the three years of residency.

An example schedule

Block 1

Block 2

Block 3

Block 4

Block 5

Block 6

OHSU Wards

Stroke

Neuro-     radiology

VA Wards

OHSU Wards

Stroke



Block 7

Block 8

Block 9

Block 10

Block 11

Block 12

Block 13

VA Wards

OHSU Wards

Neuro-   critical care

Epilepsy

VA Wards

Neuro-   critical care

Stroke

Second and Third Year Neurology (PGY-3 and PGY-4)

The second and third years of neurology training serve to expand on skills obtained during the first year and incorporate subspecialty training through consultation services and elective rotations.

The consult senior provides consultations to either the University Hospital or the PVAMC. Neurology residents round daily with the consult attending and supervise the consult team, which may include medical students, internal medicine residents, and psychiatry residents. The neurology resident on the consult service also supervises the first year neurology resident on the inpatient neurology ward. Consult rotations are four weeks in length, and a total of three months per year are spent on consult services during the second and third years.

Beyond the consultation services, residents continue to round out their education with a variety of rotations. Second year residents spend one month as a senior resident on the neurocritical care service. Per the American Board of Psychiatry and Neurology, residents also fulfill their three months of pediatric neurology and one month of psychiatry requirements during these years. Residents in their second and third years spend the remaining months on elective rotations, generally scheduled as one to two month blocks (see Elective Rotations for selections). These may include subspecialty outpatient clinic experiences or inpatient electives.

Second and third year neurology residents continue to attend a minimum of one half-day neurology clinic per week at the University Hospital and one half-day neurology clinic per week at the PVAMC.

An example schedule of a second year neurology resident (PGY-3), electives in bold,

Block 1

Block 2

Block 3

Block 4

Block 5

Block 6

Elective

VA Consult                      

Elective

Neuro-   critical care

Neuro- muscular

Neuro- muscular

Block 7

Block 8

Block 9

Block 10

Block 11

Block 12

Block 13

Elective

Peds Neuro

Peds Neuro

Stroke

OHSU    Consults

Elective

OHSU    Consults

An example schedule of a third year neurology resident (PGY-4), electives in bold,

Block 1

Block 2

Block 3

Block 4

Block 5

Block 6

Peds Neuro

VA Psych

OHSU    Consults

Elective

VA Consult                      

Elective

Block 7

Block 8

Block 9

Block 10

Block 11

Block 12

Block 13

Elective

Elective     

Elective

Elective

Elective

VA Consult                      

Elective

 

Electives/rotations

A total of thirteen four week blocks are provided to neurology residents during the second and third years, with approximately 6 months of electives per year. Elective time is flexible to accommodate the differing career paths of individual residents. Elective blocks are four to eight weeks in length. A total of three months of pediatric neurology, one month of psychiatry, and two months of basic science (e.g. neuroradiology, neuropathology, or basic science didactic elective) are required for Neurology board certification. Residents are also required to take two consecutive months of neuromuscular elective, which includes neuromuscular outpatient clinics and training in electromyography and nerve conduction studies. 

  • Cognitive/Dementia
  • Education
  • EEG
  • Epilepsy monitoring unit
  • Headache
  • Movement disorders
  • Neuroimmunology/ Multiple sclerosis
  • Neurocritical care
  • Neurointerventional radiology
  • Neuromuscular
  • Neuro-oncology
  • Neuro-ophthalmology
  • Neuro-otology
  • Neuroradiology
  • Neuropathology
  • Neurosurgery
  • Palliative care
  • Psychiatry
  • Sleep and polysomnography
  • Stroke
  • Research
  • VA Subspecialty and Teleneurology Clinic

Research and scholarship

Scholarship in its many forms is strongly encouraged in the OHSU Neurology Residency Program. All residents are expected to complete a scholarly project during the course of the residency. This could take the form of a traditional research project leading to a peer reviewed journal article, but is flexible to meet the needs of each resident and could alternatively take the form of a case series report, a web based teaching module, or development of clinical pathways or quality improvement methods. The department provides a generous book/travel fund for each resident. In addition, the department pays the major costs of travel and expenses for any resident who presents a paper or poster as first author at a national meeting.

The OHSU Department of Neurology is highly engaged in Clinical and Basic Science research, and is committed to training the next generation of neurology researchers.

To further this aim, the OHSU Neurology Residency program offers a flexible research track during residency. Qualified candidates with dedication to an academic research career may apply during their PGY-2 year to enter this program, which blocks 3-6 months across the end of PGY-3 and beginning of PGY-4 years to permit dedicated research experiences. The research block is meant to provide the foundation for applications for mentored research grants such as a K23 or VA Career Development award. The research block is in lieu of other residency elective time. Residents continue continuity clinic and night call (currently about every 10th night) during the research block, but are otherwise free of clinical responsibilities while on the research block.

Residents interested in clinical research can concurrently apply to participate in the OHSU Human Investigators Program, which provides comprehensive training in clinical research study design, statistical analysis, grant writing, and manuscript writing and presentation.

Residents interested in laboratory-based basic science can prepare themselves to submit a K08 or similar application during the PGY-4 year. More information is available upon request.

Mentoring

Each incoming neurology resident is paired with a neurology faculty advisor who meets with the resident quarterly throughout the 4 years of residency. These meetings provide an opportunity to discuss elective selection, career plans, research project guidance, feedback on attending evaluations, and feedback on the training program. In addition, the neurology residency program director and associate program director, Drs. Ed Kim and Justin Meuse, meet monthly with the residents to discuss training issues and to develop new programs and policies. Informal discussions between the program director or other faculty members and the residents regarding the residency training are encouraged.

Outpatient clinics

Residents rotate through a variety of general and subspecialty neurology outpatient clinics at University hospital throughout the 3 years. First year neurology residents spend one half-day per week in a general neurology clinic. Second and third year neurology residents spend one half-day per week in a subspecialty neurology clinic at University hospital. The six subspecialty clinics included are Aging and Dementia clinic, Epilepsy clinic, Movement Disorders clinic, Multiple Sclerosis and Neuroimmunology clinic, Neuromuscular clinic, and Stroke clinic. Residents evaluate new patients appropriate to the subspecialty clinic and also continue to follow patients seen in previous clinic rotations. Neurology faculty attendings are present at all clinics to staff patients with residents. Faculty are also seeing patients in the same subspecialty clinics and will involve the residents in team conferences and teaching exercises over the course of the clinic.

Residents rotate through the VAMC general neurology continuity of care clinics for one half-day per week throughout the 3 years. Patients with a wide variety of common and uncommon neurological disorders are seen in these clinics. Several neurology faculty are present at every clinic to provide staffing for new and follow-up patients. Residents may rotate through additional faculty subspecialty neurology clinics at the VAMC while on elective rotations. These subspecialty clinics include Stroke clinic, Dementia clinic, and Seizure clinic.

Didactics

We offer excellent conferences aimed at teaching our residents pearls of neurology as well as educating them on the future of neurology. As such these are driven by the resident needs and in the past residents have been able to shape these to fit their needs.  

Resident Core Conferences

  • Neurology "Tool Box" series: Annual series of important topics designed to teach junior residents the basics of neurology at the start of the PGY2 year
  • Monday Morning Report: Discussion of clinical cases with Department Chairman
  • Monday Morning Neuromuscular and Muscle Biopsy Conference
  • Monday Noon Conference: Rotating neuroradiology, neuro- oncology, and neuroanatomy lectures
  • Wednesday Grand Rounds: Weekly lectures on pertinent contemporary topics in neurology, typically given by neurology faculty, although guest speakers are common 
  • Thursday Noon Conference: Weekly conference presented by residents and faculty on a rotating series of subspecialty topics, includes discussion of morbidity and mortality cases once a month
  • Friday Morning Conference: Weekly, includes journal club, chief resident lectures, epilepsy review, and program director meeting
  • Friday Noon Conference: Faculty taught series over three years covering major topics including neuroanatomy, basic neurophysiology, neuropharmacology, neuropathology, and emergency neurology
  • Difficult Case Conference: Monthly discussion of challenging clinical cases with resident and faculty participation

Additional Conferences for Residents (optional and/or rotation specific)

  • Neurocritical care lecture series
  • Neuropathology (Brain Cutting)
  • Epilepsy Case Conference and Epilepsy Surgery Conference
  • Movement Disorders video case review
  • Aging and Alzheimer's case review conference
  • Neuro-oncology Tumor Board
  • "Synapse": Monthly Departmental gathering to discuss ongoing research projects of interest in the Department