The Neurology rotation schedule summary

During Duke Ward JAR rotations, the resident functions as the coordinator of a team comprised by a general neurology attending, two interns, and medical students. The resident is responsible for evaluation, care, and treatment of an average of 10 patients. On the Duke Inpatient Unit, medical interns are an integral part of the team and are on call with the neurology JAR. Thus, the Neurology JAR functions as a neurologist and not an intern. Education is focused on common neurological disorders and to gain an understanding of the basics of neuroradiology (CT, MRI, PET, angiography, myelography), Doppler ultrasound (extracranial and transcranial), peripheral neurophysiology (nerve conduction studies, electromyography, autonomic testing), and central neurophysiology (electroencephalography, evoked potentials, sleep studies). Residents attend several teaching conferences geared both to general neurologic and subspecialty topics (see conference schedule).

During the neurointensive care rotation, the JAR assists the NICU team in the care of patients in our 16-bed unit. They have the opportunity to place central lines, go to the operating room, and become comfortable with management of critical illness.

While on the clinic rotations, both at Duke and the VA, the JAR will work with several attendings, both in general and specialty neurology.

Call for JARs average every 4th night with no call while on Duke consults.

Ambulatory care experience during all three years includes a weekly neurology continuity clinic supervised by a faculty member. Weekly epilepsy and neuro-faculty clinics are part of the VA rotations.

Senior resident rotations add further responsibility to the resident's duties and broadens the resident's exposure to neurodiagnostic procedures. During the Durham VA consultation rotation, the senior resident runs the inpatient consult service. The Pediatric Neurology rotation joins the neurology resident with a pediatric neurology resident, and pediatric neurology attending in the consultative evaluation of inpatients and outpatients. Experience in the EMG laboratory includes resident participation in performing and interpreting nerve conduction studies and electromyography. Most residents perform 80-100 studies under supervision of the lab staff, fellows, and attendings. Residents also participate in weekly Muscular Dystrophy and Myasthenia Gravis Clinics. During the EEG rotation, the resident participates in reading EEG and evoked potential studies daily, as well as sleep studies. Residents participate in weekly inpatient monitoring conference discussing pre-surgical and spell characterization evaluations. Participation in a weekly Epilepsy and Sleep Disorder Clinic is included.

During two three-month blocks, the resident functions as the chief neurology resident at Duke and the Durham VA Hospital. This affords the resident additional experience in neurological diagnosis and care, as well as teaching and administrative roles. The Durham VA chief resident runs his/her own outpatient clinic four days a week. Residents complete a one month outpatient rotation in psychiatry to gain exposure to diagnostic psychiatry and psychopharmacology.

Popular resident electives include Neuropathology, Neuroradiology, Neuro-ophthalmology, or additional time in Neurophysiology. One of our most popular elective rotations allows the resident to work with various attendings in the outpatient clinic. Residents are free to design elective time to cover other topics of interest. Electives must be approved by the program director.

During Pediatric Neurology, call is from home for that consultative service. Second and third year residents share back-up call averaging every 7th day. This is home call but, early in the year, the senior residents evaluate patients seen by junior residents to facilitate the care of patients and education of the junior residents. This affords the senior resident additional consultative experience and affords the junior resident a better learning opportunity to review physical examination and ancillary studies with a senior resident.

Residents are encouraged to be involved in a research project of some type. This could include writing a review article or performing a retrospective review or prospective study.