Residency and Rotations
Post Graduate Year 1 (PGY-1) Medical Internship
The department is pleased to offer a preliminary year internship, co-sponsored with the department of Internal Medicine at Weill Cornell. The internship is integrated with the neurology program, does not require a separate application and is automatic upon matching with us. Those applicants wishing to do internship elsewhere may be permitted to join or program as a PGY-2 under special circumstances and must inform us of this at the time of application.
The preliminary year offers top-notch training in internal medicine with our highly prestigious and competitive Internal Medicine Residency Program. The following is an approximate breakdown of the rotations during this year:
- 24 weeks on various medicine inpatient services at NewYork-Presbyterian Hospital
- 8 weeks NewYork-Presbyterian Hospital ICU (4 weeks Medical ICU, 4 weeks Cardiac ICU)
- 8 weeks inpatient psychiatry at NewYork-Presbyterian Hospital
- 2 weeks Neuro-rehabitation at Burke Hospital
- 6 weeks as junior resident on the NewYork-Presbyterian Hospital neurology consult service
- 4 weeks vacation
During the psychiatry rotation, residents spend time both in the Psychiatry Emergency Room and Inpatient Service. Burke Hospital is a dedicated rehabilitation facility; residents rotate through the stroke rehabilitation unit. As junior resident on the neurology consult service, residents are introduced to clinical neurology, in preparation for their second year.
Post Graduate Year 2 (PGY-2) Assistant Resident
The PGY-2 year provides the resident with training focused on the care of inpatients. The following is an approximate breakdown of the rotations during this year:
- 7-8 weeks on the NewYork-Presbyterian Hospital neurology ward service
- 7-8 weeks on the Memorial Sloan-Kettering neurology ward service
- 8 weeks on the NewYork-Presbyterian Hospital neuroscience ICU
- 7-8 weeks as junior resident on the Memorial Sloan-Kettering Cancer Center neurology consult service
- 6-8 weeks as junior resident on the NewYork-Presbyterian Hospital neurology consult service
- 4 week selective in EEG
- 4 weeks of elective time
- 4 weeks of vacation
On the neurology wards (both at NewYork-Presbyterian Hospital and Memorial Sloan-Kettering Cancer Center), interns from the Departments of Medicine and Psychiatry take in-house call, permitting assistant residents to take call from home. Assistant residents supervise the interns and are responsible for the overall functioning of both wards, including presentation of all new admissions to the attending staff. There are approximately two-to-four admissions per day to the services at each hospital. First-year residents are supervised by the senior resident and ward attending on service. PGY-2 trainees also assume formal teaching duties for third and fourth year medical students.
Experience managing critically ill patients with neurologic disease is provided in the new, state-of-the-art Neurosciences ICU (including a portable CT scanner) where neurology residents rotate together with neurosurgery and anesthesiology residents to provide comprehensive care. Residents will care for patients with acute ischemic and hemorrhagic stroke, subarachnoid hemorrhage, status epilepticus, and Guillaine-Barré syndrome. During this rotation, neurology residents are taught several diagnostic and therapeutic procedures, including transcranial Doppler ultrasonography, central venous catheter and arterial line placement.
PGY-2 residents also learn how to see consults in several settings. PGY-2 residents again serve as junior resident on the NewYork-Presbyterian Hospital neurology consult service, working closely with attendings and supervised by either PGY-3 or PGY-4 residents at all times. Further PGY-2 residents rotate through the Memorial Sloan-Kettering Cancer Center neurology consult service, where they work with a PGY-3 resident, a neuro-oncology fellow and a neuro-oncology attending.
PGY-2 trainees receive an introduction to clinical neurophysiology during the EEG selective. Residents follow a curriculum to learn the basic science behind EEG and its applications and limitations. Residents learn to interpret standard and continuous EEGs with the clinical neurophysiology fellows and faculty and observe intraoperative monitoring.
Beginning in the PGY-2 year and continuing throughout their training, every resident follows a group of outpatients in a weekly attending-supervised neurology clinic.
Post Graduate Year 3 (PGY-3) Assistant Resident
The PGY-3 year provides the resident with training focused on consultative neurology, as well as outpatient neurology. The following is an approximate breakdown of the rotations during this year:
- 16-18 weeks on the NewYork-Presbyterian Hospital neurology consult service
- 8 weeks as senior resident on the Memorial Sloan-Kettering Cancer Center neurology consult service
- 6-8 weeks of elective time
- 4-6 weeks on the NewYork-Presbyterian Hospital Neurosciences ICU
- 6-8 weeks of ambulatory neurology
- 2 weeks of selective in EMG/NCS
- 4 weeks of vacation
The consult services at both hospitals provide the residents with exposure to a broad range of neurologic diagnosis, including neurologic emergencies. An acute stroke protocol is in place at NewYork-Presbyterian Hospital; the PGY-3 consult resident performs all initial evaluations and directs care under the supervision of the stroke attending and fellow. A brain resuscitation protocol is also being developed; the PGY-3 consult resident assesses all post-cardiac arrest patients for the utility of therapeutic hypothermia, in conjunction with the medical and neurocritical care fellows. Teaching rounds occur daily with the consult service attending and with the stroke service attending. At NewYork-Presbyterian Hospital, the consult service is shared by a day team of one PGY-3 resident, one PGY-2 resident, and 1-2 PGY-1 neurology, medicine, or psychiatry residents and a PGY-3 night float. Weekends are covered by PGY-2 and PGY-3 residents during their elective and outpatient rotations. At Memorial Sloan-Kettering Cancer Center, call is taken q4 by the residents on the consult and floor services.
The ambulatory neurology rotation is designed to provide the resident with exposure to both general neurology as well as subspecialty neurology in outpatients. The resident on the ambulatory rotation provides care to patients in the various specialty clinics, including epilepsy clinic, neuromuscular disease clinic, lumbar puncture clinic, movement disorders clinic, neuro-vascular clinic, multiple sclerosis clinic, and MDA-ALS clinic.
PGY-3 trainees continue their introduction to clinical neurophysiology during the EMG/NCS selective. Residents follow a curriculum to learn the basic science behind EMG and NCS and its applications and limitations. Residents learn to interpret EMG/NCS with the neuromuscular fellows and faculty either at the Peripheral Neuropathy Center, NewYork-Presbyterian Hospital, or the Hospital for Special Surgery. Residents may learn to perform EMG in addition to NCS and skin biopsies.
Post Graduate Year 4 (PGY-4) Senior Resident
The PGY-4 year provides the resident with training focused on preparation to become an attending neurologist by functioning as ward chief. In addition, the PGY-4 year provides in-depth training in pediatric neurology. The following is an approximate breakdown of the rotation during this year:
- Two months as neurology ward chief at NewYork-Presbyterian Hospital
- Two months as neurology ward chief at Memorial Sloan-Kettering Cancer Center
- Two months as senior resident on the pediatric neurology service at NewYork-Presbyterian Hospital
- 2-4 weeks of ambulatory neurology
- 4 weeks of neuropathology Approximately
- 4 months of elective, including opportunities for international electives in Tanzania
- One month of vacation
Senior residents assume broad responsibility for patient care on each hospital's clinical services including the supervision and teaching of assistant residents, interns, and students. Senior Resident responsibilities include the management of the intern and assistant resident teams on the neurology services; participation in Morning Report; conducting daily rounds; assisting junior residents when necessary in their consultant work; and educating junior house staff and medical students.
During the pediatric neurology rotation, senior residents assume equal responsibility as the pediatric neurology fellow. Working closely with the attending pediatric neurologist, residents manage patients in the neonatal and pediatric intensive care units and on the pediatric inpatient unit, which includes video EEG monitoring beds.
During the neuropathology selective, residents participate in weekly brain cutting sessions and multidisciplinary conferences for neuro-oncology and pediatric neurology. Residents help to interpret frozen intraoperative specimens and histological preparations of biopsy and autopsy material. In addition, the attending neuropathologist leads didactic sessions for the neurology and pathology residents.
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