The curriculum for the residency program stresses the classical training of neurologists. Diagnoses are reached on the basis of the patient's history and neurological exam, with technological tests used to confirm the conclusions of an intellectual process. A major strength of our neurology program is the active interchange with other disciplines. Neurology grand rounds are held every Friday and are attended by neurology, neurosurgery and radiology faculty members as well as by visitors from psychiatry, medicine, orthopedics and nursing.
Following is a sample schedule for the three postgraduate neurology years at Drexel. Each year the neurology residents coordinate their schedules, and while much of their time is used in satisfying board requirements for training, residents have the opportunity to pursue their own interests during three to six months of free elective time. The resident may choose to gain experience in neuroradiology or neuropathology during that time, refine skills in EEG or EMG, pursue a research interest, or spend additional time in a subspecialty rotation, such as pediatric neurology.
The first year...
During the first year of training, residents typically serve 24 weeks in the inpatient service at Hahnemann, eight weeks at Crozer-Chester, eight weeks in the stroke service, four weeks in the NICU at Hahnemann, eight weeks in ambulatory where they will be able to participate in the diagnoses and management of complicated neurological problems.
The second year...
During the second year of training, the resident serves as consultant to the medical and surgical services for eight weeks at Hahnemann University Hospital, four weeks in the stroke service. Subspecialty training typically begins in the second year. Residents spend 12 weeks in pediatric neurology training at St. Christopher's Hospital for Children in Philadelphia.
A comprehensive program in electrophysiology has been instituted at all levels of residency training. Residents learn the fundamentals of electromyography and electroencephalography in the early part of their tenure so that they can take full advantage of intensive EEG and neuromuscular rotations. Eight weeks are devoted to the interpretation of EEGs and evoked potentials during the residency. Clinical muscle physiology and the techniques of nerve conduction velocity determination and needle EMG are mastered during the eight weeks neuromuscular rotation. During the second year the residents have eight weeks of elective time in which they can choose to do research.
The third year...
Residents may serve as chief/senior resident for 26 weeks. During their third year, residents have elective rotations that they can use to gain added experience in a subspecialty, depending on their clinical interests, or that they can devote to research if they plan to pursue a career in academic medicine.
The residents do a four week rotation in rehabilitation at Hahnemann under the supervision of Dr. Darlene Forth. The residents will gain exposure to both inpatient and outpatient rehabilitation. A four week ambulatory care rotation is structured to participate in a variety of specialty and private outpatient clinics to prepare residents for outpatient management of neurological disease. The resident spends time in specialty clinics including epilepsy, neuromuscular, ALS, pain, neuro-oncology, MS and movement disorders. The four week psychiatry rotation is designed to increase the awareness of psychiatric diagnosis and management of patients in preparation for board certification. The rotation is spent on the consultation and liaison service. A four week rotation in neurosurgery which is done at Temple University Hospital is also part of the third year. There is also a four week period spent in neuropathology during this year, which is at St. Christopher's Hospital for Children. During this rotation the residents have daily slide interpretation sessions, learning both classic and advanced neuropathological techniques, and participating in frozen-section analysis under the supervision of Drexel University College of Medicine muscle pathologist and neuropathologist.
Fellowships
Following completion of the residency, fellowship training is available in clinical neurophysiology (EEG, Epilepsy, and combined EMG/EEG).
Conferences
The resident in our program spends an average of 13 hours weekly in teaching conferences. These conferences have both didactic and practical value. They are intended to increase the resident's breadth of knowledge as well as to improve patient care. The material presented will provide the resident with current information directly applicable to patient problems. In an effort to make it possible for all residents to regularly attend conferences, Friday morning has been set aside as the major conference time.
Friday Conference begins with the neuroscience lecture followed by presentations of patients with interesting neurological problems and a lecture in basic or clinical science. Below is a list of teaching conferences and rounds.
Morning report: One hour daily with the chairman, Dr. Robert J. Schwartzman.
Attending rounds: Two hours daily with faculty members.
Stroke conference: Weekly review with Dr. Giraldo of clinical, radiographic, ultrasound and electrophysiological data and up-to-date literature on current patients.
Neuroradiology: This weekly conference is attended by resident and faculty members from neurology, neurosurgery and radiology.
Neurology grand rounds: This weekly event is composed of two parts.
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Patient presentations led by Dr. Schwartzman.
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Basic/clinical science lecture delivered by faculty members or guest lecturers who present most current advances in neuroscience and clinical neurology.
Neuroscience: Weekly review course in neuroscience to prepare residents for yearly in-service examination and Boards with Drs. Alexander, Deitch and Grothusen.
Muscle conference: Biweekly review with Dr. Heiman-Patterson of current inpatients, emphasizing physical examination, electrophysiology, muscle biopsy and literature review.
Neuro-ophthalmology: This conference is held every other Thursday with Dr. Kelly Malloy.
EEG conference: Biweekly, presented by Dr. Schraeder.
Journal club: Once a month with Dr. Tabby
Outpatient Experience
A major shift in emphasis of neurology has been the move to management of neurological problems in the outpatient setting. To address this issue, an extensive ambulatory program has been incorporated into the resident curriculum.
Each resident is assigned to a general neurology continuity clinic. The resident will be able to follow individual patients over the course of their training under the supervision of faculty attending.
In addition, the resident experience is enhanced by the wide array of subspecialty clinics such as pain, epilepsy, motor neuron disease, neuromuscular, multiple sclerosis, movement disorder, and dementia. During the course of subspecialty training, the resident will spend time in each of these clinics to better cope with the management of outpatient neurology.
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