Integration and Innovation
Neurology residents at Mayo Clinic in Arizona participate in an integrated curriculum that includes courses taught by world-renowned neurologists, teleconferenced to each Mayo Clinic site. Our didactic program is one of the strongest in the nation because all faculty members are intimately involved in the training. Unlike some programs in which senior level faculty are less visible, ours conduct training across the spectrum of their careers. Following are several examples:
Under the auspices of the American Academy of Neurology, Mayo Clinic neurologist Eduardo Benarroch, M.D., has designed and directs a neuroscience course that can be attended by neurology residents from across the United States. He also oversees the neuroscience training for Mayo neurology residents at all three sites. His neuroscience course is carried by satellite from Minnesota to residents in Florida and Arizona.
Evidence-based medicine is taught by national experts Bart Demaerschalk, M.D., and Dean Wingerchuk, M.D., at Mayo Clinic in Arizona and teleconferenced to Florida and Minnesota through the Mayo Clinic Arizona Evidence-Based Clinical Practice, Research, Informatics and Training Center (MERIT) program. Its goal is to foster the lifelong critical thinking skills needed to evaluate research findings that impact patient care.
MERIT Neurology Conferences are integrated into Neurosciences Grand Rounds every two months. A trainee, a faculty member from one of the three sites with expertise in the topic area, and a MERIT faculty member lead a patient-based satellite presentation that takes participants through all aspects of the evidence-based medicine process. The peer-reviewed summary is available on Mayo's intranet and is often published in The Neurologist, giving residents an opportunity to publish in a scholarly journal before they complete their program.
- American Headache Society Neurology Resident Program
This core competency, web-based educational module was designed by program directors David Dodick, M.D., and David Capobianco, M.D. In its first year, nearly 200 residents from 62 neurology residency programs participated in the program. The case modules allow program directors outside Mayo Clinic to compare the performance of their residents to that of others who have completed the training.
In addition to teleconferenced courses, senior faculty members also spend time at the other Mayo Clinic sites for both lecture and hands-on training in patient care.
Patient-Centered Clinical Training
Clinical practice is as necessary to residency training as didactics. Every patient is unique, and it is through hands-on experience and supervision that both patient and educational needs are served. A highlight of the Mayo Clinic Neurology Residency Program is its depth of clinical experience combined with an excellent mix of routine and esoteric neurological disorders. Residents are given ample time to see patients and discuss cases with the supervising physician. Close clinical supervision continues to foster the reciprocal learning between supervisors and trainees that characterized the early days of Mayo's Neurology Program.
While the core clinical training and all subspecialty training is available at Mayo Clinic in Arizona, residents may choose to rotate to another site for a particular training or research experience. Rotations are available at Mayo Clinic's sites in Minnesota and Florida. There is also an elective at Maricopa Medical Center, a local county hospital. These options give residents opportunities to:
- See a new patient population.
- Connect with fellow residents
- Be mentored by faculty in another location.
To expand their knowledge of the field, and connect to the larger Neurology community inside and outside of Mayo Clinic, Neurology residents have opportunities to:
- Participate in department committees.
- Serve on institutional committees.
- Actively participate in national professional organizations.
For example, three of the recent past chairs of the American Academy of Neurology's Consortium of Residents and Fellows have been Mayo trainees.
Throughout your neurology residency at Mayo Clinic in Arizona, you will be involved in educational courses. The courses are designed to meet the educational needs of each post-graduate year (PGY) level. Additionally, two courses occur on a longitudinal basis throughout the neurology residency.
Post-Graduate Year 1 (PGY-1)
You will begin your adult neurology residency in the Transitional Year Residency Program.
Post-Graduate Year 2 (PGY-2)
Introductory Neurology Course
The four-month introductory neurology course takes place from July to October of PGY-2. This course consists of 51 lectures with topics ranging from the fundamentals of the neurological history and examination to evaluation and management of neurological emergencies. The intent of this course is to educate new neurology residents on the essentials of clinical neurology.
Sample lecture schedule
The neuroanatomy course is a three-month lecture series consisting of 20 lectures focused on clinical neuroanatomy. This course is taken from October to December of PGY-2. Topics include cerebral cortex, basal ganglia, cerebellum, brainstem and spinal cord anatomy. Cross-sectional and longitudinal anatomy is emphasized. The course is designed to offer a detailed, yet clinically relevant review of neuroanatomy.
Sample lecture schedule
Post-Graduate Year 3 (PGY-3)
- Clinical Neurophysiology
A highlight of the Neurology Residency Program at Mayo Clinic in Arizona is the Clinical Neurophysiology rotation at the beginning of PGY-3. This course is a two-month intensive experience in which you will learn how to perform nerve conduction studies, EMGs and interpret EEGs. With the exception of your weekly continuity clinic, you will be relieved of all patient care responsibilities during this course.
During the first month of the course you will learn how to perform nerve conduction studies of the major nerves of the face, upper limb and lower limb in hands-on practice groups with other residents and fellows. Once you have demonstrated clinical competence, you will perform nerve conduction studies on clinic patients during the second month. Also during the second month, you will learn techniques for EMG, and you will perform these studies on patients. Emphasis is placed not only on proper technique, but also on correct interpretation of clinical and electrophysiologic data.
Throughout the course, afternoons will be devoted to learning how to conduct and interpret EEGs. You will learn correct electrode placement and will have the opportunity to learn correct application techniques through hands-on practice sessions with other residents and fellows. You will be given both theoretical and practical instruction on electroencephalogram techniques and interpretation. You will independently read and interpret several EEGs on a daily basis throughout course.
You will also be given opportunities to observe autonomic studies, as well as participate in the testing of brainstem auditory, visual, and somatosensory evoked potentials during this course.
The course is highlighted by daily lectures on techniques, theory, localization, synthesis, and interpretation of EEG, nerve conduction studies, EMG and evoked potentials.
Sample lecture schedule
The second course of PGY-3 will be Basic Neuroscience. This four-month course includes 37 ninety-minute lectures which originate from Mayo Clinic in Rochester, Minn., and are simulcast between all three Mayo Clinic locations. The course content is basic neuroscience with emphasis on clinical relevance.
Sample lecture schedule
Post-Graduate Year 4 (PGY-4)
The final year of your neurology residency at Mayo Clinic in Arizona is highlighted by Advanced Neurology: a five-month board-review-style course. The 52-lecture series is aimed at assisting senior neurology residents in synthesizing all aspects of clinical neurology. It serves as the capstone educational course of the Neurology Residency Program. Topics come from all major subspecialty areas in neurology, with emphasis placed on details necessary for the independent clinical practice of neurology.
Sample lecture schedule
Ongoing Longitudinal Courses
Throughout your neurology residency at Mayo Clinic in Arizona, you will participate in a twice-monthly neuroradiology conference. This conference, directed by our core group of neuroradiologists, focuses on interpretation of normal and abnormal neuroimaging studies. Recent and interesting neuroimaging studies are reviewed, and learning points of individual cases are emphasized. Particular attention is paid to identification of neuroradiographic representation of neuroanatomic structures. Modalities explored include:
Once a month, residents are lectured by a board-certified neuro-ophthalmologist. Topics include all areas of neuro-ophthalmology.
Research opportunities at Mayo Clinic are outstanding. Your projects will depend on your interests and background. Research opportunities are divided into two broad categories: clinical and basic science laboratory research.
You will have access to Mayo Clinic's world-renowned medical records system for clinical research. During your residency, you will conduct at least one clinical research project, publish the results, and make at least one regional or national presentation.
Mayo Clinic's Clinician-Investigator Program is two years in length. When you complete this program, you will be academically prepared, competent in clinical neurology, technically skilled in research and capable of competing in today's research environment.
If you are interested in the Clinician-Investigator Program, you should indicate your interest early in your residency training. You will then be assigned to a faculty member who will help you develop a competitive written research proposal.
You are required to become certified in Basic Cardiac Life Support (BCLS) and Advanced Cardiac Life Support (ACLS). ACLS courses are held during the last week of June, before the start of the academic year. An evening ACLS course also is offered every three months to facilitate re-certification.
During your residency you will frequently prepare case study presentations. You will present pertinent information from an interesting case and conduct an in-depth discussion of that case, using evidence-based material.
To ensure that you acquire adequate knowledge and develop your technical skills, your performance will be monitored carefully during the course of your neurology training. Your supervising faculty member will formally evaluate you after each clinical rotation. Each evaluation is reviewed carefully by the program director. Electronic access allows you to develop a portfolio of evaluations, curriculum vitae, educational competence, and academic effort that will be yours on graduation.
Annual reviews of each resident occur at the Neurology Residency Committee meetings. Your performance in all aspects of neurology must be satisfactory at each level of training before you will be promoted to more advanced levels. Mayo Clinic goes to great length to help struggling trainees improve their performance.
In addition, you will regularly evaluate the faculty and our program to ensure that your educational needs are met.
You will have the opportunity to supervise and teach Mayo Clinic School of Medicine students and visiting student clerks through bedside instruction and formal didactic lectures.
You will be given an opportunity to gain experience in a number of administrative capacities during your training. Class representatives meet with the Neurology Residency Committee each month to improve the program. Additional committees led by residents focus on improving all facets of resident training.
You will meet periodically with various faculty members, administrators and the program director to discuss your individual career goals. Mayo Clinic recruits many of its staff physicians from its own training programs. When you successfully complete your neurology training, job opportunities may be available at Mayo Clinic.
Moonlighting is permitted for licensed residents only when you do not have clinical responsibilities (during research time or vacation time, for example).