Curriculum

Clinical Training (PGY-1)
Before you begin the Adult Neurology Residency Program, you need one year (PGY-1) of clinical training. This may be taken at another academic medical center, or you may apply to the Transitional Year Program at Mayo Clinic in Jacksonville.

The American Board of Psychiatry and Neurology requires that you spend one year in an accredited internal medicine program in the United States or Canada , or in a transitional program that includes at least six months in internal medicine that has been approved by the Accreditation Council for Graduate Medical Education. No neurology residency credit will be given for time spent in a residency program for another specialty.

See also:

• Transitional Year Program
• American Board of Psychiatry and Neurology

Clinical Training (PGY-2 through PGY-4)
The Adult Neurology Residency Program emphasizes the essentials necessary to become skilled in the practice of neurology, and our department hopes to instill in its residents an interest and enthusiasm for patient care, education and research.

Features of the program include:

• A comprehensive electronic medical records system
• Rotations in neuropathology, neurophysiology, neurosurgery, neuroradiology, physiatry, and psychiatry
• Strong didactic curriculum, including weekly conferences and formal didactic lectures
• Extensive outpatient experience
• Weekly continuity clinic that focuses on long-term patient follow-up
• Nine months of elective time
• Elective rotations offered in every subspecialty of neurology
• A humanistic approach to patient care

You will begin your adult neurology residency (PGY-2) with a mixture of hospital and outpatient experiences. Most of your PGY-3 year will be spent in clinical neurophysiology, neuropathology and laboratory or elective rotations. In your PGY-4 year, you will have greater responsibility at the hospital and outpatient clinic.

On clinical assignments, you will be the primary physician seeing several new neurology patients each day. During hospital assignments, you will supervise and teach junior neurology residents, medical residents and medical students. You will evaluate and manage both routine and emergency admissions, and provide consultations for other services.

Throughout your residency, you will receive regular didactic and clinical instruction in neurology, neuroradiology, physiatry and psychiatry. As your experiences increase during your residency, you will be given greater responsibility in both patient management and resident education.

Rotation Descriptions

Adult Neurology Outpatient Services
While on outpatient rotations at the clinic, you will evaluate patients with both common and unusual neurological conditions. You will participate in daily teaching, case discussions and have numerous outpatient educational opportunities.

Continuity Clinic
You will attend a continuity clinic for one-half day per week throughout the three years. In this clinic, you will develop experience with consistent follow-up of patients requiring ongoing care for a variety of neurological disorders.

Adult Neurology Inpatient Services
During your inpatient rotations, you will learn to evaluate and treat neurological emergencies in the Mayo Clinic hospital emergency room. You also will evaluate a wide variety of neurological disorders in the inpatient setting, including the intensive care unit. You will participate in teaching rounds each day in the hospital.

Child and Adolescent Neurology
Mayo Clinic has a formal affiliation for teaching and research with Nemours Children's Clinic, located in Jacksonville . Your training in caring for children and adolescents will occur under the direction of the pediatric neurology division.

During PGY-3 (two months) and PGY-4 (one month), your child and adolescent neurology assignments will be divided between hospital and outpatient clinic services. You will gain experience in dealing with acute and outpatient pediatric neurological disorders. You also will learn the appropriate evaluation of neonatal, infant, child and adolescent patients with neurological disorders.

Core Clinical Neurophysiology
During PGY-3, you will spend at least two months in a clinical neurophysiology rotation. This assignment includes didactic instruction and practical experience in the basics of:

• Electromyography (EMG)
• Nerve Conduction Studies (NCS)
• Electroencephalography (EEG)
• Evoked Potentials
• Autonomic Function Testing
• Polysomnography

After completing this rotation, you can spend additional elective time in neurophysiology (up to six months).

Neuropathology
You will spend two months rotating in neuropathology during PGY-3. This rotation will give you direct experience with anatomic neuropathology under the direction of a full-time neuropathologist. Your training also will include case reviews, brain cutting, and the study of microscopic materials.

Psychiatry
During PGY-2, your psychiatry assignment will be divided between hospital and outpatient clinical services. During this rotation, you will participate directly in the evaluation and decision-making for patients referred to psychiatry. You will learn the psychological aspects of the patient/physician relationship and importance of personal, social and cultural factors in disease processes. You will learn the principles of psychopathology, psychiatric diagnosis and therapy, and the indications for and complications of drugs used in psychiatry.

Physical Medicine and Rehabilitation
During PGY-2, your physiatry assignment will be divided between hospital and outpatient clinical services. During the rotation, you will participate directly in the evaluation and decision-making for patients referred to physiatry. You will learn the basic principles of rehabilitation and gain experience in evaluating and treating stroke, spinal cord injury, traumatic brain injury, as well as neck and back pain.

Neuroradiology
During PGY-4, your neuroradiology assignment will be divided between hospital and outpatient clinicservices. You will gain additional experience during this rotation, interpreting imaging studies with a neuroradiologist and observing neuroradiologic procedures. Radiological procedures reviewed in this rotation include:

• Computerized tomography of the head and spine, CT angiography, and spiral CT
• Magnetic resonance imaging and magnetic resonance angiography
• Conventional cerebral angiography
• Endovascular interventional procedures
• Myelography

Electives
You will have nine months of elective rotations during your residency. In addition to further training inadult or child and adolescent neurology, your elective options include the following:

• Behavioral Neurology
• Cerebrovascular Disease
• Clinical Epilepsy
• Clinical Neurophysiology
• Headache
• Movement Disorders
• Multiple Sclerosis/ Demyelinating Disease
• Neuro-oncology
• Neuro-ophthalmology
• Neuromuscular
• Neurosurgery
• Research
• Sleep Disorders

You can also choose to spend elective time in psychology and neuro-otology.

Didactic Training
Clinical conferences, seminars, small discussion groups, journal clubs, and one-on-one instruction are an integral part of Mayo Clinic's Adult Neurology Residency Program. Formal didactic courses are required during your residency. You will take basic clinical neurology, neuroanatomy and neuroradiology courses during PGY-2. Although you can schedule the clinical neuroscience course at any time, most residents take it during PGY-3. A Neurology Core Lecture Series and a neuro-ethics course are given during all three years of your residency.

Case Studies
During the neurology training program, you will prepare case study presentations. You will present the pertinent information of an interesting case, conduct an in-depth discussion of that case, and learn to systematically search and interpret the medical and scientific literature.

Teaching Opportunities
You will have the opportunity to teach residents from Internal Medicine and Family Practice, as well as Mayo Medical School students and visiting students from other medical schools through bedside instruction and formal/ informal didactic lectures. Throughout your residency, you will participate in the weekly teaching conferences. Seminars and lectures are presented throughout the year on the principles of neurochemistry, neuropharmacology, neuroimmunology and diseases related to these disciplines. Additional subspecialty conferences are presented regularly by all divisions of the neurology department.

Research Training
All neurology residents are required to conduct scholarly activity during their residency program. You may do a chart review, case report, or original investigation. A clinical studies unit is available to provide support services. A list of faculty mentors and/ or areas of interest will be provided. During your adult neurology residency, you can focus on:

• Behavioral Neurology
• Cerebrovascular Disease
• Electroencephalography
• Electromyography
• Headache
• Movement Disorders
• Muscle Disease
• Neuromuscular Junction Diseases
• Neuro-oncology
• Neurosurgery
• Peripheral Nerve Disease
• Psychopharmacology

Short-Term Research Projects
Short-term projects require a two-to six-month commitment and do not take time away from your residency responsibilities. You will have ample opportunity to pursue these projects, such as patient-generated case reports and chart reviews.

Long-term Research Projects
Long-term research projects (typically longer than six months) may require time away from your residency responsibilities. You can apply for a long-term project any time during your residency. You must first obtain permission from the Neurology Education Committee and identify a staff research mentor.

Rotations to Other Mayo Clinic Sites
As part of your neurology training, you may rotate to either Mayo Clinic in Rochester and/or Mayo Clinic in Scottsdale. These rotations offer a unique opportunity to participate firsthand in Mayo's three-campus national practice. Mayo Clinic funds the authorized additional costs of travel/ housing/ car rental and licensure fees, as well as travel expenses and lodging for you and your family.

Call Frequency
Your call schedule will vary by individual rotation. Mayo Clinic follows the recommendations of the Accreditation Council for Graduate Medical Education.

Committee Assignments
You will be given the opportunity to gain administrative experience. Neurology residents participate in the administration of the educational programs and the clinical practice at Mayo Clinic through these committee experiences.

Evaluation
Performance is monitored carefully throughout the neurology residency, in order to ensure residents acquire adequate knowledge and develop appropriate technical skills. Faculty members will formally evaluate residents after each clinical rotation. Each resident is assigned a personal faculty advisor to provide resident feedback and guidance. In addition, residents regularly evaluate the faculty in each rotation to ensure that the educational needs of the resident are being met.

Career Development
You will meet periodically with your faculty advisor and program director to discuss your career goals. Mayo Clinic recruits many of its staff physicians from its own training programs. Thus, when you successfully complete the Neurology Residency Program, new opportunities may be available at one of Mayo Clinic's group practices.