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Curriculum

Photo of Mayo Clinic Adult Neurology Residents in the simulation center

The Adult Neurology Residency at Mayo Clinic's campus in Jacksonville, Florida, is divided into two parts: an initial year (PGY-1) of graduate medical education in internal medicine followed by three years of adult neurology residency training (PGY-2 through PGY-4).

Clinical training

PGY-1

Before you begin your residency training, you must complete one year (PGY-1) of clinical training.

The American Board of Psychiatry and Neurology (ABPN) requires that you spend one year in an accredited internal medicine program in the U.S. or Canada, or in a transitional program that has been approved by the Accreditation Council for Graduate Medical Education (ACGME) and includes at least six months in internal medicine. No neurology residency credit will be given for time spent in a residency program for another medical specialty. The requirements for the PGY-1 year can be found on the ABPN website. The ABPN also requires one month of psychiatry during residency. You will complete this rotation during the PGY-1 year in order to open elective time during the PGY-2 through PGY-4 years.

The Adult Neurology Residency is strictly a categorical program with four categorical slots. In general, no separate interview with the Department of Internal Medicine is required for those interested in the categorical program. A separate interview is necessary if you are interested in the neurology residencies at Mayo Clinic's campuses in Rochester, Minnesota, or Phoenix/Scottsdale, Arizona.

A unique feature of the Adult Neurology Residency in Florida is the "Transition to Neurology" course. The course occurs during May and June of the PGY-1 year. The first month is built on a program of didactics over a variety of topics in neurology, simulations of emergent neurological conditions including brain attacks and status epilepticus, and lumbar puncture training. During this month, you are free of patient care responsibilities. In June, you are immersed into the inpatient service. You spend two weeks on the general inpatient service and two weeks in the Neurocritical Care Unit. You have limited patient responsibilities but are an active member of these inpatient teams.

PGY-2, PGY-3, PGY-4

The Adult Neurology Residency emphasizes the essentials necessary to become skilled in the practice of neurology. Our department hopes to instill in its residents an interest and enthusiasm for patient care, education and research.

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

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

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

Rotation schedule

First year (PGY-2)
Rotation Length
Adult neurology (outpatient) 3 months
Adult neurology (inpatient) 5 months
Neurocritical care unit 1 month
Electives 2 months
Neuromuscular 1 month
Second year (PGY-3)
Rotation Length
Neuropathology 1 month
Core clinical neurophysiology 2 months
Child and adolescent neurology 2 months
Adult neurology (inpatient) 1 month
Epilepsy monitoring unit 1 month
Research and quality improvement 1 month
Emergency room consults 1 month
Electives 3 months
Third year (PGY-4)
Rotation Length
Adult neurology (inpatient) 2 months
Emergency room consults 2 months
Neurocritical care unit 1 month
EEG reading 1 month
Adult neurology (outpatient) 2 months
Child and adolescent neurology 1 month
Electives 3 months
Totals
Rotation Length
Adult neurology (inpatient and outpatient) 19 months
Child and adolescent neurology 3 months
Core clinical neurophysiology 2 months
Psychiatry 1 month
Neuropathology 1 month
Neurocritical care unit 2 months
EEG reading 1 month
Epilepsy monitoring unit 1 month
Research and quality improvement 1 month
Electives 8 months
Peripheral neurology 1 month

Rotation descriptions

Adult neurology outpatient services

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

Continuity clinic

You attend a continuity clinic for one half-day a week throughout the three years. In this clinic, you 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 learn to evaluate and treat neurological emergencies in the Mayo Clinic hospital emergency room. You also evaluate a wide variety of neurological disorders in the inpatient setting, including the intensive care unit. You 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, Jacksonville. Your training in caring for children and adolescents occurs under the direction of the pediatric neurology division.

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

Core clinical neurophysiology

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

  • Electromyography (EMG)
  • Nerve conduction studies
  • Electroencephalography (EEG)
  • Evoked potentials
  • Autonomic function testing
  • Polysomnography

After completing this rotation, you can spend another two to four elective months in EMG.

Neuropathology

You spend one month rotating in neuropathology during PGY-3. This rotation gives you direct experience with anatomic neuropathology under the direction of a full-time neuropathologist. Your training also includes case reviews, brain cutting and the study of microscopic materials.

Psychiatry

During PGY-1, your psychiatry assignment is divided between hospital and outpatient clinical services. During this rotation, you participate directly in the evaluation and decision-making for patients referred to psychiatry. You learn the psychological aspects of the patient-physician relationship and the importance of personal, social and cultural factors in disease processes.

You also learn the principles of psychopathology, psychiatric diagnosis and therapy, and the indications for and complications of drugs used in psychiatry.

Peripheral neurology

During PGY-2, you have a rotation dedicated to peripheral neurology. This month includes clinic evaluation and management of peripheral nervous system diseases, including motor unit disease, radiculopathy, plexopathy, neuropathy, neuromuscular junction disease and myopathy. In addition, you are introduced to clinical neurophysiology, including an introduction to electromyography.

Electives

You have eight months of elective rotations during your residency. In addition to further training in adult or child and adolescent neurology, your elective options include:

  • Behavioral neurology
  • Brooks Rehabilitation Hospital
  • Cerebrovascular disease
  • Clinical epilepsy and epilepsy monitoring unit
  • Clinical neurophysiology
  • Clinical neuropsychology
  • Electroencephalography (EEG)
  • Headache
  • Movement disorders
  • Multiple sclerosis and demyelinating diseases
  • Neuromuscular junction diseases
  • Neuro-oncology
  • Neuro-ophthalmology
  • Neuroradiology
  • Palliative care
  • Research
  • Sleep disorders
  • Speech pathology

Didactic training

Clinical conferences, seminars, small discussion groups, journal clubs, one-on-one instruction and formal didactic courses are integral parts of the Adult Neurology Residency. You take basic clinical neurology and neuroanatomy courses during the PGY-2 year. Although you can schedule the clinical neuroscience course at any time, most residents take this during the PGY-3 year.

A Neurology Core Lecture Series is given during all three years of your residency. Our residents complete a quality-improvement project and a yearly practice-improvement project.

Case studies

During the residency, you prepare case study presentations. You 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 have the opportunity to teach residents from internal medicine and family medicine, as well as visiting medical students, through bedside instruction and formal and informal didactic lectures.

Throughout your residency, you 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.

Research training

All neurology residents are required to conduct scholarly activity during their residency. You may do a chart review, case report or original investigation. A clinical studies unit is available to provide support services, and there are resources available in the Center for Clinical and Translational Science. A list of faculty mentors and areas of interest is provided.

Additionally, all neurology residents are encouraged to complete the Fundamentals of Clinical and Translational Science (FunCaTS) course.

During your residency, you can focus on:

  • Autonomic neurology
  • Behavioral neurology
  • Cerebrovascular disease
  • Clinical neurophysiology
  • Critical care neurology
  • Electroencephalography (EEG)
  • Electromyography (EMG)
  • Epilepsy and epilepsy monitoring unit
  • Headache
  • Movement disorders
  • Multiple sclerosis and demyelinating diseases
  • Muscle disease
  • Neuromuscular junction diseases
  • Neuro-oncology
  • Neurosurgery
  • Peripheral nerve disease
  • Sleep disorders

Rotations to other Mayo Clinic sites

In the rare circumstance when a rotation is not available in Jacksonville, you may rotate to Mayo Clinic's campus in Rochester, Minnesota, or Phoenix/Scottsdale, Arizona (or both). These rotations offer a unique opportunity to participate firsthand in Mayo's three-campus national practice.

Mayo International Health Program

Our trainees are encouraged to take advantage of the Mayo International Health Program, which helps Mayo residents and fellows pursue elective rotations and provide medical care to underserved international populations in well-planned, mentored settings. The program provides selected participants with up to $2,500 in financial support to help defray travel and basic living expenses.

Call frequency

Your call schedule varies by individual rotation. Mayo Clinic follows the recommendations of the ACGME. We take the ACGME duty hour standards very seriously and ensure full compliance.

In general, call is no more than once a week. On your call day, you come in at 3 p.m., take call overnight and handle cross-cover issues, and end your call at 7 a.m. the next morning. You stay to present and round on your patients. You have the rest of the post-call day free.

About once a month during PGY-2, you have weekend day-call in which you take call and cross-cover issues from 7 a.m. to 5 p.m., when the night-call resident comes in.

Committee assignments

You are 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 Adult Neurology Residency to ensure residents acquire adequate knowledge and develop appropriate technical skills. Faculty members formally evaluate residents after each clinical rotation. Each resident is assigned a personal faculty adviser who provides feedback and guidance. In addition, residents regularly evaluate the faculty in each rotation to ensure that their educational needs are being met.

ACGME milestones are biannually reviewed by the faculty milestone committee and are discussed with each resident to ensure appropriate growth through residency.

Career development

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

  • Dec 11, 2014
  • ART933711