The first year of the Adult Neurology Residency at Vanderbilt is spent primarily in the Department of Medicine. Through the PGY-1 year Neurology residents do have a weekly Neurology clinic at the Veterans Administration Hospital.
There are three main clinical setttings for education throughout the three years of neurology training:
1) Residents assume primary responsibility for the evaluation and treatment of neurology inpatients while at the Vanderbilt University Hospital, the Nashville Veterans Administration Medical Center, and the Stallworth Rehabilitation Hospital.
2) Residents rotate through the various subspecialty outpatient clinics, where they work closely with the subspecialty faculty.
3) Residents maintain a continuity clinic composed of general neurology outpatients.
The First Year of Neurology (PGY2): The aim of the first year is to provide comprehensive clinical experience in adult neurology through both outpatient and inpatient diagnosis and management. Each resident completes 13 4-week blocks of clinical service. Residents participate in outpatient care for one block in the Ambulatory Neurology Clinic and for two blocks on the Epilepsy-EEG service. Inpatient care includes six blocks divided between the Vanderbilt stroke, Vanderbilt general, and VA general inpatient services. Three blocks are spent on the inpatient consult service. One block of psychiatry will round out the year. Each resident maintains a weekly continuity clinic at the Vanderbilt Clinic for the duration of the residency. First year residents are usually on call every sixth night, when they are expected to cover neurology inpatients and consultations, generally with a rotating psychiatry or medical intern, as well as a 2nd or 3rd year neurology resident on second call.
The Second Year (PGY3): The second year presents residents with an exceptional opportunity to lay the foundation for their future path. Fully half of the year’s clinical rotations are spent exploring subspecialties selected from a wide range of electives. Residents have the option to identify a mentor and arrange for protected time for formulating a career path. The time might be spent, for example, becoming immersed in the literature to define a course of study, to develop a clinical or basic neuroscience research project, or to write an application for a research fellowship.
The second year clinical experience is spent at the Vanderbilt Hospital, Monroe Carell Jr. Children's Hospital at Vanderbilt, and the Vanderbilt Clinic completing rotations in Child neurology (2 blocks), outpatient subspecialty clinic (2 blocks), VA senior (2 blocks), Stroke senior (1 block), EMG (2 blocks), night float (1 block divided into 2 2week blocks), and elective (3 blocks). When on night float, senior residents are primarily responsible for child neurology consultations, code strokes throughout our hospital system, and supervision of the first year resident who is also on call.
The Third Year (PGY4): In the third year, residents must demonstrate to their faculty that they are prepared to work independently. Third year residents assume an ascending level of responsibility for patient care as they take on senior ward responsibility for training junior residents in the program. The clinical and management challenges encountered will serve to reinforce the knowledge gained in the previous years and solidify the skills necessary for a successful clinical neurology practice.
Each resident serves 3 blocks in Vanderbilt Senior Inpatient Service, 3 blocks in Vanderbilt Senior Consult Service, 1/2 block as a VA Senior, 1 block in the Ambulatory Clinic, 1 block in Child Neurology, 1/2 block on night float, and 3 blocks in electives. Third year residents have the same role as the night float resident as second year residents. One of the third year neurology residents is selected as Chief Resident for the year and is responsible for developing the Grand Rounds schedules, arranging the block and vacation schedules, and generally serving in a leadership position in the residency program.