Neurology Residency: Program Structure
Beth Israel Deaconess Medical Center
Beth Israel Deaconess is a single hospital, but operates from two sets of buildings, on opposite sides of Brookline Avenue (East Campus and West Campus). The Neurology/Neurosurgery Ward and Neurology/Neurosurgery ICU is located on West Campus, along with the Emergency Department and most of the acute medical and surgical services, and the psychiatry ward. The East Campus houses some medical and surgical specialties and obstetrics/gynecology, as well as most of our outpatient facilities, including the Neurology Outpatient Offices in the Shapiro Clinical Center. The Department of Neurology provides consultation services on both campuses.
The inpatient program is divided into ward and consults rotations during the first two years, which are supervised by Chief Residents in the third year of the program. The neurology inpatient wards at both Beth Israel Deaconess Medical Center and Boston Children’s Hospital are run on a full-time staff model, where the ward team includes the first year residents and medical students under the supervision of a Chief Resident and a teaching attending. Residents take major responsibility for evaluation and management of all patients, with the support of the attending staff.
Summary of Inpatient Rotations*
|Rotation||General Ward||Stroke Ward||Neuro ICU||Children’s Ward||Rehab|
|Rotation||West Consult||East Consult||ED||Night Coverage|
|Rotation||Children’s ICU/Consult||Neuro ICU||Elective||Vacation|
|Rotation||General Chief||Stroke Chief||ED Rotation||Neuropathology|
*Rotation schedules are meant to be an approximation of an average schedule. Because of clinical need, unexpected absences, or other factors, individual schedules may vary somewhat from the typical pattern.
With a wide breadth and depth of outpatient experiences, our residents have opportunities to follow their own continuity patients for three years, as well as see clinic patients in multiple different subspecialties.
Starting in the first year of residency, residents maintain a longitudinal General Neurology clinic, working with the same attending every other week. The staffing is dynamic, with an increased level of supervision in the first year, and graded levels of autonomy in later years. Since residents work closely with this attending over three years, they often serve as not only a clinical teacher but also as an advisor and mentor. In the first year residents also rotate in a Pediatric Neurology clinic at Boston Children’s Hospital every other week. Residents find this allows them to develop a greater level of comfort with childhood neurologic diseases, which often persist into adulthood. This clinic only operates every other week in the first year, and for the second year residents pick a second Adult Neurology clinic.
Subspecialty clinics occur during elective and subspecialty blocks. During the first year, residents participate in a Neurophysiology block, when they may rotate through clinics in the subspecialties of Epilepsy, Neuromuscular, and Sleep Neurology. There is also a Neurorehabilitation block during the first year, when residents spend time in the Cognitive Neurology clinic.
During the second and third year Elective blocks, residents rotate through subspecialty clinics of their choosing. Popular clinics among residents include Neuro-ophthalmology, Neuroimmunology/MS, Movement disorders, Neuro-oncology, Headache, Autonomics, Epilepsy, Neuromuscular, Sleep, and Neuro-ID. Finally, there is an option to add a longitudinal Movement disorder clinic for 6 months during the PGY4 year, for residents with a particular interest in Movement disorders or outpatient Neurology.
|Year||1st Continuity Clinic
(All 3 years)
*alternates every other week
|2nd Continuity Clinic
*alternates every other week
|Neurophysiology and Neurorehabilitation Rotations||Elective blocks|
Boston Children’s Hospital
The Harvard Medical School Neurology Program at Beth Israel Deaconess Medical Center and Children’s Hospital Boston provides an array of teaching conferences for its residents. Adult neurology teaching rounds are held at Beth Israel Deaconess Medical Center and include a Clinical Case Conference, Neuropathology Conference, Keystone Lecture Series, Neuroradiology Conference, EEG/Epilepsy Conference, Professor’s Rounds, as well as daily general neurology teaching rounds and a variety of subspecialty teaching conferences. Pediatric neurology teaching rounds at Children’s Hospital include weekly Professor’s rounds, combining in depth discussion of clinical cases, including the neuroradiological and neuropathological aspects.
During each summer, the lecture series is supplemented by a Resident “Bootcamp” Conference Series, run by the third year residents and selected staff, to educate the incoming residents in emergency neurology. During the remainder of the year, there is a “Neurology Keystone” Lecture Series covering core topics in neurology, aimed at a PGY3 level, as well as “Topics in Neurology” conferences covering advanced topics in a variety of subspecialties.
There are weekly Neurology Grand Rounds during the academic year, in which specific topics in neurology are formally reviewed, often with a clinical case demonstration, and frequently by invited guests from outside the Program. There are endowed visiting professorships each year, allowing the program to bring in outstanding teachers and investigators from around the world to help train our residents. A Morbidity and Mortality Rounds is held once a month. A Journal Club is held monthly, in which a set of important articles in a key subfield of neurology are reviewed with an invited faculty member. There are seminars in basic neuroscience sponsored by the Department of Neurology at both Beth Israel Deaconess Medical Center and Children’s Hospital, as well as by the Department of Neurobiology in the Medical School, and by the other Harvard teaching hospitals.
|9:30||Live Patient Presentation||Neuropathology/ Neurology Keystone Lecture Series||Longwood Neurology Grand Rounds* (July-September)
|12:00||Topics in Neurology/Patient Oriented Research Curriculum||Topics in Neurology||Neuromuscular/ Epilepsy Series||Professor’s Rounds|
|4:00||Cognitive Neurology Grand Rounds||Stroke Case Conference|
*Morbidity and Mortality conference one Wednesday morning per month.