The resident's neurology training begins with the PGY 1 year. This is a preparatory year for the trainee which has a heavy emphasis on internal medicine. The resident will have rotations in general internal medicine, cardiology, critical care, emergency medicine and osteopathic manipulative medicine. There will be 4 months spent on the neurology inpatient service and 1 month on sleep medicine. Hospital coverage will be a part of experience. All these rotations will be at Grandview and Kettering Hospitals. The PGY 1 resident will do a one-month rotation in psychiatry. The PGY 1 the resident will begin seeing patients in the neurology continuity of care clinic at Cassano Health Center.
The PGY 2 year is an immersion in hospital neurology. The resident is assigned to run the inpatient services at either Grandview (350 beds) or Kettering Hospitals (500 beds). Responsibilities include a supervising PGY 1 neurology resident, admissions to the service, consultations and an active role in the stroke team to include telemedicine. Procedures include diagnostic as well as therapeutic lumbar punctures. The resident will be in charge of teaching rotators on the service, which include medical students, internal medicine as well as psychiatry residents.
In the second half of the PGY 2 year there is a required 2 month rotation on the epilepsy service. Here the resident will learn to interpret electroencephalograms and manage patients with epilepsy. Ambulatory EEG, intraoperative monitoring and an epilepsy monitoring unit are all integral to this rotation. Upon completion of the rotation, the resident is expected to continue to interpret EEGs on a scheduled basis for the remainder of their training. There will also be rotations in the ambulatory setting at the Dayton Center for Neurological Disorders. The resident will begin following other residents at the Neurology Clinic at Cassano Health Center. They will continue to see patients in the continuity of care clinic at Cassano Health Center.
The PGY 3 year begins with a 3-month required rotation on the EMG service. During this rotation the resident will focus on peripheral neurology and learn how to perform electrodiagnostic testing. EMG clinics will be regularly scheduled for the resident upon completion of the rotation in order to further refine their diagnostic skills.
A 3-month rotation in child neurology is completed during the second half of the PGY 3 year in the Neurology Department at Children's Hospital in Dayton. There is exposure to inpatients as well as the ambulatory patients with neurological disease. There is opportunity to interpret pediatric EEGs. Monthly, throughout the residency, the child neurologists host a child neurology journal club, which focuses on issues that have relevance to the adult neurologist. There is also a monthly didactic session in child neuroradiology, also hosted by Children's Hospital.
The resident will continue to gain experience in adult neurology the remainder of the PGY 3 year in the ambulatory as well as hospital settings. Hospital rotations may include one of the other four institutions the faculty covers, as well as at the primary teaching hospitals. These rotations allow the resident to have more autonomy and work one on one with the faculty members. Elective rotations are encouraged and are arranged individually with the program director. Rotations through the hospital network include sleep medicine, memory disorders, epilepsy, neurosurgery, neuroradiology, neuro-immunology, vascular/interventional neurology, OMM and PM&R. The resident can spend time in the Neuro-rehabilitation & Balance Unit. Time is allotted to learn the use of Botox for a variety of disorders.
During the PGY 4 year, the resident embarks on a 3-month rotation in neuropathology. This will serve to enhance the understanding of neurological disease at the basic science level. During this rotation there is time for ongoing exposure to outpatients, EEG and EMG. Time is allotted for study and senior project preparation.
The remainder of the senior year places a heavy emphasis on outpatient neurology and practice management skills. The residents are involved in the business of medicine from their first day however; this becomes more important as the resident nears the end of the program and prepares to enter practice. Exposure to this is gleaned from the faculty's private practice. There is also required hospital coverage, with the resident being expected to function at the level of an attending neurologist. Increased responsibility for interpretive EEG & sleep studies. Autonomy with telemedicine for acute stroke will be emphasized.