Eleven months of the PGY3 year are spent in adult neurology at Barnes-Jewish Hospital. The resident rotation schedule is identical to the PGY2 adult neurology resident schedule for that year. Rotations include the adult neurology consult and inpatient services, neurological/neurosurgical intensive care unit, adult outpatient sub-specialty clinics, and emergency department nightfloat.
One month of the PGY3 year is spent working with the child psychiatry service at St. Louis Children’s Hospital seeing inpatient consultations and participating in outpatient clinics.
The PGY4 year is spent on the clinical services at St. Louis Children’s Hospital.
Outpatient: On the outpatient clinic rotation the resident rotates through the various faculty sub-specialty clinics. Patients are seen by the resident and then presented to the attending. Subspecialty clinics include epilepsy, movement disorders, cerebral palsy, headache, tuberous sclerosis, neurofibromatosis, and neuromuscle.
Inpatient: The inpatient residents manage all neurologic issues within the hospital. Because of the number of services requiring care, these responsibilities are typically covered by two to three pediatric neurology residents and the adult neurology rotating resident.
12th Floor Neurology Ward Service-The 12th floor of St. Louis Children’s Hospital is largely dedicated to the care of neurology and neurosurgery patients. The pediatric neurology resident supervises the floor team of pediatric residents in the care of neurology patients
Consult service-The neurology consult service handles consults from the PICU, NICU, CICU emergency department, and hospital floors other than the 12th floor. Residents covering the consult service also take calls from community pediatricians and outside hospital neurologists as well as see urgent outpatient clinic consults. They also perform outpatient procedures such as lumbar punctures.
Video EEG-Residents assist our epileptologists in the care of the video EEG monitoring patients. We have six monitoring beds located on the 12th floor of St. Louis Children’s Hospital.
One month of the last year is dedicated to an adult neurology elective in order to complete the twelve required months of adult neurology to be eligible for board certification.
Residents are required to complete two months of a basic science, one month of outpatient clinical rotation, and two weeks of NICU.
The remaining 7.5 months of the year are elective. The resident may select clinical electives such as neuroradiology, additional EEG or EMG training, neuro-oncology, sleep medicine, genetics, neuro-ophthalmology, neuro-otology, or additional time in any of the sub-specialty clinics. The resident may also decide to dedicate all or part of this time to research or other career development activities.
During the neurology in-patient floor service and NNICU rotations the residents take in-house call every fourth night. During the nightfloat rotation, the resident works 6 nights of 12 hour shifts 7 pm-7 am with one night off per week.. During outpatient and consult months there is no call.
During the PGY4 year the residents take at home call. The on-call resident takes all neurology calls from St. Louis Children’s Hospital and all telephone consult calls from outside hospitals. The resident also takes calls from patient families for the division of pediatric neurology. Weeknight call is typically covered by the resident supervising the in-patient ward service. One weeknight per week is usually covered by the adult neurology rotator. Weekend call consists of coverage from Friday night to Monday morning and is divided equally among the PGY4 pediatric neurology residents. During weekend call the on-call resident covers all hospital services. They receive assistance from the adult neurology rotator one day each weekend.
The pediatric neurology continuity clinic begins during the resident’s PGY3 year. Residents spend one half-day each week in clinic and typically see 4-6 patients per clinic. Patients are assigned to a specific resident’s schedule and follow-up with that resident during their entire three years of training. The clinic is typically staffed by two to three attending physicians. Generally, all patients admitted to the hospital who do not have a neurologist at the time of admission are followed in clinic by the resident that cared for them during their hospitalization if they need on-going care. Residents handle all outpatient calls on their own patients during office hours with the assistance of the nursing staff.