Program Structure G1-G4
The structure of the residency program fulfills ACGME core-competency requirements in patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism and system-based practice. It allows for the gradual acquisition of clinical and research skills, confidence, knowledge and responsibility, while satisfying our residents’ need to care for patients, intellectual curiosity and expectations for achieving their career goals. We view such elements indispensable for the development of exceptional neurologists. We rotate at a diverse set of hospitals giving residents the experience to manage and treat a variety of neurologic conditions. Rotations are at the following hospitals: · University of Minnesota Medical Center (UMMC) · Hennepin County Medical Center (HCMC) · Veterans Affairs Medical Center (VAMC) · Fairview-Riverside Hospital · North Memorial Medical Center (NMMC) · Regions Hospital PRELIMINARY TRANSITIONAL YEAR IN INTERNAL MEDICINE (G-1) An integrated G-1 year is offered in the University of Minnesota affiliated hospital system. All applicants who match with our neurology training program are guaranteed a slot in the transitional G-1 program. Our program is distinctive in that neurology continuity clinic starts in July of the G-1 year, which allows continuous exposure from the very beginning to patients and faculty in the field of one’s choice. Residents have the opportunity to attend the neurology service-wide conferences during the G-1 year. Specific rotation blocks include: 4 blocks of internal medicine at Regions or HCMC 2 blocks of neurology at HCMC 2 blocks of internal medicine at VAMC 1 block of cardiology consults at Regions 1 block of emergency medicine at HCMC 1 block of medicine ICU (HCMC or Regions) 1 block of ambulatory medicine at HCMC 1 block of psychiatry at Regions FIRST YEAR OF NEUROLOGY TRAINING (G-2) The G-2 year at the University of Minnesota combines primary inpatient and consultation neurology with additional experience in neuro-critical care, stroke, neuro-rehabilitation, and sub-specialty outpatient clinics. This schedule is designed to provide an accelerated and comprehensive experience with acutely ill patients. For optimal preparation to care for patients due their G-2 year, residents attend Neurology “Boot Camp” towards the end of the intern year. Specific rotation blocks include: 4-5 blocks of inpatient neurology as a junior at UMMC (a total of 4 weeks within these blocks will be dedicated to night float) 3-4 blocks of stroke/neuro-critical care (2 weeks of day float and 2 weeks of night float per block) at HCMC 1-2 blocks of inpatient neurology as a junior at VAMC 1 block of epilepsy/EEG at UMMC 1 block of neuro-rehabilitation at NMMC 1 block of subspecialty clinics at various sites SECOND YEAR OF NEUROLOGY TRAINING (G-3) The G-3 year allows for a smooth transition from a junior to a senior resident in neurology as knowledge and experience solidify. The first few months of the G-3 year are based mostly on outpatient, consult and laboratory rotations, while during the latter part of the year residents start to act as seniors in an inpatient setting. Specific rotation blocks include: 3-4 block of ward senior (split among UMMC, HCMC [consult service only], and VAMC) 2 blocks of neuropathology at UMMC 1 block pediatric neurology at UMMC 1 block of clinical neurophysiology at VAMC 1 block of neuro-critical care at UMMC 1 block of consults at Riverside, 1 block of night float at UMMC/HCMC (in two 2-week blocks throughout the year) 1 block of subspecialty clinics 1 block elective time THIRD YEAR OF NEUROLOGY TRAINING (G-4) The final G4 year is a consolidation of skills and advanced responsibility. It further allows residents to pursue their personal subspecialty interests with several months of elective rotations prior to starting their fellowship or professional career. Specific rotation blocks include: 3 blocks of inpatient ward senior (UMMC, HCMC [consult service only] and VAMC) 4 blocks of elective 2 blocks of pediatric neurology 1 block of consultations at Riverside 1 block of epilepsy/EEG at UMMC 1 block of consultations at Regions 1 block of clinical neurophysiology at VAMC OVERNIGHT CALL RESPONSIBILITIES Since 2007 the University of Minnesota Neurology Residency Training Program has successfully instituted a night-float system for all its services with the exception of an occasional Saturday 24 hour call while covering inpatient services. Specific responsibilities are as follows: G-1: With the recent ACGME change, first year residents do not take 24 hour call. A combination of long-call and night float will be instituted on inpatients blocks at the discretion of the Internal Medicine and Psychiatry departments at each hospital. Note that the Emergency Medicine rotation includes 9 hour night shifts. G-2: During this year there are eight to ten weeks of night float responsibilities (in two week blocks per ACGME) during the inpatient rotations at HCMC and the University Hospital. 24-hour Saturday call at UMMC is covered by the inpatient junior residents (two at most during a block) with the other weekends off. Saturday at HCMC, which is the night-float resident’s day off, is covered by residents on electives or outpatient rotations. Otherwise, there are home call responsibilities during the VAMC rotation. G-3: There is a total of two to four weeks of night float at either the University Hospital or HCMC. There is no in-house call except for some Saturdays at HCMC, as described above. There is home call during the VAMC rotations. G-4: There is no in-house call except for some Saturdays at HCMC, as described above. There is home call during the VAMC rotations. CLINICAL AND EDUCATIONAL ACTIVITIES ACROSS YEARS The University of Minnesota Neurology Residency Program is historically committed to train some of the best neurologists in the country. To this goal continuous exposure to clinical neurology as practiced in an outpatient environment as well as up-to-date neurology lectures is imperative. Specific activities: Resident outpatient continuity clinic Service-wide conferences Rotation-specific conferences RESIDENT MENTORING AND EVALUATION ACROSS YEARS During residency each resident will receive continuous feedback on their performance and evolution towards becoming a neurologist through formal and informal evaluations. Through this process we have achieved a 100% pass-rate over the last 6 years in the ABPN board examinations while our residents are accepted to fellowships or follow careers of their choice. While feedback is provided through informal processes, such as discussions with the rounding or clinic attending, there are also formal feedback mechanisms in place such as: Mentorship program OSCE exam RITE exam End-of-year presentations Conference presentations End-of-rotation evaluations Semi-annual evaluations with program director BACKUP FOR UNEXPECTED EVENTS It is expected there will be instances of residents becoming sick, or having family emergencies, that make it impossible for them to carry on their inpatient duties for a short period of time. For such instances there is a backup “jeopardy call” system in place allowing for appropriate patient care, without our residents having to scramble to find someone to cover their service during their hour of need. OUTREACH ACTIVITIES The University of Minnesota Neurology Residency program has a long commitment to serving the community. Our residents have volunteered in several community activities both individually and as part of our program’s initiatives. Examples of such activities include the Minnesota State Fair and Brain Awareness Week among others. SOCIAL ACTIVITIES Social activities are planned on a monthly basis and include the Welcome picnic, Neurology “Night at the Movies,” Holiday Party, and mingling with other specialties.
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