Preliminary Transitional Year in Internal Medicine (PG-1)
An integrated PG-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 PG-1 program.
PG-1 residents rotate through the Hennepin County Medical Center, Regions Hospital, and the Minneapolis Veterans Administration Medical Center. Each of these facilities sponsor active training programs in all medical disciplines, providing PG-1 residents exposure to colleagues in different fields. Excellent supervision is provided by faculty and senior residents at each site. PG-1 neurology residents spend 40% of their time at HCMC, 40% at Regions and 20% at the VAMC.
Specific block rotations include 2 months of general medicine at HCMC, 2 months of general medicine at Regions, 3 months of general medicine at the VAMC, 1 month of Cardiology at Regions, 1 month of Emergency Medicine at HCMC, 2 months of Neurology (HCMC or Regions), 1 month of ICU (HCMC or Regions) and 1 month of Ambulatory Medicine at HCMC.
PG-1 neurology residents maintain a neurology continuity clinic one afternoon per week. This continuity experience begins in July of the PG-1 year and continues throughout the PG-2, 3, 4 years. PG-1 residents are encouraged to attend other neurology department educational (grand rounds, resident journal club) and social events.
First Year of Neurology Training (PG-2)
The PG-2 year at the University of Minnesota combines primary inpatient and consultation neurology with additional experience in neuro-rehabilitation, psychiatry, neurosurgery and specialty outpatient clinics. This schedule is designed to provide rapid, intense experience with acute and chronic clinical problems that relate to both the general neurology patient and the patient who has a specialized problem. Specific rotation blocks include 4 months of inpatient neurology at University of Minnesota Medical Center, a division of Fairview, 3 months of inpatient/outpatient neurology at Hennepin County Medical Center, 3 months of inpatient neurology at the Minneapolis Veterans Administration Medical Center, 1 month of neuro-rehabilitation, and 1 month of psychiatry at UMMC.
University of Minnesota Medical Center (4 months inpatient)
UMMC is a 1,868-bed tertiary care hospital which offers primary and subspecialty care to 36,859 inpatients and outpatients each year. The UMMC draws referrals from the entire upper Midwest, including the state of Minnesota, Western Wisconsin, Northern Iowa, and the Eastern Dakotas. The Neurology inpatient service admits approximately 375 patients per year, provides approximately 490 consultations per year, and manages approximately 1,223 subsequent care visits per year. Residents are exposed to a broad range of neurological disease, caring for patients with both acute and chronic disease, with problems ranging from the routine to the unusual. The inpatient neurology team administers care to the neurology ward patients and provides consultative service to the hospital. The inpatient team consists of one neurology senior resident (PG-3 or 4), 1-2 neurology junior residents (PG-2), 3 medical students and often a medicine PG-2 resident. The neurology residents at UMMC manage all aspects of patient care and perform all procedures, under faculty supervision, for all patients admitted to the neurology inpatient service. Neurology residents are given progressive responsibility for patient care in cooperation and close communication with attending neurologists.
Hennepin County Medical Center (3 months inpatient/outpatient)
HCMC, located approximately 1-mile from the medical school, is a 422-bed (910 licensed) county hospital which supplies care to approximately 22,000 inpatients and 362,000 outpatients annually. It is a level-one trauma center and has the busiest Emergency Room in the upper Midwest, logging 98,000 emergency room visits per year. It has been listed in the US News and World Reports “Top 100” hospital list for the past several years and has 9.5 neurology faculty. The neurology service admits approximately 600+ patients per year. In addition to a large volume of emergency, acute-care neurology, HCMC also offers care to patients with a diversity of chronic neurological disorders referred in to various neurological subspecialty programs. The HCMC rotation is divided into 2 six-week blocks, one inpatient and one outpatient. The inpatient team directs the care of the neurology ward inpatients, including the neurology ICU patients, and provides consultative service to the hospital as well as emergency room. The inpatient team consists of one neurology senior resident (PG-3 or 4), one neurology junior resident (PG-2), one medicine PG-2 resident, one family practice PG-2 resident, 2-4 transitional medicine PG-1 residents, 1 neurosurgical PG-1, and 3 medical students. During the 6-week outpatient block neurology PG-2 residents rotate through a variety of neurology subspecialty clinics, including Stroke, Epilepsy, Neuromuscular Diseases, ALS, Huntington’s, and Sleep Disorders.
Minneapolis Veterans Administration Medical Center (3 months inpatient)
The Minneapolis Veterans Administration Medical Center, located about 6 miles from the medical school, is a beautiful, modern, 237-bed facility that offers care to 8,021 inpatients and 67,189 outpatients per year. The VAMC and its faculty are fully-integrated into the university department. 1 full time and 9 part-time neurology faculty participate in the teaching, clinical, and research activities at the VAMC. Neurology residents are exposed to a broad spectrum of acute and chronic neurological disease. The inpatient team consists of one neurology senior resident (PG-3 or 4), one neurology junior resident (PG-2), one PG-2 psychiatry resident, and 2-3 medical students. Specialty programs exist in dementia, movement disorders, neuromuscular disease and epilepsy.
Neurorehabilitation Medicine (1 month)
PG-2 residents spend 1 month rotating through a neurorehabilitation unit at North-Memorial Hospital. A very popular rotation, this month offers residents the opportunity to acquire skills and knowledge in rehabilitation medicine as it pertains to the care of chronic neurology patients. The neurorehabilitation unit is staffed by two neurologists. This rotation emphasizes a team approach to patient management through interaction with occupational therapy, physical therapy, speech therapy, and other support services.
Psychiatry (1 month at UMMC or HCMC)
Second Year of Neurology Training (PG-3)
The PG-3 year of training is divided into several 2-month blocks, with rotations in pediatric neurology, clinical neurophysiology (EEG/EMG), neuropathology, and specialty ambulatory clinics. Four months of ward senior (split between UMMC, HCMC, Riverside and VAMC) round out the PG-3 year.
Pediatric Neurology (2 months UMMC)
The busy Pediatric Neurology service at UMMC oversees a variety of inpatient and outpatient activities. The pediatric service at UMMC supports 207 pediatric beds, 54 pediatric ICU beds and 33 neonatal ICU beds. Approximately 212 inpatient consults are requested annually, and roughly 303 outpatients are seen in the general and subspecialty pediatric neurology clinics each year. Neurology residents are exposed to a broad spectrum of disease, with acute and chronic as well as routine and esoteric problems represented. The teaching is superb, with supervision provided by pediatric neurology faculty and by senior pediatric neurology residents.
Clinical Neurophysiology (2 months UMMC)
During this rotation, PG-3 residents rotate through the very active EEG and EMG facilities at UMMC. Residents develop skills in the interpretation of routine and video EEGs, and in the care of chronic epilepsy patients. The residents also gain experience in the performance and interpretation of EMG and nerve conduction studies, as well as in the care of neuromuscular patients. Supervision is provided by several full-time subspecialty faculty. Several waveform and case conferences in neurophysiology are conducted weekly.
Neuropathology (2 months UMMC)
This is one of our most popular rotations, largely due to the superb teaching and excellent clinical material. Residents gain experience in the evaluation of gross and microscopic specimens. Approximately 90 specimens are reviewed monthly by our university neuropathologists.
Ambulatory Specialty Clinics (2 months UMMC)
Residents rotate through the busy subspecialty clinics at UMMC, including Neuromuscular Diseases/MDA, ALS, Ataxia, Movement Disorders ( click here for Parkinson's disease: An Overview), Epilepsy, Multiple Sclerosis and Dementia. This rotation offers exposure to a wide range of neurological diseases. Each clinic is staffed by full-time faculty with subspecialty and research interests in the given area.
Inpatient Ward Senior (4 months UMMC/HCMC/VAMC/RIVERSIDE)
Each PG-3 neurology resident spends 4 months as ward senior. Responsibilities include supervision of the junior residents and medical students on the inpatient service, overseeing the care of acutely ill patients with neurological disorders in the intensive care unit, and teaching. The ward senior supervises sign-in rounds and sign-out rounds daily, conducts teaching, arranges case conferences and neuroradiology rounds, and is responsible for maintaining the quality of neurological care provided by junior residents on the neurology service.
Third Year of Neurology Training (PG-4)
The final G4 year is a consolidation of skills and advanced responsibility. The PG-4 year consists of 6 months of inpatient ward senior (2 months each at UMMC, HCMC and VAMC), 1 month of neuroradiology, 1 more month of pediatric neurology, and 4 months of elective.
Inpatient Ward Senior (6 months, 2 each at UMMC, HCMC, VAMC) Described above.
Pediatric Neurology (1 month UMMC)
Described above
Elective (5 months)
Elective schedules, including the choice and duration of particular electives, are arranged by each resident in accordance with their interests and career plans. A wide range of clinical electives is available, including neuroradiology, neuropathology, psychiatry, EEG, EMG, neuro-otology, neuro-ophthalmology and sleep disorders. In addition, numerous opportunities are available for residents to participate in clinical or basic neurological research. Upon completion of the University of Minnesota Neurology Residency Training Program, graduates will have attained a broad and intense experience in all facets of clinical neurology and will be prepared to provide excellent care to their patients.
Night Call
Night call is currently 8/month for the PG-2 year, 6/month for the PG-3 year, and 4/month for the ward months during the PG-4 year (1-2/month for non-ward months during the PG-4 year). With the exception of 2 months and one week during the PG-2 year (HCMC rotation), all of this call is taken from home. With the recent increase in our resident allotment from 4 to 5 adult residents per year, the call burden will likely lighten.