Today is Thursday, Sep. 24, 2020

Department of

Neurology & Rehabilitation Medicine 

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Dr. Neel with residents

About the Program

At the University of Cincinnati, we seek motivated, mature individuals with a dedication to personal improvement, who seek to provide compassionate care for people with neurologic disorders, and are committed to a career in neuroscience.

We provide a supportive working atmosphere in which you will be treated as a colleague, an excellent physical environment, a new and updated resident clinic space, research opportunities across the spectrum of neuroscience, and a reasonable balance between service and education. Our faculty are dedicated to training high-quality clinical neurologists who will practice evidence-based medicine in a compassionate manner.  We are a family at UC, and we recruit toward maintaining that supportive environment.

The UC neurology program is an integrated, categorical four-year program. Residents matching with us will complete their internal medicine training at UC Health University of Cincinnati Medical Center. Our training program occurs mainly at the University of Cincinnati Medical Center.  We are grateful to enjoy a wonderful working relationship with our partners in pediatric neurology at Cincinnati Childrens Hospital Medical Center and our partners at the Cincinnati Veterans Administration Medical Center. We are also able to offer unique experiences at West Chester Medical Center and Drake Medical Center to round out your educational experience.

We recruit eight residents per year into our program, giving a combined cadre of 32 adult neurology residents in the program. The size of the program allows for a better balance between service and education, and allows us to offer earlier elective experiences in the training program to explore the breadth of neurology before having to make fellowship and career decisions. In addition, our size allows us to offer an intensive boot camp with general and sub-specialty didactics, diverse sub-specialty experiences, procedural workshops, and culturally relevant experiences.

Neurology residents are exposed to a vast array of neurologic problems and diseases under the guidance of an exceptional group of world-class faculty during the regular course of the residency on the inpatient and outpatient services. Electives are offered in neuro-immunology, movement disorders, cerebrovascular disease, headache medicine, neuro-critical care, palliative care, neuromuscular medicine, neurophysiology, epilepsy, neuro-behavioral neurology, sleep medicine, pain medicine, research, neuro-ophthalmology, neuro-oncology, and more.  We offer a multitude of fellowships, and have fellow trainees who also contribute to the educational environment without diminishing the educational experience for our resident trainees.

Residents are expected to be compassionate, scholarly clinical neurologists when they have completed their training at UC. But we also expect our residents to be teachers wherever they might land after residency.  Our residents teach medical students and other residents (and sometimes even other departmental faculty) throughout the course of their training program.  We offer a unique education elective that is tailored to the individual resident for those who are interested in pursuing a teaching career after residency.

Our program values educational innovation and constant feedback from our residents about how we can improve our program.  Decisions that affect the residency are conversations, and we have a high expectation for leadership in our residents from within the program even starting in the PGY1 year.

Residents are evaluated at the end of each month by their supervising faculty and twice a year by the program directors. Feedback comes in both written and oral forms, and our faculty are dedicated to giving feedback for your growth.  The program directors and program coordinator are in close communication with faculty and residents at all times to facilitate growth as opportunities arise. All residents take the written in-service examination yearly. Educational issues are discussed monthly at our Education Committee Meeting, and the program directors and program coordinator (and the majority of the faculty) will be available to you 24 hours a day during your training and beyond.

Our department is part of the larger, multi-departmental University of Cincinnati Gardner Neuroscience Institute at UC Medical Center. The UC Gardner Neuroscience Institute has been formally in existence since 1998 and is one of the major reasons for our success and growth. In April 2019, we opened the new UCGNI building. The new building has allowed us to integrate our resident clinic into the same space with our sub-specialty and general attending clinics, allowing faculty and residents to interact more and share the exact same clinical resources.  The space has also offered us closer working relationships with our partners in Neurosurgery, Physical Medicine and Rehabilitation, Neuro-Radiology, Neuro-Otology, the Brain Tumor Center, Integrative Medicine, and our outpatient physical therapy, speech therapy, and occupational therapy departments. 

 

Active Patient Care

Learning to care for patients with neurologic disease is difficult.  We feel we will give you a safe place to learn this, and a family to support you during this process.

The foundations for excellent neurologic care will be built during your time in the internal medicine preliminary year.  You will learn the basics of medicine, while still be included in general neurology resident clinic and having two distinct neurology rotations during your PGY1 year: neuro-critical care and general neurology service at the VAMC.   As you progress into your PGY2 year, you will be transitioned into caring for patients with predominantly neurologic disorders on multiple teams, including the UCMC consult team, the UCMC inpatient teams, the UCMC Epilepsy team, and more time on the VAMC team. Elective time is also built in to help you see the different sub-specialties throughout this year for career and educational growth.

To learn more about the Internal Medicine Residency here at UCMC, please visit: https://med.uc.edu/depart/intmed/residency

By the time you are a PGY3 resident, we begin to transition you to more graded independence as a senior resident, supervising junior residents from our department and other departments (Pediatric Neurology, Internal Medicine, Internal Medicine/Pediatrics, Neurosurgery, Psychiatry, and Physical Medicine and Rehabilitation) both during the day on teams and at night while doing the senior night float.  You will have 24 access to your attendings throughout this time at any clinical site you will be engaged in, helping you develop your independence in assessing and treating patients with neurologic disease. Electives are heavily emphasized in the first half of the PGY3 year to help in experiencing neurology sub-specialties and help with career decision making.

By the time you are a PGY4, we will expect you to be preparing for the next phase of your career and/or training. You will be rounding out your education in areas you might not yet feel you have had enough experience, and delving into the depths of specific areas of interest for your career. 

Two full months of dedicated EMG training and two full months of dedicated EEG training are key features of our program, so that our graduates feel comfortable with neuro-physiology when they leave us to practice.

Our residency training program has exceptional sub-specialty programs in cerebrovascular disease, epilepsy, epilepsy monitoring, neurocritical care, movement disorders, neuromuscular disease, multiple sclerosis and neuro-immunology, sleep, neuro-oncology, behavioral neurology and headache medicine. The attending faculty that will teach you in resident clinic, on the wards, and in the sub-specialty clinics reflect this broad repertoire. Our residents are able to experience and integrate the history-taking, exam skills, and clinical approaches from a wide variety of teaching neurologists which truly allows our residents to see the breadth and depth of how to approach neurologic problems.

We have integrated tele-neurology into our practice in resident continuity clinic as well as into our sub-specialty clinics.  The coronavirus pandemic has accelerated our programming in this area, and we transitioned as many experiences into virtual experiences without compromising the education of our doctors or the safety of our patients. 

In addition, our pediatric neurology program is one of the largest in the United States, with major strengths in epilepsy, movement disorders, pediatric demyelinating disorders, pediatric neuro-critical care, headache, inherited disorders of metabolism, tuberous sclerosis and neurofibromatosis. You will experience two months of inpatient pediatric neurology consult work at CCHMC during your PGY3 year and one month of outpatient pediatric neurology experiences during your PGY4 year.  While you might not have chosen pediatric neurology as your specialty, you need to be familiar with pediatric neurology to be able to benefit the communities you eventually will serve, and how to transition patients from pediatric neurology into adult neurology as they age throughout their conditions.

We can offer special experiences in community neurology practice at our partner institutions with our West Chester Medical Center Neurology experience, learning what life might be like as a practicing doctor outside of the regular academic medical center.  This is a very popular elective for our residents who are trying to decide on what lifestyle they might want after they graduate and where they will fit best.

 

A Focus on Education

Educating residents and fellows is a high priority. Our extensive didactic teaching includes grand rounds, a clinical neuroscience course, challenging case conferences, clinicopathologic conferences, chairman's rounds and journal club.

Our program includes a full set of weekly didactic conferences that address specific clinical problems—the basic neurosciences, neuro-radiology, neurosurgery, neuro-rehabilitation, psychiatry, neuro-pathology and clinical approaches to neurological diseases.

We offer courses in neuro-pharmacology and neuroanatomy, a monthly neuro-ophthalmology lecture series and multiple weekly specialty conferences (neuro-radiology with radiology and neurosurgery; neuromuscular conference with physical medicine and rehabilitation; epilepsy/epilepsy surgery with neurosurgery; and stroke team meeting with emergency medicine).

In addition, the department holds movement disorders video case conferences bi-monthly with Dr. Alberto Espay and the movement disorders faculty from here and other institutions. Dr. Espay has hosted international and U.S. movement disorders experts, including Dr. Anthony Lang and Dr. Francesca Morgante. The residents have enjoyed the wine and cheese reception with faculty and the movement team in a non-threatening learning experience after work on Wednesdays. 

Critical review of the literature takes place in the residents' journal club. Mortality and morbidity focuses on practice-based learning and systems-based learning improvement with the faculty. Residents are also trained in palliative care, communication skills, and special focus on didactics for residents as educators.

An educational stipend of $500 per year is given for books and travel. In addition, the department will provide $1,000 toward travel expenses if residents have papers accepted for presentation. All residents are expected to attend at least one national meeting during their training.

Our residents are expected to teach medical students, our inter-professional teammates, and our fellow physicians.  To this end, we offer an educational elective for those with a mind for educational innovation, such as teaching formats and across disciplines.  Our residents have created in-services for nurses throughout the hospital; active teaching sessions with partnering residencies in psychiatry and internal medicine; and virtual and remote educational tools for the non-neurologist and for the neurologist. Our residents have created medical student rotations and served on medical student graduate medical education committees for the UC College of Medicine. Through our partnerships with CCHMC, the UCCOM Internal Medicine Residency, and the UC College of Education, there are many alternate educational experiences available to our trainees.

Residents may join the Learning Community course for the medical school and work with a group of first year medical students through their second year, teaching general medical curriculum and serving as a mentor to medical students.  You will learn how to teach a medical student journal club, as well as how to teach a neurologist to conduct a journal club.  You will learn how to teach the neurologic exam to medical students in a simulation center and be given feedback on how to improve.  You will teach medical students on a variety of teams giving direct patient care.

We hope you will be teaching for the rest of your life.

 

Research Involvement

Residents become involved in clinical and basic science research during their second and third years.  Dr. Daniel Woo, our Vice Chair of Clinical Research, maintains a working list of ongoing research programs within the department.  With his assistance, we have also created a manuscript list for our residents with data that is just waiting to be written up and submitted. Our residents are prepared to present a paper at one of the national meetings, and are incentivized to do so with offer of payment for national travel beyond their travel stipend.

Our residents have excellent role models for career development in research. The StrokeNet is based in Cincinnati, Ohio, as well as housing one of 25 NeuroNEXT grant locations. Four adult and pediatric neurology faculty currently hold or are completing K23 "Career Development and Clinical Research Awards" from the National Institutes of Health.

Whether you choose a career in clinical work or a combined research academic clinical role, you will be prepared to continue scientific questioning to benefit your patients and your community.

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