Neurology residents receive extensive exposure to outpatient neurologic problems during all three years of their residency.
General Continuity Clinic Experience
Every other week for half a day, you will follow your own patients in a general neurology continuity clinic. Residents are either assigned at the University Hospitals General Neurology Clinic under the direction of Michael Devereaux, MD or at the VA Neurology Continuity Clinic under the direction of Amani Ramahi, MD.
At UH, other neurology attendings also work with the residents on a rotating schedule. Thus, each clinic is always staffed by two or three attendings. At the VA, all neurology attendings participate in the Continuity Clinic. Both at UH and the VA, residents are divided into two teams, each in clinic every other week. The teams are organized as practices. Thus, although you primarily follow your own patients, you will also care for your colleagues' patients when they are on vacation or not in clinic for some other reason.
At UH, the clinic is located on the fifth floor of the Bolwell Health Center building. The department maintains a large number of examination rooms and a large conference room at that site. All radiology is immediately available in the clinic via the PACS radiology system. The primary focus of this clinic is the management of hospital and emergency department follow-ups.
Subspecialty Continuity Clinic
Every other week for half a day, you will follow your own patients in a Subspecialty Neurology Clinic. Every year, you will be assigned to a different subspecialty attending. In this way, you will have the opportunity to have a continuity clinic where you can follow subspecialty patients that are often not present in a general neurology clinic (e.g., myasthenia gravis, progressive supranuclear palsy and seizure patients being evaluated for seizure surgery, etc.). In this way, over the three years of residency, you will work in three different subspecialty clinics and see the spectrum of outpatient neurologic illness. This is an excellent opportunity to work with sub-specialized attendings within their field of expertise.
VA Clinic Experiences
Every Monday afternoon, veterans are seen by neurology residents. The clinic is staffed by all the VA attendings together who work closely with each resident. This also functions as a continuity clinic for some of our neurology residents. While inpatient follow-ups are scheduled in this clinic, it also provides wide exposure to primarily outpatient diseases, such as Parkinson's disease, peripheral neuropathy, migraine and essential tremor.
Besides a large teaching clinic held on Monday afternoons, the VA Neurology Service maintains subspecialty clinics for care of patients with the following:
- Cognitive disorders
- Multiple sclerosis (MS)
- Neuromuscular disorders
The MS clinic has grown to be the second-largest MS center in Ohio, in terms of numbers, and is part of the Department of Veterans Affairs Centers of Excellence. The MS clinic is unique in its attention to the neuro-ophthalmological complications of MS and the application of novel therapeutic approaches for visual disabilities of these patients.
ALS and Muscle Disease Clinic
The ALS and Muscle Disease Clinic is directed by Bashar Katirji, MD, and Komal Sawlani, MD. This clinic cares for patients with ALS and chronic, mostly inherited neuromuscular disorders, including muscular dystrophy, spinal muscular atrophy and Charcot Marie Tooth peripheral neuropathy. Residents attend the Muscle Disease Clinic as part of their neuromuscular/EMG experience during their PGY3 rotation.
Outpatient Neurology Block
During the PGY4 year, senior residents spend one block on a dedicated outpatient block. During this rotation, residents will have an emphasis on behavioral neurology and movement disorders, as well as headache and multiple sclerosis.
Elective Outpatient Rotations
Residents may elect to pursue additional outpatient training during their elective time. Among outpatient clinic electives, movement disorders, neuro-ophthalmology and neuromuscular are often selected.