Adult Neurology Program
The UW Neurology Residency Program is integrated between four affiliated hospitals. The different characters of the hospitals make for a richly varied and extremely complete training experience. The Program is designed to:
The first year is an internship in Internal Medicine. We are a categorical program: all applicants who match in our program are both guaranteed an internship position at the University of Washington and are required to complete their internship training at the University of Washington.
Internal Medicine at the University of Washington is a highly selective residency program that prides itself on preparing residents equally well for primary care, subspecialties and research. Preliminary interns are fully integrated into the residency. Interns rotate to the affiliated hospitals and are trained by outstanding faculty and senior residents. Rotations include training in inpatient Internal Medicine, and ICU care as well as electives that are typically spent on consult teams or in outpatient clinics. The year includes one month of Neurology as well as one month at the end of the year that is divided between Neuro-Radiology in the mornings, with the afternoons devoted to Neurology didactics designed exclusively for the Neurology interns. This prepares the interns for their upcoming Neurology junior year and allows the resident class to come together and learn as an integrated group.
Sample Intern Year Schedule
In the first year, the resident spends three or four months as the junior ward resident at Harborview Medical Center. Call during those months is in-house, every fourth night.
Three months are spent at the University of Washington Medical Center; half of that time is spent as the consult junior resident, half as the inpatient ward junior. During the week call is by a Night Float resident. The inpatient team residents cover the weekend call.
Three months are spent at the VA Puget Sound Hospital (“VAPSH”). The resident’s time is divided between inpatient duties and clinics. The consult team and the inpatient team. The inpatient service is less busy than at the other hospitals, allowing for residents to participate in weekly general and specialty outpatient clinics. Call is home call and is every third night.
One month is spent as the inpatient junior at Seattle Children’s; the team functions mostly in a consultative role, though there are also patients assigned directly to the Neurology team. In all cases, a primary pediatric team covers the patient as well. Call is from home and is every third night.
During the second year, the resident begins to take on a leadership role on the inpatient teams. Two of the most challenging and rewarding months are spent as the “Copass” Senior Resident at HMC. The resident evaluates ED consults during the weekdays and coordinates the workload of the Copass Neurology team.
The N2 resident also spends time as senior resident on the UWMC and VAPSH Neurology services. Electives and selectives are chosen to allow residents to explore areas that interest them as they establish their career goals. Selectives are non-ward rotations that are required that may be taken in either the N2 or N3 year. They include a month each of EEG, EMG and Neuro-Pathology. Residents also choose from a broad range of Electives. Many residents choose to do additional months of EEG and EMG during their electives.
The final year is devoted to broadening the resident’s breadth and depth of neurologic expertise. The resident spends 6 weeks running the consult service at HMC. Because of the wide variety of clinical questions as well as the acuity of the patients’ conditions, many residents describe these months as both their most challenging and also those in which they learned an astonishing amount of neurology. Two months are spend as the “Sumi” senior resident at HMC; in this capacity the resident oversees the workload of both of the HMC inpatient teams and plays a leadership role in organizing clinical conferences and other teaching. One month is typically spent as Senior Resident at the UWMC. One month is spent doing Psychiatry, either in the ED or inpatient setting. The remaining months are spent completing the balance of selectives and on elective time. Many residents choose to devote a portion of their elective time to either educational endeavors or research time.
Typical rotation schedule for the N1-N3 years
The most important, high yield learning is done at the patient’s bedside, on rounds and in clinic. Our faculty are committed to this type of “real time” teaching and understand that contemporaneous discussions about live patients are extremely high-yield learning opportunities. Didactics are also an integral part of developing a broad command of the ever-expanding field of Neurology. Weekly conferences are held at every hospital. We have developed a core curriculum that repeats once every 3 years. Those lectures are held as part of the Tuesday morning didactics and the Grand Rounds series. There is a weekly Wednesday noon subspecialty conference that rotates among Stroke, Neuromuscular, Movement Disorders and Neuropathology. There are subspecialty conferences held at the various hospitals on either a weekly or monthly basis.
Residents play a crucial role in educating their co-residents, interns, students and also their attendings and patients. As trainees progress through residency they are expected to provide progressively more extensive teaching to others. There are many opportunities for “on the fly” teaching, as well as informal presentations when on inpatient services. There are also ample opportunities for formal presentations; residents give patient clinical conferences, present articles at Journal Club (along with a faculty mentor), prepare a Neuropathology Clinical Patient correlation, prepare 2 Grand Rounds presentations, and prepare a Q and I presentation in their N-3 year. Residents frequently are able to present their talks at outside forums including local, national and international conferences.
A number of our residents participate in research during their training years. For residents who are contemplating research careers, elective time during the latter 2 years of residency can be arranged to allow the resident to spend at least 4 months participating in either basic or clinical research. Several of our residents have gone on to take advantage of the T32 NIH funded research fellowship.
Benefits include 3 weeks of vacation, health, dental and disability insurance, and a retirement matching program. In addition, the Program supports attendance either at 2 national conferences, or at 1 national conference and one away rotation. A book allowance as well as membership to the AAN and journal subscription is provided.
Most residents graduating from the Program complete fellowships for further training. ACGME-accredited fellowships are available in EEG and Neurophysiology, Sleep Medicine and Cerebrovascular Neurology. There are also fellowships available in Movement Disorders, Headache and Multiple Sclerosis. In addition, there is a fully funded Research Fellowship available through an NIH funded T-32 grant program. While several of our residents stay at the University of Washington for fellowship training, many also obtain fellowships at other institutions. Examples of fellowships that our residents have done in the past few years include: