Adult Neurology Residency 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:

Intern Year

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

1 General Medicine HMC 8 ER UWMC
2 General Medicine HMC 9 Float 2 weeks/Procedures 2 weeks
3 General Medicine VA 10 Float 2 weeks/Vacation 2 weeks
4 MICU UWMC 11 Elective
5 Cardiology VA 12 Elective
6 General Medicine HMC/VA 13 Neuro-Radiology/Neurology Didactics
7 Neurology HMC

N1 Year

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. Call is from home. 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 the consult team and the inpatient team. Call is home call and is every third night. The inpatient and consult services are less busy than at the other hospitals, allowing for residents to participate in weekly general and specialty outpatient clinics.

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.

N2 Year

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 all of the ED consults during the weekdays and coordinates the workload of the two HMC Neurology teams.

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.

N3 Year

The final year is devoted to broadening the resident’s breadth and depth of neurologic expertise. The resident spends 2 months running the “Sumi” 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. One month is typically spent as Senior Resident at either the VA or 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.

A typical rotation schedule for the N1-N3 years is:

N1 N2 N3
Jul UW wards EEG HMC Sumi Sr (consult)
Aug UW consult VA Senior Resident HMC Sumi Sr (consult)
Sept HMC wards Elective Adult Clinics
Oct HMC wards HMC Copass Sr (ED consult) Elective
Nov Adult clinics HMC Copass Sr (ED consult) Elective
Dec Children's Inpatient Children's Inpatient Children's Clinic
Jan VA wards/clinic EMG Elective
Feb VA consult/clinic UW Senior Resident Neuro-pathology
Mar HMC wards UW Senior Resident Neuro-pathology
Apr HMC wards Elective VA Senior Resident
May UW wards Night Float Night Float
Jun VA wards/clinic VA Senior Resident Psychiatry

Curriculum/Teaching

The most important, high yield learning is done at the patient’s bedside and in clinic. Our faculty are committed to this type of “real time” teaching and understand that residents will gain more from discussions about live patients than discussions about articles. That said, didactics are an integral part of developing a broad command on 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 Grand Rounds series and every other Tuesday morning. There are also a number of other lectures in the various subspecialties.

Resident Teaching

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 2-3 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.

Research

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 fellowhip.

Benefits

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.

Beyond Residency

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:

Our residents ultimately find positions in both the academic world and in community practice