Neurology
Clinics and Services
Each intern completes two one-month rotations on either the inpatient or outpatient neurology services (See Stanford Neurology Department Website for further clinical information)
Stanford Hospital Inpatient Neurology
During this inpatient rotation residents divide their time between 2 main clinical services: University Neurology Service, the busy Stanford Stroke Service and covering patients on the Epilepsy Service while on-call.
University Neurology Service.
This genral neurology service treats cases of MS, myasthenia, referral cases for uncertain diagnosis such as conversion disorder, complex migraine, Guillain-Barre, paraneoplastic syndromes involving the nervous system & autoimmune diseases with central nervous system manifestations.
Stroke Service.
Residents are exposed to a full range of stroke syndromes from TIA's to massive middle cerebral arterial distribution strokes, vertebrobasilar strokes, and aneurysms. They participate in intensive case management of acute stroke patients including those who received emergent TPA treatment.
Residents spend the majority of their time learning to examine and evaluate patients admitted to the Neurology Department. Residents learn to formulate a diagnostic and treatment plan and how to implement that plan after reviewing it with the senior resident and/or attending physician. Trainees present cases to the attending physicians and follow the progress of all ward patients on a daily basis. An average case load consist of 5-10 patients combined on the three services. These patients are jointly followed by the Neurology resident and the psychiatry resident; daily progress notes are divided between the two, but the PGY-1 resident actively follows and manages all patients. They are responsible for maintaining daily progress notes in the medical record, and for dictating the hospital discharge summary. In addition, residents spend 4-5 hours weekly in seminars and case conferences. In addition, they attend daily teaching rounds which can take 4 hours per day, as each patient admitted to the ward is reviewed in-depth with an attending. Residents perform lumbar punctures and evaluate CAT scans and MRIs (with neuroradiology rounds).
Stanford Hospital Outpatient Neurology
The Stanford Neurology Clinic includes both general and specialty clinics. The specialty clinics are Epilepsy Clinic, Multiple Sclerosis Clinic, Parkinson's Disease Clinic, Neuromuscular Disorders Clinic, Movement Disorders Clinic and Child Neurology Clinic. Neurodiagnostic facilities include the EEG, EMG and evoked potential laboratories. Interns rotate through many of these clinics. Clinic population age ranges from 10 years to elderly. 75% Caucasian, 15% Hispanic, 5-10% Asian, 5-10% African-American. A large variety of neurologic disorders are seen. All socio-economic classes are represented.
Residents spend their mornings seeing 2-6 patients daily in the clinic for up to 1 hour each. This is followed by a 20-40 minute individual teaching session with the neurologist. The patient is presented and the resident's evaluation is reviewed by the neurologist who also examines the patient then discusses the case further with the resident; follow-up clinic patients are scheduled as necessary. In addition, residents spend 2 hours weekly in formal conferences. Residents attend grand rounds on Fridays and have one-hour formal case conferences. Interns work-up cases and present to attendings. All patients are seen by a staff neurologist . Residents review EMGs, Nerve Conduction Tests, EEG's, Carotid Doppler/Ultrasound Tests, perform Lumbar Punctures and evaluate CAT scans, MRIs (with neuroradiology rounds).
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