introduction - residency programs€¦ · web viewresident manual brian copeland, md program...

Resident Manual

Brian Copeland, MDProgram Director

Neurology Residency1542 Tulane Ave, Rm 763New Orleans, LA 70112504-568-4081 (Phone)504-568- 7130 (Fax)

Effective July 1, 2018

LSU School of Medicine - New Orleans

Neurology Resident Manual 2017-2018

TABLE OF CONTENTS

INTRODUCTION.........................................................................................................................3

PURPOSE......................................................................................................................................3

STATEMENT ON PROFESSIONALISM....................................................................................3

DEFINITIONS...............................................................................................................................4

LICENING POLICY.....................................................................................................................4

USMLE STEP 3 POLICY.............................................................................................................5

MEDICAL STUDENT INTERACTIONS....................................................................................5

EVALUATION POLICIES...........................................................................................................6

CLINICAL COMPETENCY COMMITTEE................................................................................6

SIX GENERAL COMPETENCIES..............................................................................................7

LEAVE...........................................................................................................................................8

PROGRAM OBJECTIVES BY LEVEL OF TRAINING.............................................................9

PROGRAM CORE CURRICULUM...........................................................................................14

SCHOLARLY ACTIVITY..........................................................................................................17

QUALITY IMPROVEMENT/PATIENT SAFETY PROJECTS................................................17

PROGRAM EVALUATION COMMITTEE..............................................................................17

SUPERVISION AND PROGRESSIVE RESPONSIBILITY POLICIES...................................18

LEVELS OF SUPERVISION BY YEAR OF TRAINING.........................................................20

AFTER HOURS CALL..................................................................................................................22

PROGRAM POLICY ON CLINICAL WORK AND EDUCATION HOURS..........................22

MOONLIGHTING......................................................................................................................22

ALERTNESS MANAGEMENT/FATIGUE MITIGATION STRATEGIES.............................22

SOCIAL MEDIA GUIDELINES................................................................................................23

GRIEVANCE POLICY...............................................................................................................24

NEW INNOVATIONS MEDICAL EDUCATION MANAGEMENT SUITE..........................25

ROTATION DESCRIPTIONS....................................................................................................26

UNIVERSITY MEDICAL CENTER NEW ORLEANS............................................................27

OCHSNER NEUROCRITICAL CARE......................................................................................28

OCHSNER-KENNER.................................................................................................................30

PEDIATRIC NEUROLOGY.......................................................................................................31

PSYCHIATRY.............................................................................................................................32

LSU CLINICS..............................................................................................................................33

VA CLINICS...............................................................................................................................35

OCHSNER VASCULAR............................................................................................................37

LSU SCHOOL OF MEDICINE – NEW ORLEANS

NEUROLOGY RESIDENT MANUAL

INTRODUCTION

The mission of the Neurology Residency Training Program of LSU School of Medicine – New Orleans (LSU SOM NO) is to provide high quality, well-rounded training in Neurology. Graduates should be competent in the practice and foundations of clinical neuroscience and prepared to enter independent practice. Part of this mission is to foster an environment of learning, career development, and scholarly activity that will enhance patient care, improve patient outcomes, and expand the quality of neurologic care provided.

PURPOSE

The purpose of this manual is to provide supplemental policies specific to the Neurology Residency Training Program that exist in addition to those laid out by the LSU SOM NO Office of Graduate Medical Education (GME) and the Accreditation Council for Graduate Medical Education (ACGME). The Program follows all of the ACGME Program Requirements for Graduate Medical Education in Neurology. Where not explicitly stated, the Program follows the LSU SOM NO House Officer Manual. This manual describes policies that are either not listed or are more restrictive than those listed in the LSU SOM HO Manual. In the event a program or departmental policy or guideline conflicts with the LSU SOM NO House Officer Manual, the House Officer Manual takes precedence.

STATEMENT ON PROFESSIONALISM:

As outlined in the LSU SOM NO House Officer Manual, Neurology residents are expected to follow the 6 elements of Professionalism: altruism, accountability, excellence, duty, honor and integrity, and respect for others. Adherence to the above principles will be evaluated through monthly evaluations, semi-annual evaluations, 360 and peer evaluations, and other means. The LSU SOM NO House Officer Manual also delineates some other behaviors reflective of a commitment to professionalism (page 4):

In addition to the above, behaviors that reflect a commitment to professionalism include completion of all tasks which are assigned to you including accurately logging and adhering to duty hour standards, medical records, case logs, attendance at conferences, alertness management, assurance of fitness for duty, recognition of impairment, adherence to policies governing transitions of care, working Core Modules and other on line assignments, maintenance of licensure and certifications, awareness of and compliance with institutional policies, adherence to policies and procedures in GME including those in the House Officer Manual, and other program and institutional requirements.

Effective July 1, 2018 3

DEFINITIONS

Resident – The term “Resident” shall mean interns and residents who have matched in the Neurology Residency Program.

Program – The term “Program” shall mean the Neurology Residency Training Program of Louisiana State University School of Medicine in New Orleans.

Director – The term “Director” shall mean the Program Director of the Neurology Residency Training Program of Louisiana State University School of Medicine in New Orleans.

GME – The term “GME” shall mean the Office of Graduate Medical Education of Louisiana State University School of Medicine in New Orleans.

LICENSING

GME Licensing PolicyAll Residents must have a valid active license or permit to practice medicine in the State of Louisiana. Requirements for medical licensure change from time to time. The Louisiana State Board of Medical Examiners (LSBME) requires passage of USMLE Step 3 before the end of the PGY 2 year to issue a permit or license to begin PGY 3 training. As part of the licensure process the LSBME uses a service of the Federation of State Medical Boards (FSMB) called the Federation Credentials Verification Service (FCVS). Once Residents have applied for permit/licensure, the Program will be completing an updated FCVS form on Residents each year so that, at graduation, FCVS has a completed record on the trainee that will greatly facilitate credentialing in his/her later professional career. When the Resident starts, the Program will have each trainee sign a release for all years of training.

All applicants and trainees must contact the LSBME regarding required examinations and documentation necessary for any form of training permits and licensure.

The LSBME issues temporary training permits to qualified PGY 1 level trainees. Temporary permits also may be issued for certain foreign medical graduates entering the U.S. on J-1 visas. Foreign citizen trainees must have standard Educational Commission for Foreign Medical Graduates (ECFMG) certification. Rules and regulations regarding trainees with visas frequently change. When questions regarding visas arise GME will refer all questions to the LSUHSC Office of Governmental Relations for final determination to ensure compliance with all institutional, state and Federal rules and regulations.

House Officers are appointed for one year. Contract renewal is subject to mutual written consent of the Department Head and the House Officer. This renewal must be made in a timely manner in accordance with ACGME requirements as outlined in our Policy and Procedure Manual and with dates set by the GME Office.


Neurology USMLE Step 3 PolicyHouse Officers must take the USMLE Step 3 exam prior to the end of their PGY1 year. If a passing result is not obtained, the test must be retaken. A copy of the USMLE Certified Transcript of Scores indicating achievement of a Step 3 passing score must be available to the Director or Program Coordinator by January 1st of the PGY-2 year. If a Resident cannot provide the required evidence of passing USMLE Step 3, his/her contract of employment will not be renewed on expiration of the current year in training. If a Resident subsequently becomes eligible, he/she may reapply for appointment (Approved by the Program Evaluation Committee 10-13-2015).

MEDICAL STUDENT INTERACTIONS

First and foremost, students will be treated in a professional and respectful manner at all times. Demeaning or abusive behavior will not be tolerated. It is the primary responsibility of the Neurology resident to create a collegial and effective learning environment for the medical students and others rotating on the service. The Neurology resident is also responsible for managing the team effectively, including medical students and rotators. The Neurology resident is responsible for seeing and being knowledgeable about ALL patients on service. It is not sufficient for a patient to have only been seen by a student.

The Neurology resident will pre-round with the students prior to staff rounds. Pre-rounds will include discussing the patients with the students and seeing the patients together, if not already done. Teaching will take place during pre-rounds, either in a sit down fashion or at the bedside. Students may be assigned reading or presentations based on the patients they have seen. “Pimping,” asking questions that the student would have no reasonable chance of answering correctly for the purposes of belittling her/him, will not be tolerated. A specific time and place for pre-rounds the next day will be communicated to all students prior to the end of the current business day. The time and place for staff rounds will also be communicated to the students by 7AM of the current business day.

Students will be assigned patients to be seen that day by 7AM. Students will see the patient and have notes written prior to pre-rounds. The maximum number of patients for students to follow will be five (5). Students will be assigned new consults as they are received, in a rotating fashion. The student will see the patient alone first. The student will then review the case with the Neurology resident, and both will see the patient together. An MD must see consults within 24 hours of the consult being placed. The maximum number of new consults for students to see for the entire business day will be three (3). If students are assigned new consults to see and document prior to morning rounds, they will not be responsible for seeing established patients unless they have seen them previously. Students may see new consults throughout the day, but they will not follow more than the maximum of five (5) patients for the purposes of writing daily notes.

The Neurology resident will write notes on ALL patients on the service by the end of the business day. Whether notes need to be completed prior to staff rounds will be at the discretion of the attending. Neurology resident notes MUST have an original HPI, physical exam,


assessment, and plan. Copying and pasting these sections from student’s or other services’ notes is not acceptable. The Neurology resident may copy and paste the past medical, family, and/or social histories and review of systems from a medical student note.

In order to gain exposure to outpatient Neurology, students on inpatient services will go to the resident continuity clinics on Monday morning at UMCNO.

Students will evaluate the resident anonymously, in order to monitor compliance with these expectations. These evaluations will be incorporated into the resident’s academic file and monitored by the Director and the Clinical Competency Committee. Failure to consistently comply with these expectations will result in progressive disciplinary action, including but not limited to, preliminary intervention, probation, and failure to renew the Resident’s contract (Approved by the Program Evaluation Committee 10-13-2015).

EVALUATION POLICIES

Evaluation of Residents occurs at every level, from faculty, peers, students, patients and clinical staff. Evaluations are distributed to designated individuals by the Program Coordinator for each clinical rotation, either through New Innovations or by paper form. The format of written evaluations incorporates the six core competencies and ACGME Neurology Milestones. In addition to the written evaluation, verbal feedback is given throughout the course of clinical rotations.

Residents will be evaluated electronically monthly by their clinical supervisor of service. Residents will receive an evaluation form for each of their rotations, as well as faculty, electronically. This will allow for an anonymous process. Residents will also be asked to complete yearly Program evaluations. All Resident evaluations will remain strictly confidential and will only be viewed by the Program Coordinator and Director.

Any faculty has the right to suspend a Resident’s clinical privileges at any time if she/he believes that the Resident is jeopardizing patient care or welfare. Such a decision must be reported to the Director immediately. Within 24 hours (of a workday), the Director will convene an ad hoc meeting composed of the chief of service, chief resident, a faculty member of the Resident’s choosing, and, if possible, the department chair to make a determination. A written document and an action plan will be developed.

CLINICAL COMPETENCY COMMITTEE

The mission of the Clinical Competency Committee (CCC) is to evaluate Residents’ performance in the core clinical competencies, prepare and ensure the reporting of Milestones evaluations of each resident to ACGME, and advise the program director regarding resident progress, including promotion, remediation, and dismissal.

The CCC also serves as the “Departmental Review Committee” should a Resident wish to address (appeal) a Director judgment on academic deficiency, misconduct, advancement,


certification, or other Resident matters.

Meetings of the CCC occur semi-annually. The CCC will systematically review each Resident’s file and make recommendations to the Director regarding final competency ratings, progression, advancement, certification, etc. Items reviewed include monthly evaluations, Resident In-Service Training Exam scores, work hour/patient/procedure logs, completion of Clinical Skills Evaluations in Neurology, ACGME Neurology Program Requirements, and other clinical and academic measures. Any Resident with performance concerns in one or more core competencies may be added to the agenda for formal file review. The CCC works with the Director to create appropriate remediation/action plans. All members of the CCC agree to keep the information discussed confidential.

Members are chosen annually and include faculty in all areas of the department. Below are the current members for the 2018-2019 academic year.

Rima El-Abassi, MD Harry Gould, MD Piotr Olejniczak, MD *Chair Ann Tilton, MD Nicole Villemarette-Pittman, PhD Maria Weimer, MD

The CCC Chair is responsible for ensuring that all Residents’ performances are evaluated in a timely manner during each rotation or similar educational assignment, and receive mentorship in all areas of concern.

The Director is responsible to provide the Resident with documented semiannual evaluations of performance with feedback, including ACGME Neurology Milestone reports, progress on the ACGME Neurology Program Requirements, documentation of the Resident’s performance during the final period of education, and verification that the Resident has demonstrated sufficient competence to enter practice without direct supervision.

SIX GENERAL COMPETENCIES

1. Patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health

2. Medical knowledge about established and evolving biomedical, clinical, and cognate (e.g., epidemiological and social-behavioral) sciences and the application of this knowledge to patient care

3. Practice-based learning and improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care


4. Interpersonal and communication skills that result in effective information exchange and teaming with patients, their families, and other health professionals

5. Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population

6. Systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system for health care and the ability to effectively call on system resources to provide care that is of optimal value.

LEAVE

VacationEach Resident at PGY1 is entitled to twenty-one (21) days (including weekends) of non-cumulative vacation leave per year. PGY 2 Residents and above are entitled to twenty-eight (28) days (including weekends) of non-cumulative vacation leave per year. Vacation leave should not ordinarily be requested before or after scheduled holidays.

No vacation will be approved during June except through the Director. The Chief Resident, supervising faculty, and Director must approve all vacations. Residents must secure coverage for or cancel patients for their continuity clinics and provide documentation of having done so. The Resident must submit a leave request, no later than 30 days prior to the intended leave for consideration. The vacation leave request must be cosigned by the covering resident and Director before being official. Vacations should be planned in advance. Blocks longer than 1 week are not allowed except in extenuating circumstances and must be approved by the Director. Two weeks must be used prior to December and the rest prior to May. If this policy is not followed, vacation time may be forfeited.

Vacation leave must be used during the academic/appointment year. No carry forward or accumulation of unused vacation leave is permitted. At the end of the academic/appointment year, any unused vacation leave will be forfeited.

Educational/InterviewHouse Officers are permitted five (5) days (including weekends) of educational leave to attend or present at medical meetings. These days may also be used for interviews. Any leave beyond 5 days must be taken from available vacation leave.

SickHouse Officers are permitted fourteen (14) days (including weekends) of paid sick leave per year. Sick leave may not be accumulated or carried forward into subsequent academic/appointment years and may only be used for the illnesses or injury of the House Officer. Extended sick leave without pay is allowable, at the discretion of the Department or as may be required by applicable law.


PROGRAM OBJECTIVES BY YEAR OF TRAINING

The table below summarizes the overall Program objectives by level of training. These are adapted from the ACGME Neurology Milestones Project. Milestones for specific areas of study within Neurology can be found in the ACGME Neurology Milestones document.

Patient CarePGY1 PGY2 PGY3 PGY4

Obtains a neurologic history Obtains a complete and relevant neurologic history

Obtains a complete, relevant, and organized neurologic history

Efficiently obtains a complete, relevant, and organized neurologic history

Performs complete neurological exam

Performs complete neurological exam accurately

Performs a relevant neurological exam incorporating some additional appropriate maneuvers

Visualizes papilledema

Accurately performs a neurological exam on the comatose patient

Efficiently performs a relevant neurological exam accurately incorporating all additional appropriate maneuvers

Accurately performs a brain death examination

Demonstrates basic knowledge of management of patients with neurologic disease

Discusses general approach to initial treatment of common neurologic disorders, including risks and benefits of treatment

Identifies neurologic emergencies

Individualizes treatment for specific patients

Initiates management for neurologic emergencies and triages patient to appropriate level of care

Appropriately requests consultations from non-neurologic care providers for additional evaluation and management

Adapts treatment based on patient response

Identifies and manages complications of therapy

Independently directs management of patients with neurologic emergencies

Appropriately requests consultations from a subspecialist for additional evaluation or management

Medical KnowledgeEffective July 1, 2018 9

PGY1 PGY2 PGY3 PGY4Attempts to localize lesions within the nervous system

Describes basic neuroanatomy

Localizes lesions to general regions of the nervous system

Accurately localizes lesions to specific regions of the nervous system

Efficiently and accurately localizes lesions to specific regions of the nervous system

Describes advanced neuroanatomy

Summarizes history and exam findings

Summarizes key elements of history and exam findings

Identifies relevant pathophysiologic categories to generate a broad differential diagnosis

Synthesizes information to focus and prioritize diagnostic possibilities

Correlates the clinical presentation with basic anatomy of the disorder

Efficiently synthesizes information to focus and prioritize diagnostic possibilities

Accurately correlates the clinical presentation with detailed anatomy of the disorder

Continuously reconsiders diagnostic differential in response to changes in clinical circumstances

Diagnoses brain deathDemonstrates general knowledge of diagnostic tests in neurology

Discusses general diagnostic approach appropriate to clinical presentation

Lists risks and benefits of tests to patient

Individualizes diagnostic approach to the specific patient

Accurately interprets results of common diagnostic tests

Explains diagnostic yield and cost-effectiveness of testing

Accurately interprets results of less common diagnostic testing

Recognizes indications and implications of genetic testing

Recognizes indications of advanced imaging and other diagnostic studies


Practice Based Learning and Improvement

PGY1 PGY2 PGY3 PGY4Acknowledges gaps in knowledge and expertise

Incorporates feedback Develops an appropriate learning plan based upon clinical experience

Completes an appropriate learning plan based upon clinical experience

Uses information technology to search and access relevant medical information

Uses scholarly articles and guidelines to answer patient care issues

Critically evaluates scientific literature

Incorporates appropriate evidence-based information into patient care

Understands the limits of evidence-based medicine in patient care

Interpersonal and Communication Skills

PGY1 PGY2 PGY3 PGY4Develops a positive relationship with patients in uncomplicated situations

Actively participates in team-based care

Manages simple patient/family-related conflicts

Engages patients in shared decision-making

Manages conflict in complex situations

Uses easy-to-understand language in all phases of communication

Manages conflict across specialties and systems of care

Leads team-based patient care activities


Effectively communicates during patient hand-overs using a structured communication tool

Completes documentation in a timely fashion

Accurately documents transitions of care

Effectively communicates during team meetings, discharge planning, and other transitions of care

Educates patients about their disease and management, including risks and benefits of treatment options

Completes all documentation accurately, including use of EHR, to promote patient safety

Effectively communicates the results of a neurologic consultation in a timely manner

Effectively gathers information from collateral sources when necessary

Demonstrates synthesis, formulation, and thought process in documentation

Effectively leads family meetings

Effectively and ethically uses all forms of communication

Mentors colleagues in timely, accurate, and efficient documentation


ProfessionalismPGY1 PGY2 PGY3 PGY4

Demonstrates compassion, sensitivity, and responsiveness to patients and families

Demonstrates non-discriminatory behavior in all interactions, including diverse and vulnerable populations

Describes effects of sleep deprivation and substance abuse on performance

Demonstrates appropriate steps to address impairment in self

Consistently demonstrates professional behavior, including dress and timeliness

Demonstrates compassionate practice of medicine, even in context of disagreement with patient beliefs

Incorporates patients’ socio-cultural needs and beliefs into patient care

Demonstrates appropriate steps to address impairment in colleagues

Mentors others in the compassionate practice of medicine, even in context of disagreement with patient beliefs

Mentors others in sensitivity and responsiveness to diverse and vulnerable populations

Advocates for quality patient care

Describes basic ethical principles Determines presence of ethical issues in practice

Analyzes and manages ethical issues in straightforward clinical situations

Analyzes and manages ethical issues in complex clinical situations

System-Based PracticePGY1 PGY2 PGY3 PGY4

Describes basic cost and risk implications of care

Describes cost and risk benefit ratios in patient care

Makes clinical decisions that balance cost and risk benefit ratios

Incorporates available quality measures in patient care

Describes team members’ roles in maintaining patient safety

Identifies and reports errors and near-misses

Describes potential sources of system failure in clinical care such as minor, major, and sentinel events

Participates in a team-based approach to medical error analysis

*Incorporated from the ACGME Neurology Milestones.


PROGRAM CORE CURRICULUM

A. GoalTo prepare Residents to function as effective independent neurologists, who can recognize and manage patients with neurologic problems, and who can provide expert advice to other medical consultants on neurologic matters.

B. Objectives To teach or reinforce the following analytical skills:

1. Describe symptoms and signs that suggest neurologic disease.2. Accurately localize symptoms and signs to the appropriate anatomic parts of the nervous

system.3. Formulate a thorough differential diagnosis, evaluation, and management strategies based

on relevant history, examination, and laboratory features.4. Describe basic tests used to evaluate neurologic problems (neuroimaging, EEG, EMG,

NCV, evoked potentials, sleep studies), list their indications, and demonstrate basic interpretation of their results.

The curriculum for a Neurology residency program should encompass training and educational experiences to prepare a physician for the independent practice of Neurology. The LSU Neurology training program will require Residents to demonstrate proficiency in each of the six core competencies described previously.

Clinical RotationsEach resident should review the rotation Goals and Objectives prior to starting each rotation. These are available in brief within this manual and in detail on the Program website. Residents are expected to arrive to their assigned clinics in a timely manner and must have approval by the supervising faculty and Director for any absences. See section under specific rotations for more details.

Elective rotationsThe overall purpose of elective rotations is to allow the Resident an opportunity to pursue areas of individual professional interest and development. Residents have at least one elective month each of her/his PGY2 through PGY4 years.

Continuity ClinicsEach Resident will be assigned to a continuity clinic at University Medical Center – New Orleans (UMCNO). These clinics will allow the Resident to develop a caseload of patients they have seen in consultation to the medical services or emergency room. It offers the academic experience of following neurological disease evolution through diagnosis, treatment and management. Cancellation of these clinics and proof of doing so must be provided prior to approval of any planned absences. Clinics are held every Monday morning at UMCNO.

14Effective July 1, 2017

ProceduresResidents will have many opportunities to perform procedures throughout the course of training. These include basic medical procedures, such as central lines, arterial lines, etc. in the Neuro-Critical Care Unit. This also includes procedures more specific to Neurology, such as lumbar punctures, botulinum toxin injections, interpreting EEG, performing and interpreting EMG/Nerve Conduction Studies, and deep brain stimulation programming. Residents are required to log all procedures in New Innovations to record their level of competence for each individual procedure.

Residents are responsible for all procedures on primary patients. If these are outside the scope of Neurology practice, appropriate services will be consulted. Lumbar punctures are not performed for other clinical services unless that service has attempted the LP and failed. If, following a complete neurological consultation and evaluation by the Resident or attending, the procedure is felt to be indicated, its performance will be discussed with the primary service.

DidacticsAttendanceAttendance to all didactics is mandatory. These include Professor Rounds, scheduled didactics, and other activities sponsored by the department. Attendance will be taken and those Residents with less than 85% attendance will be given additional assignments. Attendance at lectures takes precedence over other clinical responsibilities unless there is a patient care emergency. If a Resident encounters problems being excused from clinical responsibilities (except in the situation of emergencies), the Resident should notify the Director.

Didactic ScheduleNeurology didactics occur on Thursday afternoons, from 1-4PM. The typical structure is:

1-2PM Professor Rounds2-3PM General Neurology Lecture3-4PM Neurophysiology Lecture

Professor Rounds typically consist of a case presentation by a Resident, followed by a discussion of the evidence for the selected topic. Each Resident will present at least twice per year. These typically begin in August.

The General Neurology lectures include topics presented by faculty on subspecialty areas of Neurology, including but not limited to Behavioral Neurology, Demyelinating Disorders, Headache, Movement Disorders, Pain, Neuro-ophthalmology, and Vascular Neurology. These lectures are also supplemented with Continuum reviews when faculty speakers are not available.

Clinical Neurophysiology fellows and faculty present lectures on both basic and advanced lectures on EMG, Nerve Conduction Studies, EEG, Evoked Potentials, and Polysomnograms. Lectures also cover Epilepsy, Neuromuscular, and Sleep.

The UMC Stroke Committee Meeting occurs the second Thursday of each month from 11:30AM-12PM. Immediately following there is a Vascular Neurology case presentation from 12-1PM that replaces Professor Rounds for the day. This occurs on an alternating basis between


LSU and Tulane Neurology and is presented by the upper level Resident on the UMCNO service the preceding month. Neuroradiology conference will occur from 1-2PM and Evidenced-based Medicine/Practice of Neurology/Ethical Principles lectures from 2-3PM on these days.

Didactics in July cover important topics for the new PGY2 Residents, including Neurologic Emergencies, basics of Neuroradiology, and orientation to the various hospitals and documentation.

Recommended reading:Merritt’s Textbook of Neurology: Rowland LP, Ed 12th ed. Lea & Febiger, 2009.Principles of Neurology: Adams RD, Victor M, Ropper AH. 7th edition. McGraw-Hill, 2000.Clinical Neurology: Baker AB, Baker LB. Harper & Row. Revised annually.Neurology in Clinical Practice: Bradley WG, Daroff RB, Fenichel GM, Marsden CD. 3rd ed. Butterworth-Heinemann, 2000.Pediatric Neurology. Principles and Practice: Swaiman KF, Wright. 3rd ed.Mosby, 1999.Harrison’s Principles of Internal Medicine: 15th ed. McGraw-Hill, 2001.Neurological Differential Diagnosis: Patten, John, Springer-Verlag. 2nd ed. NewYork, 1996.Neurology in General Medicine: Aminoff, M. 3rd ed. 2001.Diagnostic Radiology: Osborn, A. Mosby, 1994.

Clinical Skills EvaluationsResident competency must be documented in five areas by evaluating a minimum of five different patients as specified below during the residency:

1. Critical care: One critically ill adult patient with neurological disease (may be in either an intensive care unit or emergency department setting or an emergency consultation from another inpatient service)

2. Neuromuscular: One adult patient with a neuromuscular disease (may be in either an inpatient or outpatient setting)

3. Ambulatory: One adult patient with an episodic disorder, such as seizures or migraine4. Neurodegenerative: One adult patient with a neurodegenerative disorder, such as

dementia, a movement disorder, or multiple sclerosis5. Child patient: One child patient with a neurological disorder

Journal Clubs Journal clubs will address a specific topic or important area in the field. They help educate Residents to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices. Journal clubs typically occur after hours on a monthly basis. Attendance is not required.

LSU Core CurriculumThis is an institutional requirement consisting of a series of modules, each approximately 5 to 10 minutes in length. Each module consists of a presentation of several slides in addition to a short (1-5 question) test. The presentation should be viewed before taking the test. A score of 80% is required for completion, and a test may be repeated until an 80% score is achieved.


ALL modules for a given House Officer’s PGY must be completed before the House Officer will be allowed to graduate or advance to the next year. Additionally, House Officers in any PGY other than 1 will be required to complete all modules up to and including the modules for their current PGY (e.g. a PGY2 must complete all 1 and 2 modules).

Reports will be run every few months and delivered to the Program Coordinator indicating the progress of the Program’s House Officers.

These modules can be found at: http://www.medschool.lsuhsc.edu/medical_education/graduate/core_curriculum.asp

SCHOLARLY ACTIVITY

Each Resident is required to participate in scholarship prior to graduating from the Program.

Examples of scholarship listed by the ACGME Neurology RRC include:1. Participation in research2. Publication in a peer-reviewed journal3. Presentation at national of regional meetings4. Preparation and Presentation at educational conferences and programs5. Organization and administration of educational programs6. Activities related to professional leadership7. Peer-review activities8. Quality of care programming

QUALITY IMPROVEMENT/PATIENT SAFETY PROJECTS

As part of the institutional Enhancing Quality Improvement for Patients program (EQuIP), each Resident is required to be involved in a quality improvement or patient safety project each year. This may be a time-limited project or may encompass an ongoing project over the course of their training. Projects are presented at the Annual Quality Improvement Forum each year and also at the departmental annual Resident Research Day, in conjunction with the annual Paddison Day Lecture.

PROGRAM EVALUATION COMMITTEE

The Program Evaluation Committee (PEC) serves as an advisory committee to the Director with regards to the planning, development, implementation, and evaluation of educational activities of the Program. The PEC meets annually in order to:

1. Review and make recommendations for revision of competency-based curriculum goals and objectives

2. Address areas of non-compliance with ACGME standards


http://www.medschool.lsuhsc.edu/medical_education/graduate/core_curriculum.asp

3. Review the program annually using evaluations of faculty, residents, and other professional staff

4. Offer feedback to the program on all areas of concern

Numerous measures are reviewed and evaluated, including but not limited to resident performance, faculty development, in-service exam results, graduate performance, board exam results, current quality improvement and patient safety projects, and program quality. During the annual review, the PEC will develop action plans to improve areas of concern within the Program, as well as to monitor and follow-up on previous action plans.

Members are chosen annually and include faculty in all areas of the department and a resident representative from each class PGY2 through PGY4. A PGY1 representative will also be included when possible. Below are the currently members for the 2018-2019 academic year:

Brian Copeland, MD Deidre Devier, PhD Rima El-Abassi, MD Piotr Olejniczak, MD *Chair Nicole Villemarette-Pittman, PhD Maria Weimer, MD Alex Cruz, MD – PGY4 Alex Ramos, MD – PGY4 Vaniolky Losada, MD – PGY3 Mary Nguyen, MD – PGY2 Aditi Varma, MD – PGY2

The PEC Chair is responsible for ensuring that the program is reviewed and that all action plans set forth are monitored and revised in a timely manner

The Director is responsible for submitting the Annual Program Evaluation to ACGME and GME.

The action plans must be reviewed and approved by the teaching faculty and documented in meeting minutes.

SUPERVISION AND PROGRESSIVE RESPONSIBILITY POLICIES

Residents must be supervised in such a way that they assume progressive responsibility as they progress in their educational program. Progressive responsibility is determined in a number of ways including determination of the appropriate level of autonomy by the supervising faculty, assessments by the Director, Chief Resident(s), and PEC, and applicable milestones. For applicable procedures, such as lumbar punctures, clinical simulation may be used to assess the Resident’s level of competence prior to performing them on patients.


Effective supervision includes defining educational objectives, assessing the Resident’s skill level through direct observation, and defining a course of progressive responsibility starting with close direct supervision and progressing to independence as the skill is mastered.

Documentation of supervision by the involved supervising faculty must be customized to the settings based on guidelines for best practice and regulations from the ACGME, Joint Commission, and other regulatory bodies. Progress notes in the chart written or signed by the faculty, addendums to a Resident’s notes, counter-signature of Resident’s notes, and medical record entries indicating the name of the supervising faculty are all examples.

In addition to close observation, faculty are encouraged to give frequent formative feedback and required to give formal summative written feedback that is competency based and includes evaluation of both professionalism and effectiveness of transitions.

The levels of supervision are defined as follows:o Direct Supervision by Faculty - faculty is physically present with the resident

being supervised.o Direct Supervision by Senior Resident – same as above but resident is

supervisor.o Indirect with Direct Supervision IMMEDIATELY Available – Faculty – the

supervising physician is physically present within the hospital or other site of patient care and is immediately available to provide Direct Supervision.

o Indirect with Direct Supervision IMMEDIATELY Available – Resident - same but supervisor is resident.

o Indirect with Direct Supervision Available - the supervising physician is not physically present within the hospital or other site of patient care, but is immediately available by means of telephonic and/or electronic modalities, and is available to provide Direct Supervision.

Oversight – The supervising physician is available to provide review of procedures/encounters with feedback provided after care is delivered.


Levels of Supervision by Year of Training

Direct by Faculty

Direct by senior residents

Indirect but immediately available -

faculty

Indirect but immediately available - residents

Indirect available

Oversight

Inpatient Services

PGY - 1 x x x x

PGY - 2 x x

PGY - 3 x x

PGY – 4 x x

Intensive Care Units

PGY - 1 x xPGY - 2 x xPGY - 3 x x

PGY – 4 x x

Ambulatory Settings

PGY - 1 x x

PGY - 2 x x

PGY - 3 x x

PGY – 4 x x

Consult


ServicesPGY - 1 x x

PGY - 2 x x

PGY - 3 x x

PGY – 4 x x

Nerve Conductions and EMG

PGY - 1 N/A

PGY - 2 x

PGY - 3 x

PGY – 4 x

tPA Administration

PGY - 1 N/A

PGY - 2 x x

PGY - 3 x x

PGY – 4 x x

Lumbar Puncture

PGY - 1 x x

PGY - 2 x x

PGY - 3 x x

PGY – 4 x x


AFTER HOURS CALL

Residents take at-home call on all rotations except in the Ochsner Neuro-critical Care Unit (NCC), which is in-house call. Call is taken for UMCNO, Southeast Louisiana Veterans Healthcare System (SLVHCS), Ochsner NCC, and Ochsner – Kenner.

New consults and stroke activations at UMCNO are only taken on even calendar days from 5PM-7AM on weekdays and 7AM-7AM on weekend days. LSU Neurology will also cover new consults and stroke activations at UMCNO on the 31st of January, May, and August. Otherwise, the Resident on call after hours is only responsible for covering established patients at UMCNO.

For SLVHCS and Ochsner – Kenner, the Resident is responsible for both established and new consults from 5PM-7AM on weekdays and 7AM-7AM on weekends.

PROGRAM POLICY ON CLINICAL WORK AND EDUCATION HOURS

The Program strictly adheres to the ACGME Clinical Work and Education Hour Requirements and monitors compliance with these requirements closely. A full description of the requirements may be found in the LSU SOM NO HO Manual and the ACGME Neurology Program Requirements (http://www.acgme.org/Specialties/Program-Requirements-and-FAQs-and-Applications/pfcatid/37/Neurology).

MOONLIGHTING

Moonlighting is defined as professional activity outside of the scope of the Resident requirements or training. In order to be considered for moonlighting, the Resident must be a PGY 3 or 4, have an unrestricted, valid Louisiana license, and be in good standing with the Program; PGY 1 and 2 residents cannot moonlight. The Resident must have permission in writing from the Director. Moonlighting hours count towards duty hours and at no time should the Resident surpass 80 hours per week. Please review the institutional moonlighting policy, which must be followed as well.

ALERTNESS MANAGEMENT/FATIGUE MITIGATION STRATEGIES

Residents and faculty are educated about alertness management and fatigue mitigation strategies via online modules and in departmental conferences. Alertness management and fatigue mitigation strategies are outlined on the pocket cards distributed to all Residents and contain the following suggestions:

1. Warning Signsa. Falling asleep at Conference/Roundsb. Restless, Irritable w/ Staff, Colleagues, Familyc. Rechecking your work constantlyd. Difficulty Focusing on Care of the Patient


http://www.acgme.org/Specialties/Program-Requirements-and-FAQs-and-Applications/pfcatid/37/Neurology

http://www.acgme.org/Specialties/Program-Requirements-and-FAQs-and-Applications/pfcatid/37/Neurology

e. Feeling Like you Just Don’t Caref. . Never drive while drowsy

2. SLEEP STRATEGIES FOR HOUSESTAFFa. Pre-call Residents

1. Don’t start Call w/a SLEEP DEFICIT – GET 7-9 ° of sleep2. Avoid Heavy Meals / exercise w/in 3° of sleep3. Avoid Stimulants to keep you up4. Avoid ETOH to help you sleep

b. ON Call Residents1. Tell Chief/PD/Faculty, if too sleepy to work!2. Nap whenever you can á > 30 min or < 2°)3. BEST Circadian Window 2PM-5PM & 2AM- 5AM 4. AVOID Heavy Meal5. Strategic Consumption of Coffee (t ½ 3-7 hours)6. Know your own alertness/Sleep Pattern!

c. Post Call Residents1. Lowest Alertness 6AM –11AM after being up all night 2. Full Recovery from Sleep Deficit takes 2 nights3. Take 20 min. nap or Cup Coffee 30 min before Driving

The Program monitors successful completion of the online modules. Residents are encouraged to discuss any issues related to fatigue and alertness with supervisory Residents, Chief Resident(s), and the Director. Supervisory Residents will monitor lower level residents during any in-house call periods for signs of fatigue. Adequate facilities for sleep during day and night periods are available at all rotation sights and Residents are required to notify Chief Resident(s) and the Director if those facilities are not available as needed or properly maintained. At all transition periods supervisory Residents and faculty will monitor lower level Residents for signs of fatigue during the hand off. The institution will monitor implementation of this indirectly via monitoring of clinical work and education violations in New Innovations, the Annual Resident Survey (administered by the institution to all residents and as part of the annual review of programs) and the Internal Review process.

SOCIAL MEDIA GUIDLINES

At LSU SOM NO, social networking (both on LSUHSC-provided services and on commercially available services) can help support our mission of medical education, research, and service to the community. The SOM is committed to facilitating a successful social media strategy for its faculty, staff, and students.

The following guidelines are for all individuals affiliated with the SOM including but not limited to faculty members, residents, students, and staff employees who participate in social media. Social media includes personal blogs and other websites, including but not limited to WordPress, Facebook, LinkedIn, Twitter, Instagram, and YouTube. These guidelines apply to anyone posting to his or her own sites, university sponsored sites, or commenting on other sites.


General Principles:1. Follow all applicable LSUHSC policies. For example, you must not share

confidential or proprietary information about LSUHSC and you must maintain patient privacy. Among the policies most pertinent to this discussion are those concerning patient confidentiality; computer, e-mail and internet use; HIPAA and FERPA; photography and video; and release of patient or student information to media.

2. Be professional, use good judgment and be accurate and honest in your communications; errors, omissions, or unprofessional language or behavior reflect poorly on LSUHSC, and may result in liability for you or LSUHSC. Be respectful and professional to fellow employees, business partners, competitors, faculty, students, and patients.

3. Social media is “real life.” Behavior in social media is no different from e-mail, public speech, classroom lecture, conversation with friends, or a poster on a wall, with the exception that it is always available in cyberspace. Anything considered inappropriate offline is likely also inappropriate online. When in doubt, it is better not to share.

4. If you are a member of the SOM community, but acting in social media as an individual, make it clear that you are expressing your own opinion and not that of the SOM or LSUHSC.

5. Ensure that your social media activity does not interfere with your work commitments.

Responsibility to Patients and Trainees:1. The SOM strongly discourages “friending” of patients on social media websites.

Providers (faculty, house staff, or other staff) in patient care roles generally should not initiate or accept friend requests except in unusual circumstances such as the situation where an in-person friendship pre-dates the treatment relationship.

2. The SOM strongly discourages personnel in management or supervisory roles from initiating personal “friend” requests with trainees they manage. “Friend” requests may be accepted if initiated by the trainee, and if the supervising personnel do not believe such contact will negatively impact the work relationship or pose potential bias regarding the trainee.

GRIEVANCE POLICY

Every Resident has the right to express his/her concerns regarding any training issue, patient care issue or conflict between peers. The resident can informally meet with the Chief Resident to express concerns. If the issue does not result in an accepted resolution, the Resident then may request a meeting with the Director and the Chief Resident. If the matter is not resolved at this level, a formal meeting will take place between the Director, the involved parties, a peer representative of the resident’s choosing, and the department Chair. Residents should also use the evaluation format to express constructive views.

All grievances regarding disciplinary action, included but not limited to probation, non-promotion, non-renewal, and dismissal, will follow the Due Process procedures outline in the


LSU SOM NO House Officer manual.

General Concepts for Conflict Resolution:Remain professional and respectful at all times. If the matter causes emotional distress, walk away and take time to sort out your concerns and address your own emotions. In all situations, it is best to directly meet with the person with whom you are potentially having a difference and discuss the matter. If you feel that a third person would be beneficial, then seek to do this. Overall matters are best resolved on an interpersonal basis. Conflicts should be addressed in the following order: Chief Resident, Attending, Director, and department Chair. If the issue concerns the Chief Resident or Attending, then the Director should be notified directly. Conflicts that directly impact patient care should be immediately taken to your supervising Attending.

NEW INNOVATIONS MEDICAL EDUCATION MANAGEMENT SUITE

The Institution has chosen the New Innovations Medical Education Management Suite to provide residency management software for management of program requirements. Residents will have access to rotation schedules and information, electronic evaluations, and other academic resources through New Innovations. Residents will be required to record clinical work and education hours, patient and procedure logs, and complete evaluations through New Innovations. Periodic monitoring will be performed to ensure that clinical work and education hours are being logged into the system. Failure to comply with this policy may result in formal disciplinary action being taken, up to and including possible dismissal from the program.


CORE ROTATION DESCRIPTIONS


University Medical Center New Orleans Inpatient Rotation

Description of RotationThe University Medical Center New Orleans (UMCNO) rotation is a primary service rotation. During this rotation, Residents will develop skills in handling acute stroke within a certified Stroke Program, as well as providing inpatient consultations and managing a primary neurology service.

Residents will be exposed to a broad range of acute neurological disorders in a tertiary care public hospital setting. Patients from all demographics and the full spectrum of healthcare coverage will be seen at UMCNO.

ExpectationsThe team typically consists of two Residents, one upper level and one junior. In addition, there are typically one Medicine resident, two students and, at times, a Neurosurgery or Psychiatry rotator. The Neurology Residents will supervise other members of the team.

The Neurology Resident is responsible for evaluating every patient, whether they are admitted to the Neurology service or being seen in consultation. The Neurology Resident will supervise the team and have primary responsibility for management of the patients seen.

The Neurology Resident only takes new consultations and stroke activations from 7AM to 5PM on even calendar days (e.g. 2nd, 4th, etc.), while Tulane Neurology takes new consults on odd calendar days. LSU Neurology will also take new consultations and stroke activations on the 31st

of January, May, and August.

Rotators typically attend the Epilepsy clinic on Monday afternoon and Stroke clinic on Tuesday morning on this rotation.

Residents will maintain a ½ day continuity clinic at UMCNO during this rotation.

Important Contacts:Toni Rougeou, RN – Cisco 702-4044

Stroke Program Coordinator Lionel Branch, MD – (504) 644-3613

Stroke Program Director


Ochsner Neuro-critical Care Rotation

Description of RotationThe Ochsner Neuro-critical Care unit (NCC) rotation exposes Residents to the NCC from the perspective of different specialties: Neurology, Anesthesiology and Internal Medicine. Residents will care for patients who have experienced severe neurologic disease, such as intracranial hemorrhages of all types, status epilepticus, CNS infections, etc. Three months of NCC are required prior to completion of the Neurology Residency Program.

ExpectationsDuring the rotation, the Resident will work with a NCC attending. Staff physicians rotate on the service, allowing the Resident to work with multiple physicians throughout the rotation. The Resident will also work with Anesthesiology interns and mid-level providers in a team setting. The Neurology Resident is responsible for the care and management of assigned patients during the day. The Resident is not responsible for answering the mid-level provider’s phone or pager unless that provider is performing a procedure and needs assistance covering calls.

Schedule:1) The Resident is responsible for seeing all their patients prior to morning report at 8AM.2) Rounds occur daily at the discretion of the attending. The Resident’s shift will end at

5PM unless on overnight call or in case of emergencies with multiple concurrent admissions.

3) The Neurology Resident will take in-house overnight call on each Monday of the rotation. Residents leave after morning report at 8AM. The Neurology Resident does not take call for any other service while on the NCC rotation.

4) The Neurology Resident will work one weekend day each week. The team members can determine whether Saturday or Sunday.

5) The Neurology Resident will maintain his/her continuity clinic each Monday morning. Once clinic is finished, the Resident will report promptly to the NCC.

6) Every Thursday morning, the Neurology Resident should leave the NCC at 11:30 in order attend Thursday didactics (and at 11:00 on the second Thursday of the month in order to attend UMCNO Stroke Rounds). By that time all progress notes should be completed. If the NCC team has not finished rounding on all of the Neurology Resident’s patients, the Resident is responsible for checking out to the other members of the team before leaving the NCC unit

Census:1) During a standard day shift, the Neurology Resident is responsible for following,

managing, and documenting on 5 established patients, assigned by the attending physician, each day, as well as up to 3 new admissions (5+3).

2) If staying overnight, the Neurology Resident will be responsible for 8 established patients, assigned by the attending, and 2 new admissions (8+2).


3) On the morning after overnight call, the Neurology Resident will be responsible for seeing 3 established patients and up to the 2 new admissions seen overnight.

The Neurology Resident should log all procedures performed in both their LSU New Innovations and their Ochsner New Innovations accounts, including procedure type, date of procedure, indication for procedure, supervising NCC Staff, and patient medical record number. The Resident typically has the opportunity to perform enough lumbar punctures and arterial line placements within the first month rotation that he/she will be credentialed to perform these procedures unsupervised thereafter.

Important Contacts:Esther Catalanotto – (504) 842-4937

Ochsner GME OfficeHarold McGrade, MD –

Director of Residency Education, NCCVivek Sabharwal, MD – (216) 312-4919

Director NCC


Ochsner-Kenner Rotation

Description of RotationThe Ochsner-Kenner rotation is an inpatient experience where Residents are exposed to patients with nervous system disease at various levels of acuity. During the rotation, Residents will develop skills in handling acute stroke, providing inpatient consultations, and evaluating patients in an LTAC setting within a private care model.

ExpectationsDuring the rotation, the Resident will work with Drs. Barton (Monday-Wednesday) and Mader (Thursday & Friday) on the inpatient consult service. The team will consist of a Neurology Resident, 1-2 medical students, and occasionally a Family Medicine resident. The Neurology Resident will supervise other members of the team.

The Neurology Resident will supervise the team and have primary responsibility for management of the patients seen. The Neurology Resident is not responsible for running stroke activations at Ochsner-Kenner, whether in the ED or on the floor, as Ochsner has a telestroke program in coordination with main campus Ochsner Clinic Foundation. However, the Resident should be available to assess the patient to facilitate this process.

Rounds typically take place later in the afternoon. However, the Neurology Resident is not expected to round past 6PM, even if staff is not finished rounding. This is both to protect from clinical work and education violations, as well as to allow flexibility should the Resident be on call. Weekend rounds will be split between the Ochsner-Kenner Resident and the LSU Clinic Resident

Residents will maintain a ½ day continuity clinic at UMCNO during this rotation. The Resident is expected to return to Ochsner-Kenner after continuity clinic to round on the service.

Important Contacts:Melissa A. Ponthieux - (504) 464-8052

Manager, Medical Staff ServicesCaroline Barton, MD – (504) 256-1554

Neurology Staff


Pediatric Neurology Rotation

Description of Rotation:Neurology Residents spend three separate one-month rotations at New Orleans Children’s Hospital, for a total of three months. These rotations will take place during the PGY 2–4 years and consist of a mixture of inpatient consultations and outpatient clinics. Consultation services include the emergency room, pediatric critical care unit, and inpatient unit settings. Residents are responsible for consultations on a rotational basis with other residents from Pediatrics and Tulane Adult Neurology, as well as the Pediatric Neurology Fellow.

Residents will maintain a ½ day continuity clinic at UMCNO during this rotation. The Resident is expected to return to Children’s Hospital after continuity clinic to round on the service.

Literature: Fenichel’s Clinical Pediatric Neurology . A collection of essential articles will be provided at the beginning of the rotation

Important Contacts:Stephen Deputy, MDJessica Gautreaux, MDShannon McGuire, MDDaniella Miller, MDRashmi Rao, MDAnn Tilton, MDJeremy Toler, MDMaria Weimer, MDJoaquin Wong, MD


Psychiatry Rotation

The Psychiatry rotation serves to expose Neurology Residents to patients with mental illness. During the rotation, Residents may also be exposed to patients with behavioral and cognitive changes as a result of neurologic, degenerative, substance use or systemic disorders. This rotation takes place at the UMCNO, primarily on the Consult-Liaison Service.

The Resident will maintain a ½ day continuity clinic at UMCNO. The Resident on the Psychiatry rotation will also be responsible for covering UMCNO subspecialty clinics on Monday afternoon, unless otherwise notified. After clinic, the Resident is expected to return to the unit to help with admissions/consults.

Expectations:

1. The Resident will contact Dr. Erich Conrad for instructions on time and location to start the rotation. (P)

2. The Resident will arrive in a timely manner and treat staff, patients, and family members with respect. (P)

3. The Resident will maintain his/her ½ day continuity clinic, as well as afterhours call responsibilities while on the Psychiatry rotation. (PC)

4. The Resident will attend Neurology Professors Rounds from 1-2, but may attend Psychiatry lectures for the remainder of Thursday afternoons. (P)

5. Dr. Conrad must approve all leave requests.

Important Contacts:Sedette Skaggs - (504) 568-7912

Psychiatry Program CoordinatorErich Conrad, MD

Psychiatry Program Director, UMCNO Consult-Liaison Service Director


LSU Clinic Rotation

Description of RotationThe Clinic rotation is an outpatient experience where Residents are exposed to patients with nervous system disease in an ambulatory setting.

ExpectationsThe Resident will is responsible for attending outpatient clinics in the LSU Multispecialty Clinic. The Resident will have access to multiple subspecialty clinics. The Resident is expected to spend time with various attending Neurologists. The Resident will maintain a ½ day continuity clinic at UMCNO. The Resident on this St. Charles Clinic rotation will also be responsible for covering UMCNO subspecialty clinics on Monday afternoon, unless otherwise notified.

Clinics are held at 2025 Gravier St. on the fifth floor. Clinics begin at 8:00 am unless otherwise specified.


LSU Clinics

Monday Tuesday Wednesday Thursday Friday

AM

Epilepsy(Olejniczak)

Neuromuscular(El-Abassi)MDA Clinic

(3rd Monday)

Headache(Voigt)

MS(Lovera)

Neuromuscular(England)

Pain(Gould)General(Charlet)

ALS Clinic(1st Tuesday)

Headache(Voigt)

Movement/Behav(Copeland)

MS(Lovera)

Epilepsy(Olejniczak)

General(Charlet)

EMG Clinic(England/Fellows)

General(Charlet)

Movement/Behav(Copeland & Rao)

PM

Epilepsy(Olejniczak)Headache

(Voigt)Neuromuscular

(El-Abassi)MDA Clinic

(3rd Monday)

Headache(Voigt)

MS(Lovera)

Neuromuscular(England)

Pain(Gould)General(Charlet)

ALS Clinic(1st Tuesday)

Headache(Voigt)


MS(Lovera)

DIDACTICS

EMG Clinic(England/Fellows)

General(Charlet)

Movement/Behav(Copeland & Rao)

Clinic located at 2025 Gravier Street


VA Clinic Rotation

Description of RotationThe Clinic rotation is an outpatient experience where Residents are exposed to patients with nervous system disease in an ambulatory setting.

ExpectationsThe Resident will be responsible for attending outpatient clinics in the VA Clinic. The Resident will have access to multiple subspecialty clinics. The Resident is expected to spend time with various attending Neurologists. The Resident will maintain a ½ day continuity clinic at UMCNO. The Resident is expected to return to the VA after continuity clinic for afternoon VA walk-in/telemedicine clinic.

Clinics are held on the seventh floor. Clinics begin at 8:00 am unless otherwise specified.


VA Subspecialty Clinics

Monday Tuesday Wednesday Thursday Friday

AM UMCNO Continuity Clinic

Headache/Botox(El-Abassi)


EMG

Resident New Patients

(El-Abassi)

EMG

ALS Clinic

Epilepsy(Rutherford)

General Neuro(Danon, El-

Abassi)

Movement(Perez)

EMG

General Neuro(El-Abassi)

Multiple Sclerosis(Lovera)

EMG

PM EMG

Resident Follow-up

(El-Abassi)


EMG

Resident New Patients

(El-Abassi)

EMG

DIDACTICS

General Neuro(El-Abassi)

Multiple Sclerosis

(Lovera – once monthly)

EMG


Ochsner Vascular Rotation

Description of RotationThe Ochsner Vascular Rotation allows Residents the opportunity to work in a Comprehensive Stroke Center, where they will have both primary and consulting responsibilities. They will work with board certified Vascular Neurology staff and be exposed to advanced neurovascular techniques such as interventional treatments of stroke and Transcranial Doppler. Residents will also be exposed to telestroke, as Ochsner covers a large network across southern Louisiana.

ExpectationsThe Neurology Resident will be part of the Vascular Neurology team, composed of rotators, mid-level providers, and Vascular Neurology staff.

Residents will continue to take call for UMCNO/Ochsner-Kenner/VA but are not responsible for after-hours call for the Vascular Neurology service.

Residents will maintain a ½ day continuity clinic at UMCNO during this rotation. The Resident is expected to return to Ochsner after continuity clinic to round on the service.

Important Contacts:Gabriel Vidal, MD –

Director, Ochsner Vascular Neurology SectionJoseph Tarsia, MD –

Vascular Neurology StaffMegan McKowan, PA-C – 842-6529

Chief APP, Vascular Neurology Service


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