The Child and Adolescent Neurology Residency rotation schedule is structured so that your responsibilities in teaching and patient care increase as you gain greater experience. You follow patients longitudinally throughout your residency in your continuity clinic.

The first rotation is in child neurology so you can become oriented to Nemours and the Division of Neurology. Your time is divided between the inpatient and outpatient services. You also attend a course in basic neurology through afternoon teleconferences that are shared between Nemours and Mayo Clinic.

Residents spend 12 months on the child neurology consult and outpatient services, 12 months in adult neurology (maximum of six  months inpatient service), and have mandatory rotations in clinical neurophysiology (two months), neuropathology (two months), and child psychiatry (one month). There is ample time (seven months) for elective rotations.

Rotation descriptions

Child neurology inpatient services

During hospital rotations at the adjacent 160-bed Wolfson Children's Hospital, you admit and care for patients on the neurology service and provide neurological consultations for the general pediatric service, pediatric intensive care unit, neonatal intensive care unit, pediatric medical and surgical subspecialties, and the emergency room.

You gain experience with a wide variety of acute and subacute neurological diseases, from common to unusual pediatric neurological problems. The neurology inpatient service at Wolfson includes adult and child neurology residents, pediatric and at times family practice residents, and students. Child and adolescent neurology residents are expected to coordinate team activity and participate in teaching of more-junior residents and students.

Child neurology outpatient services

The child neurology outpatient clinic serves both primary and consultative patients from other pediatric services. All patients are seen under the supervision of an attending child neurologist. You can see and manage a broad spectrum of pediatric neurological problems, and you gain experience in the evaluation and treatment of common and unusual neurological disorders in children and adolescents of all ages. In addition, you have an opportunity to work in our Neurocognitive Testing Center with our neuropsychologist and school psychologists to participate in the assessment of children with a diverse array of developmental, learning, communication, and cognitive disorders.

Throughout your residency, you have your own child neurology continuity clinic for one-half day every week. This allows you the opportunity to follow a panel of your own patients over a period of several years under the supervision of an attending pediatric neurologist.

Adult neurology inpatient services

During your inpatient assignments, you evaluate neurological disorders in the inpatient setting, including the intensive care unit. You also learn to evaluate and treat neurological emergencies in the Mayo Clinic hospital emergency room and participate in daily teaching rounds.

Adult neurology outpatient services

While on outpatient rotations, you evaluate patients with common and unusual neurological conditions. You participate in daily case discussions and have outpatient education opportunities on special outpatient teaching services.

Core clinical neurophysiology

During the first two months of your second year, you and all the Mayo Clinic adult neurology residents in Florida have an intensive clinical neurophysiology rotation. This assignment includes didactic instruction and practical experience in the basics of:

• Autonomic function testing
• Electroencephalography (EEG)
• Electromyography (EMG)
• Electronystagmography
• Evoked potentials
• Nerve conduction studies (NCS)
• Polysomnography

After completing this rotation, you can spend elective time in EEG, EMG or the sleep service.

Child psychiatry

In your second year, you spend one month with the Division of Psychology and Psychiatry at Wolfson Children's Hospital, where you are exposed to an array of inpatient and outpatient psychological and psychiatric disorders.

Electives

You have six blocks of elective rotations to use throughout your residency in addition to the three blocks of adult electives. Typically, you have one block of elective in the first year, one block in the second year, and four blocks in the third year. In addition to further training in child neurology, you have many elective options in clinical, laboratory specialty, and research at Nemours, Mayo Clinic's Florida campus and Mayo Clinic in Rochester, Minnesota.

Call frequency

The call schedule is different for each rotation. Mayo Clinic College of Medicine and Science follows the recommendations of the Accreditation Council for Graduate Medical Education (ACGME).

Research training

You are required to participate in one or more research projects in clinical, laboratory or basic investigation during your Child and Adolescent Neurology Residency. To facilitate the development of research skills, Nemours offers courses in research methodology and evidence-based medicine, which residents are encouraged to attend.

Short-term research projects require a two- to six-month commitment and do not take time away from your residency responsibilities. You have ample opportunity to pursue projects such as patient-generated case reports and chart reviews under the supervision of a faculty research mentor.

Long-term research projects (typically longer than six months) require time away from your residency responsibilities. You can apply for a long-term project at any time during your residency. You must first obtain permission from the program director and identify a faculty research mentor.

Didactic training

Clinical conferences, seminars, small discussion groups, journal clubs, and one-on-one instruction are all an integral part of the Child and Adolescent Neurology Residency. Nemours and Mayo Clinic have an integrated teleconference system that allows residents to attend conferences at any site without having to travel.

Child neurology residents — while on adult neurology rotations — participate in Mayo adult neurology teaching conferences and can attend selected adult conferences in person or via teleconference. Similarly, there are dedicated child neurology clinical conferences, journal club, neuroradiology, and other conferences in which resident attendance and participation is expected. In addition, there are formal didactic courses that are required during your residency.

During your three years of training, you take core clinical neurology, neuroscience, neuroanatomy, neuropathology, and ethics courses in addition to the required two-month clinical neurophysiology course at the start of your second year.

Evaluation

To ensure that you acquire adequate knowledge and develop the appropriate technical skills to meet program expectations, your performance is monitored carefully during the Child and Adolescent Neurology Residency. You are formally evaluated by supervising faculty members on a regular basis and meet with the program director to review these evaluations. In addition, you regularly evaluate the faculty to confirm that your educational goals are being met.