Rotation Schedule by Year

At least one year of training in an approved PGY-1 year is required before entering the Neurology Residency. Although many residents do the PGY-1 year in a Yale program, training may also be done at another ACGME-accredited institution/program. Eight months of internal medicine are required. However, ample elective time has been arranged with the cooperation of the Internal Medicine Department at Yale to enable residents to pursue additional clinical opportunities and approved research and scholarly activities during this year. Since the 2018-19 academic year, all PGY-1 neurology residents at Yale spend at least eight weeks in neurology rotations, including stroke and neurocritical care, in order to achieve earlier integration into the neurology department and better preparation for the intensive neurology training in PGY-2 - 4.

The first year of neurology training is designed to provide an intensive clinical experience in a structured teaching setting. The primary goal of the PGY-2 year is for the resident to achieve a high degree of competence in the clinical assessment, evaluation, and treatment of patients with neurological disease. Residents will also gain experience in the appropriate use and interpretation of diagnostic tests.

Yale General Junior: 4 weeks. Residents work with a team that includes an attending, residents, and medical students. They take primary responsibility for the care of non-vascular/general neurology patients on the inpatient Ward. Supervision is by a PGY-4 resident and attending.

1. Yale Stroke Junior: 4 - 5 weeks: Residents work with a team that includes an attending, fellows, residents, APRNs/PAs, and medical students. They take primary responsibility for the care of vascular/stroke neurology patients on the inpatient Ward. Supervision is by a PGY-3 or PGY-4 resident, fellow, and attending. The Stroke Junior resident covers the inpatient wards from 6 a.m. - 8 p.m. each Saturday.
2. VA Junior: 4-6 weeks: Residents work with a team of attendings, residents and students and care for neurology patients on the neurology service. Residents also participate in subspecialty clinics, such as epilepsy, stroke, movement disorders, multiple sclerosis, sleep medicine and neuromuscular. Residents also help provide consults on inpatients for other services and in the ER. Supervision is by a VA senior resident (PGY-3 or PGY-4) and attending. The second VA junior (VAJ2) will be responsible for reviewing routine EEGs and the inpatient video-EEG files under the supervision of the VA attending.
3. Neuroscience ICU (NICU): 4 weeks: NICU residents are charged with managing neurology patients admitted to the NICU. They work closely with the attending and fellow to devise and execute a plan of care. It is also expected that residents gain an understanding of neurosurgical ICU patients. Starting in 2023, residents began to acquire experience with neurocritical care consults, providing recommendations on the most complex neurological complications of systemic illness, including management of hypoxic brain injury after cardiac arrest.
4. Emergency Neurology/ED Swing: 3-5 weeks: Residents are stationed in the Yale Department of Emergency Medicine. They function as neurological consultants on all neurologic cases presenting to the Yale Emergency Department. Supervision is by a PGY-4 resident, clinical fellows in neurocritical care and vascular neurology, and attending physicians in general neurology, vascular neurology and neurocritical care. The Swing resident starts their shift in the early afternoon and serves as the primary contact for neurological emergencies from mid-afternoon to evening, with the support of the ED resident. These roles are designed to balance the challenges of being the primary contact for neurological emergencies with timely completion of clinical tasks and documentation. ED/Swing residents each have one day off per week on Saturday, with the residents from the Inpatient Consult Junior or St. Raphael Campus Consults covering the respective shift on the weekend.
5. Yale Consult Junior and St. Raphael Campus Consults: 6 weeks (combined): Residents provide consultative services to all other departments within the hospital. Under supervision of the Yale Senior Consult Resident and an attending, the Yale Consult Junior is responsible for seeing new consults and stroke codes on Yale inpatients. This resident also covers the off day for the ED resident. The SRC residents will provide inpatient consultations at the St. Raphael Campus of Yale-New Haven Hospital, under the direct supervision of an attending neurologist. This rotation provides the opportunity for more direct clinical mentorship, and the experience of providing consultative services in a smaller hospital environment. Residents on this rotation also cover the off day for the Swing resident.
6. Inpatient Night Float and Consult Night Float: 6 weeks: The inpatient night float resident covers the Yale inpatient neurology and neurology ICU services six nights per week. Supervision is by an inpatient PGY-3 and PGY-4 resident and attending physician on call. The consult night float resident provides consultation services to the Yale Pediatric and Adult Emergency Departments and all Yale New Haven Hospital inpatient services six nights per week. Daytime activities such as weekly clinic are canceled for both rotations. Supervision is by an inpatient PGY-3 or PGY-4 resident and attending physician on call. Since the 2021 academic year, residents have alternated between these services during their two-week block: one week as the INF resident and one week as the CNF resident.
7. Clinics: 8 weeks: Every six weeks, residents will attend a combination of general continuity clinics and subspecialty clinics. Continuity clinics are held at Yale, half day, Monday and Tuesday (continuity and hospital discharge follow up for non-stroke patients); at the VAMC, half day Wednesday and half day Friday; and at Cornell Scott Hill Health Center on Monday afternoon. Each resident follows his/her own cohort of patients for three years, assuming all responsibility for outpatient care with supervision by an attending. Additionally, the Yale Neurology Urgent Access Clinic (NUAC), half day on Thursday, provides another avenue for follow up care for patients discharged from the inpatient ward and consult services or the Emergency Room. The VAMC Half-Day Consult Clinic on Tuesday and Friday mornings, which residents staff during their VA and Clinics rotations, provides new consultations, from which patients are then enrolled in the continuity clinic. Residents have approximately five free half days during each clinic block, which are spent in selected subspecialty outpatient clinics. A few times a year, all residents on the clinic block are responsible for covering consults at Gaylord Rehabilitation Center on Wednesdays and Fridays.
8. EEG/EMG: 6 weeks: Residents will divide their time between the EEG services (Epilepsy Monitoring Unit and ICU-EEG service) and the outpatient EMG lab. They will not have primary patient care responsibilities so they can concentrate on developing skills in the interpretation of neurophysiological tests. The rotation will be augmented by asynchronous learning resources, including the EEG Video Lecture Curriculum and the AES Resident EEG Course.
9. Vacation: 4 weeks

The second year of neurology training is directed toward focused training in key areas of neurology. Three months of child neurology (split between PGY-3 and PGY-4 year) are required during all adult neurology residency programs, providing in-depth exposure to the pediatric population. 2.5 months of elective time allow residents to tailor their training with additional subspecialty clinical pursuits, research projects and other scholarly opportunities.

1. Yale Stroke Senior: 4-6 weeks: The stroke inpatient senior resident leads a team consisting of a junior neurology resident, APRNs/PAs, and medical students who care for stroke patients on the neurology ward. Along with the stroke fellow, they will fulfill an educational role, provide formal and informal teaching of topics related to stroke neurology. The stroke senior is supervised by the attending and by the fellow, but plays an active role in management of patients. The Stroke Senior resident covers the inpatient wards from 6 a.m. - 8 p.m. on Sunday.
2. Neuroscience ICU: 4 weeks: Combination of the same rotation as during the PGY-2 year and the new NICU senior role (see below)
3. Pediatric Neurology: 4 weeks: Residents are supervised by Pediatric Neurology faculty, and provide consultations for patients on the pediatrics ward, Newborn Special Care Unit, Pediatric ICU and Pediatric Emergency Room. Residents also attend half-day clinics an average of one time per week.
4. Emergency Neurology/ED Swing: 4-6 weeks: Same rotation as during the PGY-2 year
5. VA Junior: 4 weeks: Same rotation as during the PGY-2 year
6. Yale Consult Junior: 2-3 weeks: Same rotation as during the PGY-2 year
7. Night Float (INF/CNF): 4 weeks: Same rotation as during the PGY-2 year
8. Clinics: 8 weeks: Same schedule as during PGY-2 year
9. Elective/Jeopardy: 10 weeks: Residents are provided mentoring by the program director, chairman, and other faculty members to select approximately five months of electives in their last two years. Residents are encouraged to obtain intensive exposure to research, other scholarly work, or specific fields in neurology or related to neurology. At least two weeks in the PGY-3 year should be spent on the neurophysiology rotation, unless the resident proposes an alternative plan that ensures adequate achievement of neurophysiology objectives. Many residents spend time pursuing a clinical or basic science research project in collaboration with a faculty member in Neurology or other departments at Yale University. Many of these projects culminate in presentations at national meetings and publication in peer- reviewed journals. In some cases, electives may be taken off-campus, provided that the necessary documentation and approval has been obtained.
10. Vacation: 4 weeks.

The PGY-4 year of neurology residency training is one of advanced clinical responsibility and in-depth study in elective areas of interest. Each resident will complete 16 weeks of senior clinical rotations, including the Consult Service at Yale New Haven Hospital and the General Neurology services at Yale and the West Haven VA Medical Center. These rotations are considered the core of the senior resident educational experience, and provide an invaluable transition to clinical practice, fellowship, or academic neurology. Three months during the year are available for electives.

During the PGY-4 year, the senior residents assume a major role in teaching within the residency program and for the supervision of medical students rotating on the neurology service.

1. Yale General Senior: 4-6 weeks: The general senior resident leads a team of junior residents and medical students who care for non-vascular/general neurology patients on the neurology ward. This leadership position is closely supervised by an attending physician, but the senior resident plays an active role in management of patients. The senior resident also supervises the ED resident and night float residents and should be available for guidance 24 hours a day.
2. Yale Consult Senior: 4-6 weeks: Residents provide consultative services to all other inpatient services in the hospital except Pediatrics. Together with the Consult Attending, this resident acts as the main liaison between neurology and other services in the hospital for inpatient care. The Consult Senior also supervises the Consult Junior resident and medical students on the consultation service.
3. VA Senior: 4-6 weeks: The VA senior is a PGY-3 or PGY-4 resident. Together with an attending physician, the senior resident supervises a team of junior residents and medical students who care for neurology patients on the wards and in the ICUs and perform consults for other services in the hospital. Residents also attend an average of three clinics per week. The senior resident is responsible for distributing the work among team members on the neurology service, which usually includes PGY-3 and PGY-2 neurology residents, a psychiatry intern, a medicine resident and medical students.
4. NICU Senior: 2 weeks: This is the senior resident role on the neurosciences ICU service, new for 2024. The residents will supervise the team from Monday to Friday and will cover on Wednesday when the juinor resident is off. Team consists of a PGY-4 or -3 senior resident, a PGY-2 junior resident (two juniors for July and August), and in the second half of the year, there is typically a PGY-1.
5. Elective/Jeopardy: 10-12 weeks: Electives during the PGY-4 year are the same as those during the PGY-3 year, except PGY-4 residents on elective are responsible for backup only for other senior residents. At least 1 - 2 weeks of elective should be spent on neurophysiology rotations.
6. Pediatric Neurology: 6 weeks: Same rotation as during the PGY-3 year
7. Psychiatry: 4 weeks: Residents work with the Yale Psychiatry Consult Liaison Service providing psychiatric consultative services to the rest of the hospital.
8. Clinics: 8 weeks: Same structure as PGY-2 and PGY-3 years
9. Gaylord: 2 weeks: PGY-4 residents will rotate for two weeks through offsite Gaylord Specialty Healthcare, a dedicated rehabilitation hospital, to learn principles in rehabilitation medicine as related to neurologic patients often encountered in the acute inpatient setting.
10. Vacation: 4 weeks