Rotation Schedule by Year

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 rotates through the Consult Service at Yale-New Haven Hospital. During this year, the resident also spends time directing the General and Stroke inpatient Neurology Services at Yale and the West Haven VA Medical Center as Senior Ward Resident. This provides a useful transition to clinical practice, fellowship, or academic neuroscience. Three blocks during the year are available for electives.

Residents, at all levels, play an important role in the neurology teaching program. During the PGY-4 year, the senior residents assume a major responsibility for teaching within the residency program, and for the supervision of medical students rotating on the neurology service. PGY-2 and PGY-3 residents also actively participate in medical student teaching.

Model PGY-4 Schedule

Yale General Inpatient Senior: 4 weeks. The general inpatient 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 general senior resident is on call from home overnight to staff consults and discuss other patient concerns with the night float rotations.

Yale Consult Senior: 4-6 weeks. The consult senior resident manages the inpatient consult team, supervising a junior neurology resident, medicine and psychiatry rotating residents, and medical students. Together with the Consult Attending, this resident acts as the main liaison between the Neurology Department and other services in the hospital for inpatient care.

VA Senior: 4-6 weeks. 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 4-6 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, and medical students.

Psychiatry: 4 wee ks. Residents work with the Yale inpatient Psychiatry Consult Service providing psychiatric consultative services to the rest of the hospital. A pilot program is being developed to give some residents exposure to acute inpatient psychiatry in place of psychiatry consults.

Pediatric Neurology: 7-8 weeks. Same rotation as during the PGY-3 year.

Elective: 8-10 weeks. Electives during the PGY-4 year are the same as those during the PGY-3 year, except PGY-4 residents on elective do not take call.

Gaylord: 2 weeks. Each PGY-4 resident completes a 2-week rotation in Physical Medicine and Rehabilitation at Gaylord. This rotation has been designed to maximize exposure to the range of services available to patients rehabilitating from neurological disorders. This includes time on the inpatient service and outpatient clinics, but also exposure to Occupational Therapy, Physical Therapy, Speech Therapy, Sleep Disorders Clinic, Brace Clinic, Post-polio Clinic and Industrial Rehab. EMG’s, Selective Nerve Blocks, Baclofen Pump refills, and Botox injections are performed on a scheduled basis.

Clinic Block: 8 weeks (one week every 6 weeks). Same rotation as during the PGY-2/PGY-3 years.