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Welcome to. Weekly Duties. Monday Clinics. AM Continuity Clinic Lord & Taylor Building 1 st Floor 8:00 AM to noon (ideally) Staff: Drs. Sumner, Gutierrez, Mader , Branch You will have 6 patients scheduled every clinic Occasional snacks or lunch by drug reps. Epilepsy.
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Monday Clinics • AM Continuity Clinic • Lord & Taylor Building • 1st Floor • 8:00 AM to noon (ideally) • Staff: Drs. Sumner, Gutierrez, Mader, Branch • You will have 6 patients scheduled every clinic • Occasional snacks or lunch by drug reps
Epilepsy • Monday afternoons after Continuity Clinics • Assigned residents • Electives (Psych, Research, other elective months) • Clinic • Epilepsy: • Lord & Taylor • 1st Floor • Staff: Dr. Mader
Multiple Sclerosis Clinic • 1st Monday afternoon of the month • Assigned residents (same as Epilepsy clinic) • MS • Lord and Taylor • 1st floor • Staff: Dr. Lovera
Stroke Clinic • Every Tuesday 8:00 AM – noon • Assigned residents • Elective resident(s) • Stroke • Lord and Taylor • 1st floor • Staff: Dr. Branch
Didactic Thursdays • Every Thursday starting at 1pm • 1542 Tulane Ave. 7th floor conference room • Line-up: • 12:00 – Lunch • 1:00 – Professor’s Rounds (case or guest lecturer) • 2:00 Neuroradiology/Neuropathology • 2:30 – Core Curriculum (Merrit’s Quizzes or Continuums) • 3:00 – Fellow Conference
Didactic Thursdays:Professor Rounds • Case Presentation • Faculty and residents present • You should present a complete case with HPI, Neuroexam, Labs, Imaging or anything else that is available. • When possible you can bring the patient. • After your case presentation you should have a brief presentation about the diagnosis.
Didactic ThursdaysStroke Conference • 2nd Thursday of every month at 11:30AM • UH Basement conference room • Will replace professors rounds • Alternate presentations with Tulane • We will do July and every other month there after • Resident to present will be the resident assigned to UH the prior month
Didactic Thursdays:Neuroradiology/Neuropath • We alternate Thursdays between radiology and neuropath. • Should be about a 15 minute presentation. • Present a neuropathology slide or neuroradiology image. • Follow by discussion of the diagnosis
Core Curriculum • This year we will alternate weeks • Merritt’s Chapter Quizzes • Every two weeks • Each resident will have a chapter assigned • Residents will be responsible for creating a quiz of their assigned chapters • Continuums • Every two weeks • Resident will have continuum assigned • Discussion of Continuum questions
Friday Morning • Neuropathology at Children’s • Pain Rounds at UH
Call • 4 to 6 call nights a month • Home call • Even days: • University Hospital • Touro • Kenner • Odd days: • Touro • Kenner • UH Floor Call
Call • University (Even days) • Stroke call • Stroke pager • Ideally respond within 15-20 minutes to make tPA decision • ER consults • Floor call for admitted primary patients • University(Odd days) • Floor call only
Call • Touro/Kenner (Monday – Thursday) • Routine consults can be seen by the resident on service the next day • Get patient’s name and room number • Give information to resident in AM • Urgent or STAT consults need to be seen and discussed with staff the same day
Call • Kenner (Friday-Sunday) • All consults need to be seen within 24 hours and staffed • Call or text the resident covering for the weekend so the patient can have appropriate follow-up
Call • You will always have a PGY 4 resident as back up. • During the first 3 months you will be required to call your back up for every consult at UH. • Call staff on call directly for any consult at Touro or Kenner.
Ochsner-Kenner • Inpatient Consults/Outpatient Clinics • Clinics • Wednesday: VA Clinic 8 or 9-12 • Friday: Dr. Gutierrez • Inpatient Consults from LSU Medicine, LSU Family Practice and Private MDs
Ochsner-Kenner • Consult Service Staffed by either Dr. Barton (M-W) or Dr. Mader (R-F) • On your first day go to the GME office to get registered • Parking: Free • Free Breakfast and Lunch
Touro Infirmary • Inpatient Consults • Consults mainly from private doctors, LSU medicine, LSU OB/GYN, and rehab services
Touro Infirmary • Inpatient Consults Staffed by Dr. Gutierrez, Dr. Branch, and Dr. Fiore. • Go to GME office and register on first day of your rotation to get ID and access to computer system • Free Lunch • Free Parking at Delachaise garage with ID access
WEEKENDS: • During weekends you should round on patients that you have been following during the week. • Coverage for the weekends will be split among the residents working at Touro and Kenner. • Please inform the chief of who will be covering what weekends. • We will not be taking new consults at Touro but the patients should have a note daily until we sign off. • Some patient may not need to be rounded on daily but this is at the discretion of the attending on service, but when in doubt write the note.
St. Charles Clinic • Clinics – St. Charles Clinic • 3700 St.Charles Ave., 4th Floor • Tuesday: MDA Clinic with Dr. Gutierrez and Dr. England • Wednesday: VA Clinic (divide equally if two residents on clinic) • Friday: Dr. England (or Kenner depending on the schedule) • Validated daily parking in Prytania garage
Touro/Clinic hybrid • New rotation • Due to high volume of consults at Touro I have made a rotation to allow “backup” at Touro • Help Touro resident with rounds on Monday and Friday afternoons also Thursday morning. • The other days will function as the Clinic schedule outlined above
VA Clinic • Every Wednesday • 8AM - Noon (Kenner resident) • 8am - 4PM (Clinic resident) • Noon – 4PM (Ochsner clinic resident) • Both residents work with Dr. Danon for 8 - 12 clinic • 1 - 4 clinic with Dr. El-Abassi • Please be sure your VA access codes are working at least the Tuesday before you start!
VA Clinic • Please be sure your VA access codes are working at least the Tuesday before you start! • Credentials expire about every 90 days • Working to see if remotely logging in will be sufficient • May need to go to VA monthly to login to keep credentials active
University Hospital • Inpatient Primary and Consults • Team will consists of Neurology resident(s), Medicine, Psychiatry Resident, and medical students • Staffs: Dr. Sumner, Dr. Branch, Dr. Mader, and others • Stroke pager system for tPA • LSU takes new patients on even days and Tulane on odd days
University Hospital • We will admit strictly neurological cases and medically uncomplicated stroke and TIA patients • Since resident on call will take care of floor calls it is IMPORTANT to check out patients everyday to whoever is on call • Divide weekend follow up coverage among residents on the team
University Hospital • We are responsible for all stroke activations M-F 7AM - 5PM • Weekend stroke call is done by on call resident 7a-7a • Tulane will cover 7a-7a on the odd weekend day • Even days – ER/floor consults • Odd days – Tulane will handle all new consults
Ochsner Inpatient • Two weeks NeuroICU • 7AM – 5PM • Checkout from on-call resident and/or moonlighter at 8AM in conference room across from room 3075. • Two staff physicians and two midlevel-providers divide patients for morning rounds • Ask staff who you should round with but in general round on the same patients
Ochsner Inpatient • Two weeks Stroke/Vascular Neurology • 7AM – 5PM • Work with Stroke service with Vascular Neurology staff and medicine residents • Call schedule continues as with ICU • You only work the weekends that you are on call • Be there at 7AM to see the ICU patients • Weekends not on call are off days
Ochsner Inpatient • Call • In-House Call • You will be on call the 1st of the month and every 5th night (Q5) thereafter (i.e. 1st, 6th, 11th, 16th, 21st, 26th) • You are expected to care for 8 patients • You can do only two (2) new admits • The rest of the patients are cared for by a moonlighter • Call ends at 7AM • Turn over spectralink and pager no later than 7AM to moonlighter, midlevel, or incoming resident • You should leave after checkout
Ochsner Outpatient • Outpatient Clinics • Rotate through different clinics: • Movement Disorders (M&T) – Dr. Lea and Dr. Haughton • VA – Wednesday afternoon (leave by noon to arrive on time) • Sleep (Baptist R&F)
Ochsner Outpatient • Clinic resident takes call on the 2nd of the month and Q5 thereafter (i.e. 2nd, 7th, 12th, 17th, 22nd, 27th) • Only work weekends you are on call as in the ICU
Pediatric Neurology • Round with Neurology team • Attending (changes weekly) • +/- Peds Neurology Fellow (Dr. RashmiRajendra) • +/- Tulane Neurology Resident • Medical Student(s) • See floor and ICU consults and new consults/admissions from the ED
Pediatric Neurology • Round times daily depend on staff • Generally table round with Pediatrics team then bedside rounds with Neurology team • Rotation is changing and details will be provided as available
Pediatric Neurology • Wednesday conference • Case presentation • You are expected to present or help present a casein conjunction with the other residents or the fellow • Journal Club after lunch • Articles will be provided by Staff or fellow • Presentation by fellow or staff
Other Rotations • Psych – 1 month in the MHERE • Hours vary depending on staff • Team of PGY 1 Psych and medical students • Research – Find a mentor to work on a long term research project or publication
Students • You are the resident in charge of your service • Patients • Students • Students depending on capability and timing are to be assigned 1-2 patients to follow • Our primary goal with students in to TEACH
Students • We are responsible for all notes, orders, labs, and follow-up for every patient • Full notes (as appropriate) should be written after student notes • Take every opportunity to teach about the Neuro exam and localization as well as pathophysiology
Students • Students are there to learn and are expected to be hard workers • In general they get much more in a short period by following one patient • Very difficult to know everything about multiple patients • Any complaints should be directed to the PGY4s then the attending as appropriate
Other Topics • Book fund • $500 annually • Can be used for any work related expenses • Vacation • 4 weeks • Christmas schedule will be discussed later in year
Other Topics • Step 3 • Licensing • RITE • Moonlighting • New Innovations • Journal Club
Books that you may want to have this year Neuroanatomy Through Clinical Cases by Hal Blumenfeld Pocket Neurology By David M. Greer Merritt's Neurology by Lewis P. Rowland
Books that you may want to have this year The Massachusetts General Hospital Handbook of Neurology by Alice W Flaherty On Call Neurology: On Call Series by Randolph S. Marshall MD Aids to the Examination of the Peripheral Nervous System
Any Questions? Feel free to approach, call or email us at any time with questions or concerns
Expectations • Work hard • Maintain a “family” environment • Help each other as much as possible
Expectations • HAVE FUN!!!