NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
EMORY UNIVERSITY DEPARTMENT OF NEUROLOGY
RESIDENCY PROGRAM HANDBOOK
TABLE OF CONTENTS
PAGE 2
Core Values
PAGE 3
Resident Job Responsibilities
PAGE 5
Rotation Objectives
PAGE 53
Evaluations
PAGE 63
Teaching Responsibilities
PAGE 65
Neurology Clinical Clerkship
PAGE 65
Visiting Professors
PAGE 66
Discretionary Funds and Support
PAGE 67
Transcription Tips
PAGE 68
Morning Report Presentations
PAGE 69
Department & Medical School Policies
PAGE 71
Faculty/Staff Assistance & Wellness Program (FSAP)
PAGE 73
Patient Telephone Call Guidelines
PAGE 74
Lecture & Conference Schedules
PAGE 76
ACGME Program Requirements for Neurology
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NEUROLOGY RESIDENT HANDBOOK
Emory University
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EMORY UNIVERSITY DEPARTMENT OF NEUROLOGY
Core Values of the Emory Neurology Residency Training Program
 We recognize that learning is inherently communal in nature. We strive to promote an
environment which nurtures the professional interaction necessary to strengthen our
neurologic community.
 We believe that students learn best by interacting with a subject and are committed to
drawing medical students and junior colleagues into the process of active learning.
 We welcome diversity, encourage critical inquiry, and embrace paradox in the constant act
of reconciling established concepts with new evidence in the process of life-long learning.
 We treat people with respect and believe that individuals who are given respect and
responsibility respond by giving their best.
 We strive for excellence and require honesty and integrity in all we do.
 We recognize that intellectual rigor is required to amass neurological knowledge; likewise,
an ethos of trust, compassion, and respect is essential to creating a future neurologist.
 We recognize our limits as well as our capabilities and act accordingly at all times.
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NEUROLOGY RESIDENT HANDBOOK
Emory University
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RESIDENT JOB RESPONSIBILITIES
POSITION DESCRIPTION FOR RESIDENT PHYSICIANS
Department of Neurology
Emory University School of Medicine
Atlanta, Georgia
Introduction
The RRC-approved residency-training program at Emory University School of Medicine is under the
direction of Dr. Allan Levey, Chairman, Dr. Jonathan Glass, Program Director, and Dr. Jane Gilmore,
Associate Program Director. The residency-training program currently utilizes the following hospitals:
Emory University Hospital and Emory Clinic
Grady Memorial Hospital
Veterans Affairs Medical Center
Egleston Children’s Hospital
Wesley Woods Health Center
General Principles of the Training Program for Residents in Neurology at Emory University
1. The house staff physician meets the qualifications for resident eligibility outlined in the Essentials of
Accredited Residencies in Graduate Medical Education in the AMA Graduate Medical Education
Directory.
2. As the position of house staff physician involves a combination of supervised, progressively more
complex and independent patient evaluation and management functions and formal educational activities,
the competence of the house staff physician is evaluated on a regular basis. The program maintains a
confidential record of the evaluations.
3. The position of house staff physician entails provision of care commensurate with the house staff
physician’s level of advancement and competence, under the general supervision of appropriately privileged
attending teaching staff. This includes:
 participation in safe, effective, and compassionate patient care;
 developing an understanding of ethical, socioeconomic, and medical/legal issues that
affect graduate medical education, and of how to apply cost containment measures in the
provision of patient care;
 participation in the educational activities of the training program and, as appropriate,
assumption of responsibility for teaching and supervising other residents and students,
and participation in institutional orientation and education programs and other activities
involving the clinical staff;
 participation in institutional committees and councils to which the house staff physician is
appointed or invited; and
 performance of these duties in accordance with the established practices, procedures, and
policies of the institution, and those of its programs, clinical departments and other
institutions to which the house staff physician is assigned, including among others, state
licensure requirements for physicians in training where these exist.
 each resident will maintain a one half day per week outpatient continuity clinic at Grady
Hospital.
Position Description for Resident Physicians Specific to PGY Level
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NEUROLOGY RESIDENT HANDBOOK
Emory University
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1.
PGY-2
A.
B.
C.
2.
PGY-3
A.
B.
C.
3.
The PGY-2 neurology resident rotates through the inpatient neurology services at Emory and
Grady Hospitals, including rotations in Neuro-ICU at Emory Hospital. They will typically
spend one month on an elective service, such as rotating through different neurology
subspeciality clinics, or on the Wesley Woods Neurology Consultation service.
Fundamental duties include the performance and documentation of the history and physical
examination; writing of orders and otherwise carrying out the care plan for their patients as
directed by the attending and senior resident. They also perform minimally invasive
techniques such as lumbar puncture.
Direct supervision of the PGY-2 neurology resident occurs on a regular basis. Each patient
seen by the resident is also personally evaluated by the attending and/or the senior resident.
The exception is at night at Emory Hospital where any patient seen is discussed with the
attending by phone. Those admitted to the hospital will then be seen by the attending the
following day.
The PGY-3 neurology resident rotates through subspeciality rotations and electives such as
Neuromuscular, Epilepsy, Child Neurology, Neuro-ophthalmology, and Neuropathology.
They will also begin to rotate on the Inpatient and Consult services at Emory and Grady
Hospitals where they will have a more supervisory and teaching role.
Fundamental duties are the same as the PGY-2 neurology resident, except they will be
expected to be able to formulate a diagnostic and therapeutic care plan for the patients they
see.
Direct supervision of the PGY-3 neurology resident continues as the attending will see and
evaluate the vast majority of the patients seen by the resident.
PGY-4
A.
B.
C.
D.
The PGY-4 neurology resident rotates through Inpatient and Consult services at Emory and
Grady Hospitals, as well as the Veterans Affairs Medical Center. They will complete any
remaining required subspeciality rotations such as Child Neurology. The remaining months
will be spent in elective rotations in subspecialty services in the Department of Neurology.
Fundamental duties are the same as those of PGY-2 and PGY-3 neurology residents
Direct supervision of the PGY-4 neurology resident by an attending neurologist
continues, although it is expected that it should be more to confirm the impression and care
plan for patients evaluated by the resident, rather than have it dictated by the attending as
would be the case for more junior residents.
Two or three of the PGY-4 neurology residents will be selected as Chief Residents. They have
the additional duties of developing the resident rotation schedules, setting up Grand Rounds
and other administrative, as well as teaching activities.
Approved, Neurology Education Committee, September, 2005
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NEUROLOGY RESIDENT HANDBOOK
Emory University
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ROTATION OBJECTIVES
Emory University Hospital Neurology Inpatient Service
Emory University School of Medicine
I.
Introduction
This document provides guidelines for neurology resident training while on the inpatient service at
Emory University Hospital. The patient population consists of patients with both emergent and nonemergent problems. Patients with primary neurologic problems are evaluated and managed in the
Emergency Department, the inpatient neurology service, and in the intensive care units. A broad range of
problems are cared for in this setting including, but not limited to coma, encephalopathy, dementia, seizures,
and weakness. The resident must learn to assign specific diagnoses and management strategies, represented
by such entities as stroke, epilepsy, neuromuscular diseases, movement disorders, and degenerative diseases.
II.
Description
During the first year of neurology training, 3 first-year neurology and 1 senior neurology resident are
assigned to the inpatient service each month. The senior resident (second or third year of training) functions
as the team leader for 3 junior residents and 1 or 2 medical students.
In addition to the 3 neurology residents assigned to the in-patient service, an additional resident may
be assigned to the Neurology/Neurosurgery ICU for one month rotations. At least one month of ICU
experience is required of each resident during the three years of training.
III.
Rotation Directors and Faculty
Jane Gilmore, M.D., Associate Program Director, coordinates the resident’s experience on the
inpatient service.
Department of Neurology faculty are assigned to attending roles on the inpatient service on a monthly
basis. These individuals have been selected for their excellence in both patient care and teaching. There is
also a dedicated neurology/neurosurgery ICU attending who has completed neurology training, a stroke
fellowship, and a neurology/neurosurgery intensive care fellowship.
IV.
Rotation Environment
Emory University Hospital provides care to the surrounding community and referral care to the
metro-Atlanta area as well as the state of Georgia and surrounding region. There is an active Emergency
Department with full-time emergency physician faculty coverage, a 14-bed neurology/neurosurgery ICU,
and 24 beds on the dedicated neurology/neurosurgery floor. A full-spectrum of highly sophisticated support
facilities are available as well as physician consultative services.
V.
Educational Objectives/Expectations
 Obtain an orderly and detailed history from the patient, reliably eliciting appropriate information
 Conduct a thorough general and neurological examination, reliably detecting abnormal findings
 Correctly integrate the findings from the history and physical examination to localize the neurological
problem and generate etiologic hypotheses
 Formulate a diagnostic plan incorporating appropriate laboratory, imaging, and physiologic tools to
further refine the diagnostic impression
 Define a logical and comprehensive management plan for the patient’s problem
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Emory University
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









Critically analyze and interpret biomedical data
Participate in the ongoing management of the patient, including discharge planning
Participate in the evaluation and decision-making for patients requiring surgical management
Participate in the evaluation and decision-making for patients with neurologic presentations of
psychiatric disease
Understand the importance of personal, social, and cultural factors in disease processes and their clinical
expression
Participate in the evaluation and management of the patient in the Emergency Department or ICU
Learn the indications for and basic principles of rehabilitation for neurologic disorders
Appreciate the parameters for appropriate and cost-effective patient evaluation
Understand the management of end-of-life palliative care, pain relief, and counseling of patients and
families, including issues related to brain death and the vegetative state
Communicate and interact effectively and appropriately with patients, medical staff, and colleagues,
including acting as a role model for the health care team
VI.
Evaluation
The residents will be evaluated by the attending physicians as well as by each other. The attending
physician will give the resident formal feedback at such times as the faculty member thinks is appropriate,
but certainly at the end of the rotation. A written evaluation will be filed with the residency program
director’s office.
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NEUROLOGY RESIDENT HANDBOOK
Emory University
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ROTATION OBJECTIVES
Emory University Hospital Neurology Consultation Service
Emory University School of Medicine
I.
Introduction
This document provides guidelines for neurology resident training while on the neurology
consultation service at Emory University Hospital. The patient population consists of patients with comorbid
or secondary neurologic problems occurring in the setting of primary medical or surgical illnesses. Patients
are evaluated and managed in the Emergency Department; intensive care units; and on various medical,
surgical, psychiatry, and rehabilitation services. A broad range of problems are cared for in this setting,
including but not limited to coma, encephalopathy, dementia, stroke, seizures, movement disorders, and
weakness. The resident must learn to assign specific diagnoses and management strategies, represented by
such entities as stroke, epilepsy, neuromuscular diseases, movement disorders, and degenerative diseases.
II.
Description
During the second and/or third year of neurology training, the resident is assigned to the neurology
consultation service where he/she functions as the team leader for medical and (occasionally) junior
neurology residents and 1 or 2 medical students.
III.
Rotation Directors and Faculty
Jane Gilmore, M.D., Associate Program Director, coordinates the resident’s experience on the
consultation service.
Department of Neurology faculty are assigned to attending roles on the neurology consultation
service for two-week blocks. These individuals have been selected for their excellence in both patient care
and teaching.
IV.
Rotation Environment
Emory University Hospital provides care to the surrounding community and referral care to the
metro-Atlanta area as well as the state of Georgia and surrounding region. There is an active Emergency
Department with full-time emergency physician faculty coverage and a full range of specialty and
subspecialty services and ICUs. A full-spectrum of highly sophisticated support facilities are available as
well as physician consultative services.
V.
Educational Objectives and Expectations
 Obtain an orderly and detailed history from the patient, reliably eliciting appropriate information
 Conduct a thorough general and neurological examination, reliably detecting abnormal findings
 Correctly integrate the findings from the history and physical examination to localize the neurological
problem and generate etiologic hypotheses
 Formulate a diagnostic plan incorporating appropriate laboratory, imaging, and physiologic tools to
further refine the diagnostic impression
 Define a logical and comprehensive management plan for the patient’s problem
 Critically analyze and interpret biomedical data
 Communicate clearly with the patient’s primary service and other consulting services,
and participate in the ongoing management of the patient, as appropriate to the
situation
 Participate in the evaluation and decision-making for patients requiring surgical management
 Participate in the evaluation and decision-making for patients with neurologic presentations of
psychiatric disease
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NEUROLOGY RESIDENT HANDBOOK
Emory University
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





Understand the importance of personal, social, and cultural factors in disease processes and their clinical
expression
Participate in the evaluation and management of the patient in the Emergency Department or ICU
Learn the indications for and basic principles of rehabilitation for neurologic disorders
Appreciate the parameters for appropriate and cost-effective patient evaluation
Understand the management of end-of-life palliative care, pain relief, and counseling of patients and
families, including issues related to brain death and the vegetative state
Communicate clearly and interact effectively with patients, medical staff, and
colleagues
VI.
Evaluation
The residents will be evaluated by the attending physicians as well as by each other. The attending
physician will give the resident formal feedback at such times as the faculty member thinks is appropriate,
but certainly at the end of the rotation. A written evaluation will be filed with the residency program
director’s office.
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NEUROLOGY RESIDENT HANDBOOK
Emory University
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ROTATION OBJECTIVES
Grady Memorial Hospital Neurology Inpatient Service
Emory University School of Medicine
I.
Introduction
This document provides guidelines for neurology resident training while on the inpatient service at
Grady Memorial Hospital. The patient population is made up of both emergent and elective admissions. A
broad array of neurologic problems are evaluated and cared for at Grady.
II.
Description
The Grady in-patient neurology service is a demanding rotation characterized by a great deal of
resident autonomy and responsibility for patient care. Organization and efficiency are of key importance on
this service. The team consists of the attending, 1 senior and 2 junior neurology residents, 1 medical intern,
1 psychiatry intern, and medical students.
III.
Rotation Director and Faculty
Dr. Mike Frankel, Chief of Neurology at Grady, Dr. Jaffar Khan, and Dr. Archana Koganti, in
conjunction with faculty from Emory and other sites, provide attending coverage at Grady. Residents are
encouraged to contact Dr. Frankel or any member of the faculty (whether assigned to Grady or not) at any
time if assistance in patient management is needed.
IV.
Rotation Environment
Neurology patients are located primarily on the 12A Ward of Grady Memorial Hospital with
overflow patients in other areas of the hospital. Neurology ICU patients are located in the 7K ICU with
overflow patients located in other ICUs.
V.
Educational Objectives/Expectations
At the conclusion of the Grady neurology inpatient rotation, the first year resident should be able to
meet the following objectives:
 Elicit a thorough and pertinent history; conduct a thorough general and neurological examination; record
data in an organized written record
 Define the neurological localization and formulate a logical differential diagnosis of the neurologic
problem
 Present an outline of a logical approach for appropriate diagnostic evaluation
 Describe an appropriate plan of treatment and begin implementation under the direction of the senior
neurology resident and attending
 Present the above information concisely and clearly to the attending physician and other members of the
inpatient team
 Develop a basic understanding of relevant serologic tests, cerebrospinal fluid analysis, neuroimaging
interpretation, and the use of other neurodiagnostic tests such as electroencephalography and
electromyography
 Understand the basic aspects of managing critically ill patients who have unstable neurological problems
in the emergency room and in the intensive care unit
 Actively participate in the educational discussion during teaching rounds and show a thorough
understanding of the relevant anatomy, pathology, and therapeutic options related to patient care
 Relate successfully to patients, families, and professionals; display professional attitudes toward learning
by showing interest and responsibility in patient care; sensitivity to patients’ needs; good interpersonal
relationships and tact; good work habits and consistency; curiosity as well as evidence of a desire to learn
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Emory University
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and improve (by reading, study, discussions); and ability to improve (response to suggestions/
corrections)
At the conclusion of the Grady neurology inpatient rotation, the second- or third-year neurology resident
should be able to meet the following objectives:










Manage responsibly a group of inpatients with acute neurological problems with guidance from the
attending
Display a thorough understanding of the process of neurological localization and of formulating a logical
differential diagnosis of a neurologic problem
Display a thorough understanding of the relevant anatomy, pathology, and therapeutic options for each
patient on the inpatient service
Describe the appropriate use of neurodiagnostic tests and their relevance in clinical decision-making for
each patient on the inpatient service
Provide teaching to other members of the team including neurology residents, interns, and students by
presenting and presiding over didactic sessions regarding anatomy, pathology, clinical diagnosis, and
therapy based on relevant literature
Display an ability to present effectively each patient’s history, physical, assessment, and plan in a concise
and straightforward format
Develop an advanced understanding of relevant serologic tests, cerebrospinal fluid analysis,
neuroimaging interpretation, and the use of other neurodiagnostic tests such as electroencephalography
and electromyography
Develop an advanced understanding of all the relevant aspects of managing critically ill patients who
have unstable neurological problems in the emergency room and in the intensive care unit
Relate successfully to patients, families, and professionals; display professional attitudes toward learning
by showing interest and responsibility in patient care; sensitivity to patients’ needs; good interpersonal
relationships and tact; good work habits and consistency; curiosity as well as evidence of a desire to learn
and improve (by reading, study, discussions); and ability to improve (response to suggestions/
corrections)
Display an ability to communicate effectively with patients and their families regarding compassionate
end-of-life decisions
VI.
Evaluation
Written evaluations will be filed monthly with the Program Director’s office. In addition, the attending will
review the resident’s performance with him/her at the end of the rotation and at such times as may be
necessary.
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Emory University
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ROTATION OBJECTIVES
Grady Memorial Hospital Neurology Consultation Service
Emory University School of Medicine
I.
Introduction
This document provides guidelines for neurology resident training while on the Neurology
Consultation Service at Grady Memorial Hospital. The patient population includes patients with both
emergent and non-emergent problems. A wide range of neurologic problems are encountered on this service,
including coma, delirium, dementia, seizures, stroke, gait disturbances of various etiologies, and others.
II.
Description
The consult team consists of the attending, 1 senior and 1 junior neurology resident, rotating residents
from other services (Medicine, Neurosurgery) and medical students.
III.
Rotation Director and Faculty
Dr. Mike Frankel, Chief of Neurology at Grady, Dr. Jaffar Khan, and Dr. Archana Koganti, in
conjunction with faculty from Emory and other sites, provide attending coverage. Residents are encouraged
to contact Dr. Frankel or any member of the faculty (whether assigned to Grady or not) at any time if
assistance in patient management is needed.
IV.
Rotation Environment
The Neurology Consultation Service provides service to an active Emergency Department as well as
to a full range of specialty and ICU services at Grady.
V.
Educational Objectives/Expectations
 Elicit a thorough and pertinent history; conduct a thorough general and neurological examination; record
data in an organized written record
 Define the neurological localization and formulate a logical differential diagnosis of the neurologic
problem
 Present an outline of a logical approach for appropriate diagnostic evaluation
 Display a thorough understanding of the process of neurological localization and of formulating a logical
differential diagnosis of a neurologic problem
 Display a thorough understanding of the relevant anatomy, pathology, and therapeutic options for each
patient on the inpatient service
 Describe the appropriate use of neurodiagnostic tests and their relevance in clinical decision-making for
each patient
 Provide an assessment and recommendations for care in a format that is both legible and understandable
to non-neurologists
 Provide teaching to other members of the team including neurology residents, interns, and students by
presenting and presiding over didactic sessions regarding anatomy, pathology, clinical diagnosis, and
therapy based on relevant literature
 Display an ability to present effectively each patient’s history, physical, assessment, and plan in a concise
and straightforward format
 Develop an advanced understanding of relevant serologic tests, cerebrospinal fluid analysis, the
interpretation of neuroimaging, and the use of other neurodiagnostic tests such as electroencephalography
and electromyography
 Develop an advanced understanding of all the relevant aspects of managing critically ill patients who
have unstable neurological problems in the emergency room and in the intensive care unit
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Emory University
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


Develop an advanced understanding of the pathophysiology, diagnosis and treatment of neurologic
problems associated with medical diseases
Relate successfully to patients, families, and professionals; display professional attitudes toward learning
by showing interest and responsibility in patient care;
sensitivity to patients’ needs; good interpersonal relationships and tact; good work habits and
consistency; curiosity and evidence of a desire to learn and
improve (by reading, study, discussions); and ability to improve (response to suggestions/corrections)
Display an ability to communicate effectively with patients and their families regarding compassionate
end-of-life decisions
VI.
Evaluation
Written evaluations will be filed monthly with the program director’s office. In addition, the
attending will review the resident’s performance with him/her at the end of the rotation and at such times as
may be necessary.
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Emory University
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ROTATION OBJECTIVES
Neuroscience Critical Care Unit (NCCU) Rotation
Emory University School of Medicine
I.
Introduction
This document provides guidelines for neurology residency training in neurocritical care medicine.
The scope of neurocritical care encompasses the three separate disciplines of neurology, neurosurgery, and
critical care medicine. As such, much of the time spent by a neurology resident in neurocritical care will be
focused on the critical care aspects of managing acutely ill neurologic patients.
II.
Duration
Each Neurology resident will spend one or more fully dedicated months on this rotation.
III.
Rotation Faculty
Owen B. Samuels, M.D., Assistant Professor of Neurology and Neurosurgery
Wendy Wright, M.D., Assistant Professor of Neurology and Neurosurgery
IV.
Rotation Environment
The rotation will take place primarily in the Neuroscience Critical Care Units (2G/3G ICUs) at
Emory University Hospital. These clinical units are state-of-the-art intensive care units with all the standard
facilities to manage critically ill patients. A continuous flow of neurocritical care patients is seen under
direct faculty supervision.
V.












Educational Objectives and Expectations
The resident will be expected to
Evaluate and manage, under direct faculty supervision, all neurology patients
admitted to the NCCU
Assist in the evaluation and management of neurosurgery patients admitted to the
Neuroscience critical care unit
Obtain an orderly and detailed history from the patient and/or family members,
reliably eliciting appropriate information
Correctly integrate the findings from the history and the neurological and medical
examinations to localize the neurologic and critical care problems
Formulate a diagnostic plan incorporating appropriate laboratory, physiological data,
and imaging
Define a comprehensive management plan for the patient’s neurocritical problem(s)
Appreciate the considerations of appropriate and cost-effective patient evaluation
Understand the management of end-of-life issues, palliative care, and counseling of
patients and families, including issues related to brain death and the vegetative
states
Become familiar with the brain death exam and ancillary assessments of brain death
Manage various aspects of hemorrhagic stroke such as SAH, ICH, SDH, and EDH
hemorrhages
Become familiar with cerebral hemodynamics as they relate to management of
various disease entities such as SAH, ICH, and acute ischemic stroke
Learn about the principles of intracranial pressure monitoring (e.g., ventricular
catheters, Camino monitors) and the medical management of increased intracranial pressure and cerebral
edema
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



Manage patients with status epilepticus and become familiar with various
pharmacologic management strategies
Manage routine critical care and medical aspects of patient care
Become familiar with the diagnosis and management of fluid and electrolyte
abnormalities associated with neurologic and neurosurgical diseases such as SIADH and diabetes
insipidus
Communicate and interact effectively with the floor neurology team, as well as
with patients, medical staff, and colleagues
VI.
Evaluation
Since the resident is under frequent supervision of the rotation director, there should be ample
opportunity for immediate feedback on issues of patient history, examination, and ICU management. In
addition, a formal evaluation, which goes into the resident’s master file, will be filled out at the completion
of the rotation. Feedback from the resident to the rotation director during the rotation will be encouraged,
and formal evaluation of the rotation by the resident will occur at the completion of the rotation.
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ROTATION OBJECTIVES
Neuromuscular Disorders / Electromyography (EMG)
Emory University School of Medicine
I.
Introduction
This rotation will provide basic knowledge and clinical experience in neuromuscular
pathophysiology, diagnosis and therapy. In addition the resident will become proficient with the technical
aspects of nerve conduction studies (NCS) and electromyography (EMG), as well as, the interpretation and
clinical application of the findings. Exposure to the clinical aspects of neuromuscular disorders in children
and adults will be derived from the outpatient clinic and inpatient consultation services. A fundamental
knowledge of the histopathology of neuromuscular disease will be obtained through the review of muscle
and nerve biopsies in the neurology neuromuscular laboratory.
II.
Duration
Each neurology resident will spend one or more months on the rotation. In addition, each resident
will attend the introductory lecture series for new Neuro-physiology fellows, in the year in which the resident
is scheduled to participate in this rotation.
III.
Rotation Faculty
The neurology resident works with several different board certified neurologists. Each faculty
member has additional board certification in electrophysiology and/or electromyography. The resident is
also taught by electrophysiology fellows and a technician.
Faculty Members: Jonathan Glass, M.D., Linton Hopkins, M.D., Jaffar Khan, M.D., John Sladky,
M.D., Michael Benatar M.D, PhD, Taylor Harrison MD
IV.
Rotation Environment
The rotation takes place at The Emory Clinic, Emory University Hospital, and Grady Memorial
Hospital. The vast majority of patients are seen in an outpatient laboratory setting, but inpatients are also
evaluated. All of the EMG machines are digital. There are many educational resources available to the
residents at the site of the laboratory: video tapes, audio tapes, textbooks, interesting case files.
V.
Objectives
Upon successful completion of this rotation, the Neurology Resident will be able to:
1) Obtain a comprehensive history of neuromuscular-specific signs and symptoms, from patients and
other lay historians, in addition to obtaining comprehensive general historical history and
examination.
2) Develop an appropriate differential diagnosis of neuromuscular disease based upon the clinical data.
3) Appropriately order and apply the results of laboratory, genetic and electrophysiologic testing as
indicated by the history and physical examination findings.
4) Distinguish the electrophysiological characteristics of myopathy from neuropathy.
5) Distinguish the electrophysiological characteristics of demyelinating neuropathy from axonal
neuropathy.
6) Appropriately choose patients that would benefit form a muscle and or nerve biopsy.
7) Distinguish the histopathological findings of a neuropathy from a myopathy.
8) Become familiar with the information obtained from the common stains used for the
histopathological analysis of muscle and nerve biopsies.
9) Choose appropriate pharmacologic, physical therapy, and counseling modalities for the
neuromuscular diseases.
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10) Become familiar with the use, adverse effects and monitoring of the immunomodulatory medications
commonly used to treat various neuromuscular diseases.
11) Be able to perform the common motor and sensory nerve conduction studies of the upper and lower
extremities.
12) Be able to perform the needle examination.
13) Identify and apply the clinical significance of the waveforms analyzed during the needle examination.
14) Become aware of the common technical fallacies and pitfalls of nerve conduction studies.
Upon successful completion of this rotation, the neurology resident will have:
1) Completed multiple EMG/NC studies and interpreted the results
2) Been exposed to the clinical and basic science research of the Neuromuscular Faculty
3) Prepared, presented and defended a EMG/NCS at the EMG conference on Tuesday Morning
VI. Daily Schedule
Monday
AM
Clinic (Benatar)
Tuesday
AM
EMG Conf
Clinic (Glass)
Wednesday
AM
Thursday
AM
EMG (Benatar)
Muscle and
Nerve Histopath
PM
PM
MDA Clinic or
ALS Clinic or
Dalton
PM
EMG (Harrison)
EMG (Khan)
EMG (Sladky)
Glass Rounds
PM
Friday
AM
Grand Rounds
Resident Lec
Independent
Reading
PM
Peds NM Clinic
at Dunwoody
(Sladky)
Note: On the first Wednesday of every month the Resident will attend the MDA clinic in Dalton, GA
for the entire day (with Dr. Linton Hopkins – call 404.778.3452 for more info). Grady continuity
clinic should be scheduled (or swapped) so that residents do not miss key sessions.
VII.
Evaluation
The resident is evaluated by the faculty at the end of the rotation based on his or her ability to achieve
the above described expectations. Feedback is given on a daily basis by the supervising faculty. A written
evaluation is submitted to the Program Director at the conclusion of the rotation.
VIII. Reading List
Required Reading:
1) Griggs RC. Evaluation and Treatment of Myopathies.
2) Mendell JR, Kissel JT, and Cornblath DR. Diagnosis and Management of Peripheral Nerve
Disorders
3) Stewart JD. Focal Peripheral Neuropathies.
4) Preston DC, Shapiro BE. Electromyography and Neuromuscular Disorders.
5) Perotto. Anatomic Guide for the Electromyographer.
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Recommended Reading:
1) Dyck, P. Peripheral Neuropathy
2) Engel AG. Myology: Basic and Clinical
3) Katirji, B. Neuromuscular Disorders in Clinical Practice
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ROTATION OBJECTIVES
Epilepsy and Electroencephalography (EEG)
Emory University School of Medicine
I.
Introduction
This six week, full-time rotation will provide essential knowledge and clinical experience in epilepsy
pathophysiology, diagnosis, and therapy, and in interpretation and application of electroencephalography
(EEG). The resident’s exposure to epilepsy and EEG will be primarily via participation in three areas: (1)
outpatient epilepsy clinic (2) inpatient and outpatient EEG reading (3) epilepsy monitoring unit.
II.
Duration
Each Neurology resident will spend six weeks on this rotation. In addition, each resident will attend
the introductory lecture series for new Neuro-physiology fellows, in the year in which the resident is
scheduled to participate in this rotation.
III.
Rotation Director and Faculty
Rotation Director:
Suzette LaRoche, M.D., Assistant Professor of Neurology
Additional Faculty:
Page B. Pennell, M.D., Associate Professor of Neurology
Charles M. Epstein, M.D., Professor of Neurology
Sandra Helmers, M.D., Associate Professor of Neurology
Thomas R. Henry, M.D., Professor of Neurology
Philip J. Holt, M.D., Assistant Professor of Neurology and Pediatrics
Archana Koganti, M.D., Assistant Professor of Neurology
Larry D. Olson, M.D., Assistant Professor of Neurology and Pediatrics
These faculty members are board certified by the American Board of Psychiatry & Neurology in adult or
pediatric neurology, and are board certified or eligible in clinical neurophysiology. Fellows enrolled in the
department’s ACGME-accredited Clinical Neurophysiology Training Program also participate in this
rotation.
IV.
Rotation Environment
The primary sites of the rotation are the Emory University Hospital, the Emory Clinic, and Grady
Memorial Hospital. These procedures are interpreted in reading rooms of the Clinic and Hospital, which are
equipped with high-resolution digital display. The Clinical Neurophysiology Fellows’ Room is available to
the Residents for on-site access to reference texts and other education materials including an EEG teaching
syllabus and EEG teaching files. The residents have access to the extensive collection of texts and journals
of the Emory University School of Medicine Biomedical Library, located in a nearby building.
V.
Educational Objectives and Expectations
A. Outpatient Epilepsy clinic
Expectations: Participation in 2 half day clinics at Emory Epilepsy Center working with various epilepsy
attendings and 1 half day clinic at the Grady Seizure Clinic.
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Objectives:
1) Obtain comprehensive history of ictal semiology and other epilepsy-specific signs and symptoms in
addition to obtaining comprehensive general neurological history and examination.
2) Describe commonly occurring abnormalities detected with EEG, MRI and other laboratory studies used
in initial seizure evaluation, and appropriately order and apply results of these studies in patient care.
3) Classify seizures and epilepsies based on clinical and laboratory data.
4) Choose appropriate anti-epileptic drug (AED) therapy and other therapies for initial treatment of
seizures, and describe pharmacokinetics, pharmacodynamics, dosing and important adverse effects of
commonly used AEDs.
5) Identify AED-refractory seizure disorders, describe applications of diagnostic video-EEG monitoring in
evaluation of uncontrolled seizures, and utilize reports of video-EEG in clinical care of patients with
epileptic and non-epileptic seizures.
6) Describe epilepsy surgery, vagus nerve stimulation, the ketogenic diet, and other therapies used in AEDrefractory epilepsies.
B. Outpatient/Inpatient EEG:
Expectations: Personally interpreted and prepared reports for 30 routine inpatient or
outpatient
EEG studies and personally run one routine EEG, including electrode application.
Participation
in
daily EEG attending rounds.
Objectives:
7) Describe the physiological basis of scalp EEG generation.
8) Describe all steps in acquisition of routine EEG (based, in part, on personally undergoing a routine EEG).
9) Define generators of evoked potentials and interpret normal and abnormal studies (including intraoperative monitoring).
10) Describe and recognize normal features of waking and sleeping EEG activity in infants, children, adults
and elderly.
11) Describe and recognize pathological EEG features including focal and generalized interictal epileptiform
activity, focal and diffuse background slowing and periodic patterns.
12) Recognize common EEG artifacts and benign variants.
13) Recognize common patterns seen in comatose and severely encephalopathic patients and describe their
clinical significance.
14) Recognize electrographic presentations of status epilepticus.
C.
Epilepsy Monitoring Unit:
Expectations: Obtain history and physical examination of epilepsy monitoring patients upon
admission and daily follow-up thereafter. Follow at least one patient at a time in detail including daily
review of video and EEG findings. Participation in daily EMU attending rounds.
Objectives:
15) Differentiate non-epileptic and epileptic seizures based on semiology and electrographic presentation.
16) Recognize and describe ictal EEG discharges both focal and generalized.
17) Recognize various seizure semiologies and classify by seizure type and epilepsy syndrome.
18) Become familiar with epilepsy surgery evaluation including intracranial EEG monitoring and cortical
mapping.
In addition, on successful completion of this rotation, the Neurology Resident will have:
1) Prepared and presented a one-hour presentation on an important topic of epilepsy or EEG at the
Thursday Teaching Conference.
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VI.
Evaluation
The Clinical Neurophysiology faculty member(s) who supervise the resident during the rotation will
provide a written evaluation of the resident. The final written evaluation is submitted to the Director of the
Neurology Residency Training Program. In addition, each resident will be required to take a test at the end
of the rotation that will cover the educational objectives outlined above. Each resident will also be given the
opportunity to take the annual clinical neurophysiology in-service examination in the spring of their PGY-4
year to assess their central neurophysiology knowledge.
VII. Reading List
Required Reading *:
1) Fisch B. Spehlmann’s Primer of EEG.
2) Leppik IE. Contemporary Diagnosis and Management of the Patient with Epilepsy, 5rd Ed. 2002.
* To be completed by the end of the one-month rotation.
Recommended Reading:
Daley DD, Pedley TA (eds.). Current Practice of Clinical Electroencephalography, 2nd Ed. New York:
Raven Press. 1990.
Wyllie E (ed.). The Treatment of Epilepsy: Principles and Practice, 2nd Ed. Philadelphia: Lippincott
Williams & Wilkins. 2001.
Other Recommended Sources:
Engel J Jr, Pedley TA (eds.). Epilepsy: A Comprehensive Textbook Philadelphia: Lippincott-Raven
Publishers. 1998.
Lüders HO (ed.) Epilepsy Surgery Philadelphia: Lippincott Williams & Wilkins. 1992.
Niedermeyer E, Lopes da Silva F (eds.). Electroencephalography: Basic Principles, Clinical Applications,
and Related Fields, 3rd Ed. Baltimore: Williams & Wilkins. 1993.
Nuwer MR. Evoked Potential Monitoring in the Operating Room. Raven Press: New York. 1987.
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ROTATION OBJECTIVES
Neurology Services at Wesley Woods Center
Emory University School of Medicine
I.
Introduction
The Wesley Woods Neurology rotation offers a rich environment for Medical Students, Psychiatry
Residents, Neurology Residents, and Attendings to learn together in the unique setting of the Wesley Woods
Center. The focus at Wesley Woods is on aging in its broadest sense. The Emory University Center for
Health in Aging is housed on the Wesley Woods campus and brings together expertise and medical
leadership from the Schools of Medicine, Nursing, Public Health, and Theology to the study and practice of
Gerontology and Neuroscience. The Departments of Neurology, Psychiatry, Rehabilitation, Pathology, and
Medicine provide medical services and conduct most of the research activities at Wesley Woods.
II.
Duration
The Neurology resident spends two months on the Neurology rotation at Wesley Woods during the first and
second years of training.
III.
Rotation Faculty
Allan Levey, M.D., Ph.D.
Chairman of Neurology
Director, Alzheimer’s Disease Center
James Lah, M.D., Ph.D.
Chief of Neurology at Wesley Woods
Director, Wesley Woods Neurobehavior Program
Jorge Juncos, M.D.
Associate Chief of Neurology at Wesley Woods
Director, Inpatient Services
These individuals and other faculty from the Movement Disorders and Cognitive Neurology programs,
provide attending coverage on the inpatient Neurology Consultation Service as well as the outpatient
Neurology Subspecialty Clinics based in the Wesley Woods Health Center.
IV.
Rotation Environment
The Neurology Service provides consultation liaison services to the Psychiatry, Medicine, and Rehabilitation
Services at Wesley Woods Hospital. Additional services are provided at Budd Terrace and A.G. Rhodes
Nursing Home. The inpatient setting provides opportunities to develop skill in diagnosing and managing
neurologic illnesses in a diverse group of hospitalized geriatric patients. The Wesley Woods campus is also
home to several outpatient clinics focusing on Parkinson’s, Alzheimer’s, Huntington’s, and other
neurodegenerative diseases. Since these diseases typically have a chronic, progressive clinical course, the
outpatient clinic is the best setting in which to gain first-hand experience with these diseases. Out-patient
programs include the Alzheimer’s Disease Center, Memory Disorders Clinic, Huntington’s Disease Center
and Clinic, the Movement Disorders Program and associated clinics (Parkinson’s Disease, Dystonia,
Tourette’s, and Botulinum Toxin and Spasticity Clinics), and the Sleep Disorders Laboratory. Residents
participate in both the in-patient and out-patient activities during their rotation.
V.
Educational Objectives and Expectations
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General Educational Goals
 Appreciate the parameters of normal aging and learn to diagnose and treat age-related neurologic
problems
 Develop familiarity with the evaluation and management of Parkinson’s, Alzheimer’s, and other
common neurologic diseases affecting elderly patients
 Gain an understanding of the pathogenesis of neurodegenerative disorders
 Learn to recognize neurologic presentations of psychiatric disease and to appreciate the psychiatric
manifestations of neurologic disorders
 Learn to appreciate and weigh social and cultural factors in the clinical expression and management of
chronic, age-related neurologic disease
 Achieve an appreciation for special decision-making considerations involving elderly patients based on
their individual life circumstances as well as medical circumstances
 Learn to appreciate the special rehabilitation issues of the elderly and/or cognitively impaired
 Learn to communicate and relate successfully with patients, families, medical staff and ancillary
personnel who participate in the care of patients with chronic, age-related neurologic disorders
 Appreciate bioethical issues inherent in providing comprehensive neurologic care to the elderly and to
those with chronic, degenerative neurologic disease
Expectations for Neurology Attending
 Teach appropriate neurologic evaluation and management skills through individual case discussions and
critical review of the clinical decision making process.
 Plan and prepare formal didactic sessions. Relevant topics may be selected based on appropriate cases
from the inpatient or outpatient services. Alternatively, topics may be selected from the rotation syllabus.
 Coordinate outpatient clinical participation by Medical Students and Psychiatry Residents.
 Participate in development and refinement of a core syllabus for the Wesley Woods Neurology rotation.
 Provide feedback and written evaluations for all Medical Students and Residents.
Expectations for Neurology Resident
 The Neurology Resident will direct and supervise members of the Neurology Consultation service.
 Participate in teaching activities for junior team members.
 Attend outpatient clinics in Memory Disorders (Monday AM) and Movement Disorders (Tuesday AM)
Clinics each week. In addition, the Neurology Resident will participate in Huntington’s Disease clinic
every other week (2nd and 4th Thursday AM).
 Develop expertise in the evaluation and management of Parkinson’s and related movement disorders,
Alzheimer’s disease and other dementias, gait disorders, altered mental status, agitation in demented
patients, and other common neurologic problems encountered in geriatric populations.
 Achieve a thorough understanding of the pathophysiology and principles of management for important
causes of basal ganglia disorders and dementing illnesses.
VI.
Evaluation
The residents will be evaluated by the attending physicians as well as by each other. The attending physician
will give the resident formal feedback at such times as the faculty member thinks is appropriate, but certainly
at the end of the rotation. A written evaluation will be filed with the residency program director’s office.
Updated 8/04
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Wesley Woods Neurology Rotation
INTRODUCTION
The Wesley Woods Neurology rotation offers rich opportunities for Medical Students, Psychiatry Residents,
Neurology Residents, and Attendings to learn together in the unique setting of the Wesley Woods Geriatric
Center. The Neurology Consultation Service provides inpatient Neurology Consultations in the Wesley
Woods Geriatric Hospital. The inpatient setting provides opportunities to develop skill in diagnosing and
managing neurologic illnesses in a diverse group of hospitalized geriatric patients. The Wesley Woods
campus is also home to several outpatient clinics focusing on Parkinson’s, Alzheimer’s, Huntington’s, and
other neurodegenerative diseases. Since these diseases typically have a chronic, progressive clinical course,
the outpatient clinic is the best setting in which to gain first-hand experience with these diseases.
EDUCATIONAL GOALS
The general educational goals of the Wesley Woods Neurology Rotation are to:
 Develop familiarity and expertise in the evaluation and management of Geriatric inpatients with Parkinson’s disease,
Alzheimer’s disease, gait disorders, and other common neurologic conditions affecting elderly patients.
 Achieve an appreciation for special decision-making considerations involving elderly patients based on their individual life
circumstances as well as medical circumstances.
 Learn the clinical features and principles of management for neurodegenerative conditions through regular participation in
outpatient Movement Disorders, Cognitive Neurology, and Huntington’s Disease clinics.
 Expand the base of knowledge on the clinical features and pathophysiology of a variety of neurodegenerative diseases through
independent reading, directed reading, and didactic sessions.
EXPECTATIONS FOR NEUROLOGY ATTENDING
 Teach appropriate neurologic evaluation and management skills through individual case discussions and critical review of the
clinical decision making process.
 Plan formal didactic sessions at least once weekly. Relevant topics may be selected based on appropriate cases from the
inpatient or outpatient services. Alternatively, topics may be selected from the rotation syllabus.
 Coordinate outpatient clinical participation by Medical Students and Psychiatry Residents.
 Participate in development and refinement of a core syllabus for the Wesley Woods Neurology rotation.
 Provide feedback and written evaluations for all Medical Students and Residents.
EXPECTATIONS FOR NEUROLOGY PGY-3 RESIDENT
 The Neurology Resident will direct and supervise members of the Neurology Consultation service.
 Participate in teaching activities for junior team members.
 Attend one half-day outpatient clinic in Movement Disorders (Tuesday AM – Dr. Alan Freeman) and Cognitive Neurology
(Monday AM – Dr. Allan Levey) each week. In addition, the Neurology Resident will participate in Huntington’s Disease
clinic every other week (2nd and 4th Thursday AM – Drs. Greenamyre and Testa).
 Develop expertise in the evaluation and management of Parkinson’s disease and related movement disorders, Alzheimer’s
disease and other dementias, gait disorders, altered mental status, agitation in demented patients, and other common
neurologic problems encountered in geriatric inpatient populations.
 Achieve a thorough understanding of the pathophysiology and principles of management for important causes of basal ganglia
disorders and dementing illnesses.
EXPECTATIONS FOR PSYCHIATRY PGY-1 RESIDENT
 Develop familiarity with the evaluation and management of neurological conditions commonly encountered among
hospitalized geriatric patients.
 Participate in teaching Medical Students the basics of history-taking and physical examination, and refine his or her own skills
in Neurologic History and Examination.
 Develop familiarity with outpatient evaluation of common movement disorders and dementing illnesses. The Psychiatry
Resident will participate in one half-day outpatient clinic per week with the Neurology Attending. In addition, the Attending
will coordinate additional outpatient exposure in other specialty areas (e.g. Movement clinic if Attending’s specialty is
Cognitive Neurology).

Achieve a basic understanding of the pathophysiology and principles of management for the most
important causes of dementia and movement disorders.
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PROCEDURES FOR NEUROLOGY ADMISSIONS TO WESLEY WOODS GERIATRIC HOSPITAL
Selection of appropriate admitting service




Neurology patients with acute medical illnesses may be appropriate for admission to the Medicine service at WWGH. Typical
indications for admission might include evaluation and treatment of acute infections, metabolic disturbances, and mild
encephalopathy.
Patients with baseline dementia and significant behavioral disturbances or those patients with primarily psychiatric or
neuropsychiatric indications for admission are appropriate for admission to the Psychiatry or Neuropsychiatry units.
If the patient is a new patient who requires an extensive diagnostic assessment for a neurological condition, consider admitting
the patient to the EUH Neurology service.
Any Neurology Attending with admitting privileges at WWGH has the option of admitting patients independently. These
patients will not be covered by the Wesley Woods Neurology Consultation Service, and the Neurology Attending assumes
primary responsibility for all aspects of the patient’s admission and care.
Admission procedures
As a courtesy to our Medicine and Psychiatry colleagues, direct contact should be made by the Neurology Attending
with the Medicine or Psychiatry Attending.
Medicine admissions: Monday-Friday, 8am-5pm



Page the Medicine Inpatient Attending with patient information (name, date of birth, diagnosis with HPI, and availability
of Wesley Woods outpatient or hospital records) to confirm that the patient meets admission criteria, discuss approach to
the case, and ascertain bed availability.
Ask Neurology admissions coordinator to contact Intake Office (404-728-6222) with patient information, insurance
information, and diagnosis.
Ask Neurology admissions coordinator to page Neurology Resident on Wesley Woods Neurology Consultation Service
regarding admission and fax clinic notes if available.
Psychiatry or Neuropsychiatry Unit admissions: Monday-Friday, 8am-5pm




Ask Neurology admissions coordinator to contact the Intake Office (404-728-6222) with patient information to confirm
that patient fulfills criteria for admission and that a bed is available.
Intake office will determine whether the patient will be admitted to Dr. Larry Tune or Dr. Frank Brown.
The Neurology Attending will page Dr. Tune or Brown to discuss the patient.
Ask Neurology admissions coordinator to page Neurology Resident on Wesley Woods Neurology Consultation Service
regarding admission and fax clinic notes if available.
Medicine/Psychiatry/Neuropsychiatry Unit admissions: Weekdays after 5pm, Saturday, Sunday


In general, admissions after regular weekday hours will occur after the patient has been evaluated by the EUH or CLH
Emergency Department, and the ED staff will coordinate these admissions.
In rare instances, if direct admission is felt to be appropriate, this should be coordinated with the service appropriate OnCall Attending (WWGH schedule available through WW operator at 404-728-6200).
Neurology consultations



The patient will frequently require evaluation and management of chronic neurologic conditions, and it is anticipated that the
Neurology Consultation team will assist the primary service during the hospitalization.
The admitting service will routinely order a Neurology consultation.
The Neurology Consultation team will be expected to follow the patient throughout the hospitalization.
Follow up care


Follow-up in Medicine or Psychiatry clinics may be arranged as deemed appropriate by the primary service.
The Neurology Consultation team will assist in arranging appropriate Neurology follow-up and communicate with the
patient’s outpatient Neurologist.
Problem resolution
Please report any difficulties with these procedures to Jim Lah (PIC #15358 or jlah@emory.edu).
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ROTATION OBJECTIVES
Neuro-Ophthalmology
Emory University School of Medicine
I.
Introduction
This document provides guidelines for neurology residency training in the clinical subspecialty of
neuro-ophthalmology. The scope of neuro-ophthalmology encompasses two parent disciplines, neurology
and ophthalmology. As such, much of the time spent by a neurology resident in neuro-ophthalmology
should be focused on learning the anatomy, physiology, pathophysiology, examination techniques, and
language of the discipline of ophthalmology.
II.
Duration
Each neurology resident will spend one or more months assigned to the NeuroOphthalmology Unit for full-time outpatient clinical training.
III.
Rotation Director and Faculty
The neurology resident will have full-time one-on-one contact with a fellowship- trained neuroophthalmologist, board certified in either ophthamlmology or neurology, with a clinical practice primarily
dedicated to neuro-ophthalmology. Ophthalmologists or neurologists currently in neuro-ophthalmology
training will also provide supervision and teaching.
Rotation Director:
Faculty:
Nancy J. Newman, M.D.
Professor of Ophthalmology and Neurology
Instructor in Neurosurgery
Valerie Biousse, M.D.
Assistant Professor of Neurology
IV.
Rotation Environment
The rotation will take place primarily in the Neuro-Ophthalmology Unit at Emory University. This is
a state-of-the-art facility with all the standard equipment needed to perform a complete neuro-ophthalmology
examination, including acce4ss to slit lamp biomicroscopy, indirect ophthalmoscopy, formal visual field
testing and ocular photography. There is an on-site neuro-ophthalmlogy library with access to all the
standard resource texts of neuro-ophthalmology, neurology, ophthalmology, and neurosurgery. There is a
continuous flow of neuro-ophthalmology patients seen under faculty supervision. The resident will regularly
perform initial patient work-ups including history and examinations utilizing the techniques of neurology and
ophthalmology. The resident will receive instruction and experience in ordering and evaluating tests of
visual function, such as perimetry, and in interpreting neuro-imaging and electrophysiologic testing,
including visual field evoked potentials and electroretinography. Frequent neuro- imaging consultation and
conferences are an integral activity of the Unit
V.
Educational Objectives and Expectations
The neurology resident will be exposed to a wide variety of conditions falling within the scope of
neuro-ophthalmology. This experience will include disorders of the anterior and posterior afferent visual
pathways, the ocular motor system, orbital disease, disorders of the cranial nerves and disorders of the
eyelids. The resident should be able to assess the patient with visual loss, diplopia, nystagmus, papillary
abnormalities, or ptosis. The major categories of disease affecting the eye, orbit, and brain, including
infections, neoplasm, occlusive and non-occlusive vascular disease, inflammatory disorders, degenerative
conditions, hereditary disease and nonorganic psychogenic disorders, will be experienced. The neurology
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resident will also be exposed to other eye conditions that are generally considered within the scope of other
ophthalmic specialties.
By the end of the neuro-ophthalmology rotation, the neurology resident should gain the following skills:
 Be conversant with the anatomy of the cerebral visual pathways and brainstem motility pathways.
 Be able to perform a reliable neuroophthalmic history and examination and communicate this
information efficiently.
 Feel comfortable with the basic evaluation of patients with optic neuropathy (especially optic
neuritis, anterior ischemic optic neuropathy, compressive optic neuropathy, chronic papilledema),
disc edema, unexplained visual loss, diplopia (3rd, 4th, 5th, 6th nerve palsies, supranuclear and
internuclear disorders, myasthenia gravis, thyroid ophthalmopathy), ptosis and nystagmus.
 Be able to order appropriately and interpret Goldmann and Humphrey visual fields.
VI.
Evaluation
Since the resident is under almost constant supervision of the rotation director, there should be ample
opportunity for immediate feedback on issues of patient history, examination and management. In
addition, a formal evaluation that goes into the resident’s master file will be filled out at the completion
of the rotation. Feedback from the resident to the rotation director during the rotation will be encouraged
and formal evaluation of the rotation by the resident will occur at the completion of the rotation.
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ROTATION OBJECTIVES
Child Neurology
Emory University School of Medicine
I.
Introduction
In order to fulfill their Neurology Residency training requirements every Neurology Resident will
complete training in Child Neurology. The rotation will include experience in both inpatient and outpatient
settings and, in addition to general child neurology, will include exposure to more specialized areas of the
discipline such as neonatal neurology, neurorehabilitation, pediatric epilepsy and epilepsy monitoring,
neuromuscular disease, and movement disorders in childhood. Residents will learn diagnostic and
management principles for common and rare neurological conditions in children. Emphasis will be placed
on fundamental issues of developmental neurobiology as they apply uniquely to normal/abnormal
neurodevelopment in children.
II.
Duration
The neurology resident will spend a minimum of three months on the Pediatric Neurology rotation
during the second and/or third year of training.
III.
Rotation Director and Faculty
Overall responsibility for coordinating the various components of the rotation will reside with the
Division Director, John T. Sladky, M.D. Four other faculty members will also participate on a rotating basis
as the primary inpatient attending who will supervise the inpatient component of the rotation and who will be
responsible for daily teaching rounds with the resident and medical students.
IV.
Rotation Environment
The Division of Pediatric Neurology at the Emory University School of Medicine has inpatient
consultative responsibilities at four sites: Egleston Children’s Hospital, Hughes-Spaulding Children’s
Hospital, and the Grady Memorial and Crawford Long Hospitals’ neonatal nurseries. The primary inpatient
neurology service is at Egleston Children’s Hospital. The core education during the rotation is structured
around this experience with daily didactic teaching rounds followed by teaching rounds at the bedside.
Residents will be supervised in inpatient consultations at each of the other facilities. In addition, there are
busy Emergency Departments at both Egleston and Hughes-Spaulding for which acute neurological
consultative services are provided.
While on the Child Neurology rotation, residents will participate in a minimum of three half-day
general child neurology outpatient clinics each week. Two of the clinics are on the Emory campus, with the
third at Hughes-Spaulding. Each of the resident clinics is staffed by two attending pediatric neurologists to
provide resident supervision but, more importantly, to utilize this fertile environment for the one-on-one
mentoring of the residents in the practice of clinical child neurology. In addition to the assigned clinics,
elective participation in specialized clinics is encouraged. These sub-specialty experiences include epilepsy,
ketogenic diet, neuromuscular, neurogenetics, brain tumor, neurorehabilitation and spasticity clinics.
V.
Educational Objectives/Expectations
Neurology residents will perform their Pediatric Neurology rotation in the second and third years of
their neurology residency. It is anticipated that, at this stage of their training, they will have mastered the
basics of adult general neurology and will be able to take a fluent history and be familiar with the
neurological examination. During the course of their rotation residents will be exposed to patients and their
families in both inpatient and outpatient settings and will refine their understanding of the following topics:
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









The normal pattern and tempo of acquisition of developmental skills in children and patterns of
deviation from normal in pathological conditions
Nuances of the neurological examination unique to preterm and term neonates, infants, and toddlers
Developmental influences on neurodiagnostic investigations
Importance of genetic factors in the evaluation of children with abnormal neurological
development
Pathogenesis of neurogenetic/metabolic degenerative disorders unique to this age group
Management of children with chronic neurological diseases and the impact of those diseases on families
Recognition and management of pediatric neurological emergencies in the Emergency room and
intensive care unit
Refine communication skills with patients, families, and other health care providers in coordinating the
care of complex neurological disorders
Understand social and cultural factors as they influence disease presentation and management strategies
Incorporate bioethical issues into the overall plan for comprehensive care of the patient and their family
VI.
Evaluation
The responsibility for the formal written evaluation of the resident will be assumed by the attending
Neurologist who was the primary inpatient attending during the resident’s rotation. These will be completed
only after consultation with other faculty members who interacted with the resident in outpatient clinic
settings before submission to the Residency Director. Because residents and faculty work closely together
on a daily basis, there is ample opportunity for informal feedback and constructive criticism during the
course of the rotation. For similar reasons, the Attending Neurologist comes to know the strengths and
weaknesses of each of the residents quite thoroughly in the course of their three months on Pediatric
Neurology. These insights are incorporated into a final evaluation prepared by the Division Director after
completion of the three-month rotation. The residents also complete a formal but anonymous evaluation of
their attending at the end of each month.
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ROTATION OBJECTIVES
Outpatient Clinics
Emory University School of Medicine
I.
Introduction
This rotation allows the resident to attend a variety of neurology subspeciality clinics with neurology faculty.
II.
Duration
Duration: ½ month to 1 month
III.
Rotation Faculty
Rotation Director: Dr. Jane Gilmore, the Associate Residency Program Director. All Neurology faculty
members may participate in the rotation. Resident must designate at least one faculty member to compile
faculty feedback in order to write a Resident Evaluation at the end of the rotation.
IV.
Educational Objectives and Expectations:
o The resident is scheduled to attend nine half-days of clinic. One half day will be in their own continuity
clinic at Grady, and the remainder will be in different subspeciality clinics per half day, including Ataxia,
Epilepsy, Movement Disorders (including Huntington’s Disease, Tourettes, Botulinum Toxin, Surgical,
as well as general Movement Disorders), Vestibular, Neuro-ophthalomology, Stroke, Neuromuscular
(including ALS, MDA, Dalton, as well as general Neuromuscular), Sleep, Child Neurology, and
Neurobehavior Clinic.
o The resident is expected to be at all clinics on time and actively see and evaluate patients with the
attending.
o Additional reading or study is at the discretion of the faculty.
o If the resident wishes to do a clinic other than what is assigned in the schedule outlined below, they
MUST submit a revised rotation schedule to the program coordinator one month in advance of the start
date of the rotation. All faculty members will be informed of your anticipated participation in their clinic
in advance of your rotation start date.
VI. Daily Schedule
Monday
Tuesday
Wednesday
AM
Levey Neurobehavior
AM
DeLong –
Movement
Disorders
AM
Continuity Clinic
OR
Henry - Epilepsy
PM
Continuity Clinic
OR
Rye - Sleep
PM
Chimowitz - Stroke
PM
Continuity Clinic
OR
Tusa – Vestibular
Thursday
AM
Greenamyre –
Huntington’s (WW)
OR
Evatt – Mvmt. Dis
PM
Continuity Clinic
OR
Hopkins Neuromuscular
Friday
AM
Grand Rounds &
Resident Lecture
PM
Freeman –
BoTox
OR 1st Wed
ALL DAY- Dalton
with Hopkins &
Sladky - MDA
Each ½ day is assigned as above, except Friday morning for Grand Rounds and other conferences.
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IV.
Rotation Environment
The clinics will take place at The Emory Clinic, Wesley Woods, and The Center for Rehabilitation Medicine,
and Grady Hospital.
VIII. Reading List
Required and Suggested Reading assigned at the discretion of the individual faculty.
VII. Evaluation
Each resident will select one or two faculty to write Resident Evaluations at the end of the rotation. Any
additional faculty may fill out evaluations as they see fit. The resident is expected to submit an Attending
Evaluation to the Program Coordinator on their faculty evaluator(s).
Faculty evaluator(s) must be designated by the resident:
Evaluator(s): ________________________________ _________________________________
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Emory University
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ROTATION OBJECTIVES
Atlanta VA Hospital Rotation
Emory University School of Medicine
I.
Introduction
This document provides guidelines for neurology residency training at the Atlanta VA Hospital. The
scope of activities for the resident at the VAH includes neurological consultation services for inpatients and out-patients, including consultations in the Emergency Department.
II.
Duration
The neurology resident will typically spend one month or four weeks on this rotation.
III.
Rotation Director
George Wilmot, M.D., Ph.D., Assistant Professor of Neurology
IV.
Rotation Environment
The rotation will take place at the Atlanta VAH, located on Clairmont Road. This location is
approximately three miles from the Emory medical center complex. The VAH is a busy facility
treating veterans from the Atlanta metropolitan area as well as throughout Georgia. Patients are
referred to the Atlanta VAH for sub-specialty care, including neurological care, from other VA
facilities. CT and MR imaging is available at the Atlanta VAH.
V.
Educational Objectives and Expectations
The resident will be expected to:
 Provide expert neurology consultation services to in-patients and out-patients at the Atlanta
VAH. There should be appropriate follow-up of these patients.
 Provide responsive consultation advice to physicians at the Atlanta VAH, as well as other
VAH physicians contacting the neurology service.
 Present the patients evaluated to an attending neurologist in a manner dictated by the urgency
of the neurological problem. Consult urgently with an attending neurologist if there are
critical issues regarding optimal patient care.
 Be available for clinic sessions in a timely fashion and provide consultation to the in-patient
service and Emergency Department in a responsive manner, appropriate to generally accepted
standards of care.
 Be familiar with the level of scientific evidence guiding patient management decisions.
 Be familiar with the scientific basis of neurobiology that is appropriate for providing expert
neurological care.
 Be a teaching resource for health professionals at the Atlanta VAH.
VI.
Evaluation
The neurology attending physicians will provide feedback to the neurology resident on an on-going
basis. In addition, a formal evaluation, which goes into the resident’s master file, will be filled out at
the completion of the rotation by those attendings spending time with the resident. Feedback from the
resident to the Rotation Director will be encouraged, and formal evaluation by the resident of the
Atlanta VAH rotation will occur at the completion of the rotation.
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ROTATION OBJECTIVES
Neuropathology
Emory University School of Medicine
I.
Introduction
The goal of the neuropathology rotation is to provide residents with basic factual information and
experience in neuropathology necessary to begin a successful career in academic or community neurology,
with particular attention to covering the broad spectrum of disorders encountered on Neurology Board
Examinations.
II.
Duration
Each neurology resident will spend two months on the rotation during their second or third year of
neurology training.
III.
Rotation Director and Faculty
The neurology resident works with several different board certified neuropathologists, research
scientists, and fellows, including the following:
Stephen Hunter, M.D., Assistant Professor and Director of Neuropathology
Bruce Wainer, M.D., Ph.D., Professor of Pathology and Neurology
Daniel Brat, M.D., Assistant Professor of Pathology
Jonathan D. Glass, M.D., Professor of Neurology and Pathology (Nerve and Muscle)
John T. Sladky, M.D., Professor of Pediatrics and Neurology (Nerve and Muscle)
IV.
Rotation Environment
The rotation takes place at Emory University Hospital, where the resident will also have access to
relevant specimens from other hospitals in the Emory system. Nerve and muscle pathology is done in the
Neuromuscular Laboratory, WMB 6th floor.
V.
Educational Objectives
 Become familiar with the basic principles and diagnostic criteria involved in the interpretation and
reporting or pathology specimens from the brain and spinal cord. These specimens will include surgical
frozen sections, permanent sections and cytology preparations.
 Become familiar with the technique of brain cutting and the salient features of brain and spinal cord
diseases encountered at autopsy. The resident will understand basic pathophysiologic mechanisms
involved in degenerative, vascular, infectious, demyelinating, neoplastic, and metabolic diseases of the
nervous system.
 Become familiar with the basic principles involved in the interpretation of nerve and muscle biopsy
specimens.
 Initiate the acquisition of an updated knowledge base in the emerging field of molecular pathobiology.
 In addition to the learning experiences provided through brain cutting, surgical and autopsy sections, the
resident will also have access to teaching slides and self-study questions for review during the rotation.
VI.
Expectations
The resident is expected to participate in sign-out rounds as well as the review of frozen sections
when scheduled. The resident is also expected to attend Neuroradiology/Neuropathology Conference, where
correlative radiographic and pathologic cases are presented in the context of the patient’s clinical
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presentation and findings. Weekly sign-outs of Nerve and Muscle specimens with the Neuromuscular
Pathology faculty.
VII.
Evaluation
A written evaluation will be submitted to the Program Director’s office at the conclusion of the
rotation. Because of the close day-to-day contact between the residents and the neuropathologists, informal
feedback is given throughout the rotation.
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ROTATION OBJECTIVES
Sleep/Epilepsy Neurophysiology Elective
Emory University School of Medicine
I.
Introduction
This is an elective rotation that provides residents with practical knowledge and experience using
neurophysiologic tests to assess consciousness, and diagnose sleep and epilepsy-related disorders.
Residents will become familiar with the technical aspects of polysomnography (PSG), multiple sleep
latency tests (MSLT), actigraphy, intra-operative monitoring (IOM) and electroencephalography
(EEG), as well as the interpretation and clinical application of the findings. Residents will have an
opportunity to interview, examine and manage patients with various sleep disorders including
narcolepsy, restless legs syndrome, sleep disordered breathing, REM behavior disorder (RBD) and
pediatric sleep disorders. Residents will review a variety of EEG studies including routine inpatient
and outpatient recordings, ambulatory EEG, continuous ICU EEG monitoring and ictal recordings
obtained in the epilepsy monitoring unit. A fundamental knowledge of the neuroanatomical and
neurophysiological systems involved in consciousness, epileptigenesis, sleep homeostasis, sleep
disorders and circadian rhythm generation will be obtained through weekly research and clinical
conferences, as well as attending and fellow supervision during diagnostic testing.
II.
Duration
4 weeks
III.
Rotation Faculty
Rotation Directors:
Suzette LaRoche, M.D., Assistant Professor of Neurology (Epilepsy)*
Jeffrey S. Durmer, M.D., Ph.D., Assistant Professor of Neurology (Sleep)*
Epilepsy Faculty:
Page B. Pennell, M.D., Associate Professor of Neurology*
Charles M. Epstein, M.D., Professor of Neurology*
Sandra Helmers, M.D., Associate Professor of Neurology*
Thomas R. Henry, M.D., Professor of Neurology*
Philip J. Holt, M.D., Assistant Professor of Neurology and Pediatrics*
Archana Koganti, M.D., Assistant Professor of Neurology*
Larry D. Olson, M.D., Assistant Professor of Neurology and Pediatrics
Sleep Faculty:
David B. Rye, M.D., Ph.D., Associate Professor of Neurology*
Donald L. Bliwise, Ph.D., Professor of Neurology
Kathy P. Parker, Ph.D., R.N., Professor of Nursing
Gary Freed, DO, Professor of Pediatrics
Michael Decker, R.N., PhD, Assistant Professor of Neurology
Glenda Keating, Ph.D., Instructor of Neurology
*These faculty members are board certified by the American Board of Psychiatry & Neurology in adult or
pediatric neurology, and are board certified or eligible in Clinical Neurophysiology, or are Diplomates of
the American Board of Sleep Medicine.
IV.
Educational Expectations:
 The resident is scheduled to attend three half-days of sleep clinic. Two half days will be in the adult
sleep clinic, and the remainder will be in pediatric and adolescent sleep clinic.
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 The resident is expected to be at all clinics on time and actively see and evaluate sleep medicine
patients with fellows and attendings.
 The resident is responsible for interpretation and preparation of reports for at least 25 routine
inpatient and/or outpatient EEG studies, and run one routine EEG, including electrode application.
 The resident is responsible for interpretation and preparation of reports for at least 20 outpatient PSG
studies and MSLT studies, and run one routine PSG and/or MSLT, including set-up.
 The resident is responsible for interpretation of 5 actigraphy studies.
 The resident is responsible for attending and interpreting 4 IOM studies.
V. Educational Objectives:
 Be able to obtain a comprehensive history of sleep and wake symptoms in children and adults, and
develop an appropriate differential diagnosis and rudimentary treatment plan for intrinsic and
extrinsic disorders of sleep and wake.
 Describe the physiological basis of scalp EEG generation, and all steps in the acquisition of routine
EEG.
 Describe the physiological basis of EEG, surface electromyography (EMG), electro-oculography
(EOG), breathing patterns, sleep stage generation and all steps in the acquisition of routine PSG.
 Describe and recognize normal and abnormal findings on routine IOM.
 Describe and recognize normal features of waking and sleeping PSG/EEG activity in infants,
children, adults and elderly.
 Describe and recognize pathological PSG/MSLT/EEG features including sleep related breathing
disorders, periodic limb movements, narcolepsy, RBD, focal and generalized interictal epileptiform
activity, focal and diffuse background slowing and periodic EEG patterns.
 Recognize common PSG/EEG artifacts and benign variants.
 Recognize common EEG/PSG patterns seen in depressed, comatose and severely encephalopathic
patients and describe their clinical significance.
 Recognize electrographic presentations of status epilepticus.
 Understand the application of actigraphy to circadian rhythm disorders and nocturnal movement
disorders.
 Understand the basis and application of behavioral sleep medicine techniques.
VI.
Daily Schedule:
Monday
AM
Adult Sleep
Clinic (Durmer)
PM
Adult Sleep
Clinic (Rye,
Parker, Bliwise)
IV.
Tuesday
AM
Peds.&Adol.
Sleep Clinic
(Durmer)
Wednesday
9-11 AM
PSG/MSLT
Teaching,
Research &
Case Present.
PM
PSG/EEG
interpretation
PM
PSG/EEG
interpretation
Rotation Environment
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Thursday
AM
IOM (Epstein)
12:30
EEG Teaching,
Research &
Case Present.
PM
EEG/PSG
interpretation
Friday
9-10:30 AM
Epilepsy Surg.
Conference
10:30
Grand Rounds
PM
EEG/PSG
interpretation
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
The primary sites of the rotation are the Emory University Hospital, the Emory Clinic and the
Egleston Children’s Hospital of Children’s Healthcare of Atlanta. PSG and MSLT recordings in
adults are performed in the Emory University Sleep Laboratory using stationary digital equipment as
well as ambulatory equipment for hospital-based consultations. Similar studies with pediatric patients
are performed in the Egleston Sleep Laboratory using stationary and portable digital systems. EEG
recordings in adults are performed in the Emory University EEG Laboratory using stationary systems
and portable digital systems for IOM. These procedures are interpreted in reading rooms associated
with each laboratory, and may be accessed remotely. Actigraphy-based studies are performed in
patient homes’ using ambulatory units which are returned to the Emory Sleep Laboratory for
interpretation. Residents have available a wide range of basic and clinical literature and textbook
collections for reference within the epilepsy and sleep medicine administrative and faculty offices. In
addition, residents have access to the extensive collection of texts and journals of the Emory
University School of Medicine Biomedical Library.
VIII. Reading Lists
Primary EEG Reading:
Fisch B. Spehlmann’s Primer of EEG.
Leppik IE. Contemporary Diagnosis and Management of the Patient with Epilepsy, 3rd Ed. Newtown, PA:
Handbooks in healthcare. 1997.
More EEG Reading:
Daley DD & Pedley TA (Eds.). Current Practice of Clinical Electroencephalography, 2nd Ed. New York:
Raven Press, 1990.
Wyllie E (Ed.). The Treatment of Epilepsy: Principles and Practice, 2nd Ed. Philadelphia: Lippincott
Williams & Wilkins, 2001.
More EEG/Evoked Potentials Resources:
Engel J Jr, Pedley TA (Eds.), Epilepsy: A Comprehensive Textbook Philadelphia: Lippincott-Raven
Publishers, 1998.
Lüders HO (Ed.) Epilepsy Surgery Philadelphia: Lippincott Williams & Wilkins, 1992.
Niedermeyer E, Lopes da Silva F (Eds.). Electroencephalography: Basic Principles, Clinical Applications,
and Related Fields, 3rd Ed., Baltimore: Williams & Wilkins, 1993.
Nuwer MR, Evoked Potential Monitoring in the Operating Room. Raven Press: NY, 1987.
Sleep/PSG Reading (selected sections of texts and atlases available):
Aldrich MS, Sleep Medicine. Oxford University Press, 1999.
Kryger M, Roth T, Dement W (Eds.), Principles and Practice of Sleep Medicine, 4th Ed.,
Elsevier/Saunders, 2005.
Rechtschaffen A & Kales A, A Manual of Standardized Terminology, Techniques and Scoring
System for Sleep Stages of Human Subjects.
Pressman MR, Primer of Polysomnogram Interpretation. Philadelphia: Butterworth-Heinemann
Publishing, 2002.
Sheldon S, Riter S, Detrojan M (Eds.), Atlas of Sleep Medicine in Infants and Children. Futura
Publishing, 1999.
More Sleep/PSG Reading:
Avidon AY and Roos KL (Eds.), Seminars in Neurology: Introduction to Sleep and Its
Disorders; 24(3): September, 2004.
Avidon AY and Roos KL (Eds.), Seminars in Neurology: Sleep in Neurological Practice; 25(1):
March, 2005.
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Chokoverty S (Ed.), SleepDisorders Medicine: Basic Science, Technical Considerations and
Clinical Aspects, 2nd Ed., Philadelphia: Butterworth-Heinemann Publishers, 1999.
Chokroverty S, Hening WA, Walters AS (Eds.), Sleep and Movement Disorders. Philadelphia:
Butterworth-Heinemann Publishing, 2002.
Espana RA & Scammell TE, Sleep Neurobiology for the Clinician, SLEEP, 2004; 27(4):811820.
Hauri P & Linde S, No More Sleepless Nights, 2nd Ed. Philadelphia: Wiley Press, 1996.
Mindell JA, Sleeping Through the Night, Philadelphia: Harper Collins Publishers, 1997.
VII. Evaluation
Residents will be required to keep a log book of EEG, PSG, MSLT, actigraphy and IOM cases observed and
interpreted during the month. The log book should include all pertinent clinical data and neurophysiologic
findings for each case. The log book will be collected at the end of the rotation and used along with sleep and
epilepsy faculty assessment to determine the resident’s level of sophistication with these neurophysiologic
tests. Weekly sleep clinics and PSG & EEG conferences (Wed. and Thurs.) will be used primarily as
educational sessions, but will also serve as a venue for residents to demonstrate their fund of clinical and
neuro-scientific knowledge on specific topics. Residents are required to present cases or technical topics that
demonstrate interesting clinical or research issues at the sleep and epilepsy conferences.
_________________________
Signature of Resident
________________________
Signature of Faculty
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ROTATION OBJECTIVES
General Neurophysiology
Emory University Hospital Neurology Elective
Emory University School of Medicine
I.
Description:
This is an elective rotation that provides residents with practical knowledge and experience using
neurophysiologic tests to assess epilepsy-related disorders and neuromuscular disease. This elective is meant
to build on the resident’s basic experience gained during the neuromuscular and epilepsy rotations. The
resident will acquire experience with the technical aspects of performing nerve conduction studies,
electromyography, and electroencephalography as well as the interpretation of the data, report generation and
clinical application of the findings. The resident will acquire this knowledge through time spent in the
neurophysiology laboratory, attendance at conferences, and the performance and review of these studies with
the neurophysiology attending.
II.
Rotation Advisor and Faculty:
Rotation Advisor: Jaffar Khan, M.D.
Residents may also work with the following faculty members: Michael Frankel, M.D., Archana Koganti,
M.D., Jonathan Glass, M.D. Michael Benatar, M.D. Ph.D.
III.
Rotation Environment:
The primary site of the rotation is Grady Memorial Hospital, with ancillary lab experience and conferences at
Emory University Hospital and Clinics.
IV.
Educational Objectives:
 Describe the physiological basis of scalp EEG generation and all steps in the acquisition of routine EEG.
 Describe and recognize normal features of waking and sleeping EEG activity in adults and elderly.
 Recognize common EEG artifacts and benign variants.
 Recognize common EEG patterns seen in depressed, comatose and severely encephalopathic patients and
describe their clinical significance.
 Recognize electrographic presentations of status epilepticus.
 Describe applications of and interpret basic diagnostic video-EEG monitoring in evaluation of refractory
seizures.
 Develop an appropriate differential diagnosis of neuromuscular disease based upon the clinical and
electrophysiological data.
 Distinguish the electrophysiological characteristics of myopathy from neuropathy.
 Distinguish the electrophysiological characteristics of demyelinating neuropathy from axonal
neuropathy.

 Be able to perform the common motor and sensory nerve conductions studies of the upper and lower
extremities.
 Identify and apply the clinical significance of the waveforms analyzed during the needle examination.
 Become aware of the common technical fallacies and pitfalls of nerve conduction studies.
Educational Expectations

The resident will be expected to independently perform EMG/NCS with supervison during the
rotation.
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



The resident will be expected to independently interpret and generate reports on EEGs during the
rotation. All reports will be reviewed by the attending and discussed with the resident.
The resident will be expected to independently interpret and create reports on EMG/NCS during the
rotation. All reports will be reviewed by the attending and discussed with the resident.
The resident will be expected to attend the Grady and Emory Neurophysiology conferences and
Emory Neuromuscular conference.
The resident will be expected to give one 30 minute conference for the Grady Neurophysiology
conference.
VI. Daily Schedule
Monday
AM
-Perform/review
EEG/EMG
studies
Tuesday
AM
8 AM – Emory
neurophysiology
conference
Seizure Clinic
(per schedule)
-Perform/review
EEG/EMG
studies
PM
12:15-1 PMGrady
neurophysiology
conference
PM
-Perform/review
EEG/EMG
studies
-Perform/review
EEG/EMG
4 PM –
???Neuromuscul
ar Rounds
Wednesday
AM
-Perform/review
EEG/EMG
studies
Thursday
AM
-Perform/review
EEG/EMG
studies
Friday
AM
Grand Rounds
Resident
Lectures
Independent
Reading
PM
-Perform/review
EEG/EMG
studies
PM
PM
-Perform/review
EEG/EMG
studies
Perform/review
EEG/EMG
studies
5:30-6:30 PM –
Combined
NR/Neuro/NS/
NP conference
VII. Reading List
Required Reading:
1) Preston DC, Shapiro BE. Electromyography and Neuromuscular Disorders.
2) Perotto. Anatomic Guide for the Electromyographer.
3) Fisch B. Spehlmann’s Primer of EEG.
4) Leppik IE. Contemporary Diagnosis and Management of the Patient with Epilepsy, 3rd Edition.
5) Daley DD and Pedley TA. Current Practice of Clinical Electroencephalography.
6) Wyllie E. The Treatment of Epilepsy: Principles and Practice, 2nd Edition.
Recommended Reading: (both located in the Health Sciences Library)
6) Griggs RC. Evaluation and Treatment of Myopathies.
7) Mendell JR, Kissel JT, and Cornblath DR. Diagnosis and Management of Peripheral Nerve Disorder.
8) Stewart JD. Focal Peripheral Neuropathies.
9) Dyck P. Peripheral Neuropathy.
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10) Engel AG. Myology: Basic and Clinical
11) Katirji, B. Neuromuscular Disorders in Clinical Practice.
12) Engel J, Pedley TA. Epilepsy: A Comprehensive Textbook.
13) Niedermeyer E, Lopes da Silva F. Electroencephalography: Basic Principles, Clinical Applications,
and Related Fields.
VIII. Evaluation
The resident will be evaluated by Dr. Jaffar Khan and/or Dr. Archana Koganti.
Signatures:
____________________________________
Resident
date
_____________________________________
Rotation Advisor
date
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Emory University
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ROTATION OBJECTIVES
Dizziness and Balance Clinic
Emory University School of Medicine
I.
Introduction
Patients with complaints of dizziness and/or disequilibrium are seen at the Dizziness and Balance
clinic. Residents will become familiar with aspects of history taking, physical examination,
diagnostic evaluation, and treatment of benign paroxysmal positional vertigo, migraine-associated
dizziness, vestibular neuritis, Meniere’s disease, psychogenic dizziness, and non-vestibular gait
imbalance.
II.
Duration
2 weeks (daily)
4 weeks (could add 2nd elective)
III.
Rotation Faculty
Dr. Ronald Tusa, Professor, and Dr. Sharon Hartman, Assistant Professor, Dizziness and Balance
Center, Department of Neurology.
IV.
Educational Objectives and Expectations:
o The resident is scheduled to attend six half-days of clinic. One half day will be in their own
continuity clinic at Grady, and the remainder will be in clinic.
o The resident is expected to be at all clinics on time and actively see and evaluate patients with the
attending.
VI.
Daily Schedule
Monday
Tuesday
AM
Hartman - Clinic
AM
Vestibular Testing,
PT observation,
review PowerPoint
PM
Tusa – Clinic
PM
Hartman - Clinic
Wednesday
AM
Hartman - clinic
PM
Tusa – Clinic
Thursday
Friday
AM
Vestibular Testing,
PT observation,
review PowerPoint
AM
8:30-9:30
Vestibular case
conference; Grand
Rounds & Resident
Lecture
PM
Tusa – Clinic
PM
Vestibular Testing,
PT observation,
review PowerPoint
IV.
Rotation Environment
The clinics will take place at The Center for Rehabilitation Medicine, 2nd floor.
VIII. Reading List
Required reading “Practical Management of the Dizzy Patient” by Joel A. Goebel
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VII.
Evaluation
There will be both a video and a written test on the last day of the rotation. Dr. Tusa or Hartman will
go over the test with the resident for addition learning experience. The resident is expected to submit
an Attending Evaluation to the Program Coordinator and a D&B evaluation form to Dr. Tusa or
Hartman.
_________________________
Signature of Resident
________________________
Signature of Faculty
__________________
Dates of rotation
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ROTATION OBJECTIVES
General Neurology
Emory University Hospital Neurology Elective
Emory University School of Medicine
I.
Description
This is an elective rotation that provides residents with experience in evaluating and managing general
neurology patients. The resident will be exposed to patients with a variety of neurologic disorders,
including, but not limited to, demyelinating disease, CNS neoplasms, headache, neuromuscular disorders,
epilepsy-related disorders, and progressive degenerative neurologic disease including movement disorders
and dementias. The resident will gain this experience through clinics, electromyography
(EMG)/electroencephalography (EEG) lab, and conferences.
II.
Rotation Advisor and Faculty
Rotation Advisor: Gregory Esper, M.D.
Residents may also work with the following faculty members: Patricia Behlmer, M.D.
III.
Rotation Environment
The primary site of the rotation is The Emory Clinic, with ancillary experiences taking place at Emory
University Hospital and Grady Memorial Hospital.
IV.
-
Educational Objectives
Evaluate, diagnose and manage patients with demyelinating disease.
Evaluate, diagnose and manage patients with CNS neoplasms.
Evaluate, diagnose and manage patients with headaches.
Evaluate, diagnose and manage patients with neuromuscular disorders.
Evaluate, diagnose and manage patients with neurologic pain syndromes.
Evaluate, diagnose and manage patients with epilepsy-related disorders.
Evaluate, diagnose and manage patients with progressive degenerative neurologic disease, including
movement disorders and dementias.
Educational Expectations
- The resident is expected to attend all clinics with the aforementioned attendings.
- The resident is expected to independently interpret EEGs and EMG/ nerve conduction studies (NCS)
and create reports. All reports will be reviewed by the attending and discussed with the resident.
- The resident is expected to independently perform lumbar puncture procedures, injections for
headaches, and injections for carpal tunnel syndrome. The attending will be available for all
procedures performed.
- The resident will be expected to attend the Emory Neurophysiology, Combined, and Epilepsy
conferences.
- The resident may be expected to attend Grady seizure clinic during the rotation.
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VI. Daily Schedule
Monday
AM
Clinic –
Behlmer/Esper
Seizure Clinic
(Grady) – per
schedule
Tuesday
AM
8 AM – Emory
neurophysiology
conference
EMG/NCSEsper
Wednesday
AM
Independent
Reading
Thursday
AM
Clinic-Esper
LP clinic
(per schedule)
Friday
AM
Grand Rounds
Resident
Lectures
Independent
Reading
LP clinic
PM
ClinicBehlmer/Esper
PM
ClinicBehlmer/Esper
EEGs-Esper
EEGs-Esper
PM
Clinic-Esper
EEGs-Esper
5:30-6:30 PM –
Combined
NR/Neuro/NS/
NP conference
(per schedule)
PM
12:30-1 PMEmory Epilepsy
Conference
Clinic-Esper
EEGs-Esper
PM
Independent
Reading
LP clinic
(per schedule)
VII. Reading List
1) Olanow, CW, Watts, RL, Koller, WC. “An algorithm (decision tree) for
management of Parkinson’s disease (2001): Treatment Guidelines.” Neurology 56(11),
Supplement 5. 12 June 2001, pp. S1-S88.
2) To be determined.
VIII. Evaluation
The resident will be evaluated by Drs. Gregory Esper and Patricia Behlmer..
Signatures:
___________________________
Resident
date
____________________________________
Rotation Advisor
date
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ROTATION DESCRIPTION
Movement Disorder
Emory University School of Medicine
I. Introduction
This rotation will provide basic knowledge and clinical experience in movement disorders to Neurology residents.
Similar to the treatment of patients with movement disorders, the schedule is centered on outpatient exposure. The
resident will also have the opportunity to observe intra-operative monitoring of patients undergoing neurosurgical
procedures for the treatment of movement disorders, and may also observe (and participate in) clinical research. The
various clinical settings provide a rich variety of experiences with patients with movement disorders.
II. Duration
This is an elective rotation. Neurology resident are expected to spend at least one month on this rotation.
III. Clinical Faculty
Stewart Factor, D.O. (director), Garrett Alexander, M.D., Ph.D., Mahlon DeLong, M.D., Marian Evatt, M.D., Alan
Freeman, M.D., James Greene, M.D., Ph.D., Robert Gross, M.D., Ph.D. (primary appointment in Neurosurgery), Jorge
Juncos, M.D., Claudia Testa, M.D., Ph.D., Thomas Wichmann, M.D., George Wilmot, M.D., Ph.D.
IV. Clinical Fellow
Christine Doss, M.D.
V. Environment
Patients are seen at the Wesley Woods Health Center. Although excellent text books are available for study, the
residents will gain most of their experience with movement disorders by seeing patients with these diseases.
In addition to the exposure to clinical problems that arise in the care of movement disorder patients, the resident is
encouraged to get also acquainted with a number of specific procedures/interventions during this rotation:
1. Functional neurosurgery sessions, done to alleviate the symptoms of movement disorders. Electrophysiologic
recording, done routinely to help surgical targeting offers a unique opportunity to directly experience some of
the neuronal abnormalities that underlie these disorders.
2. Data collection/patient evaluation procedures in clinical trials
3. Toxin (Botox, Myobloc, Dynaport) injections in the treatment of dystonia
4. Genetic counseling as part of the care for patients with Huntington’s disease
VI. Objectives
Upon successful completion of this rotation, the resident will be able to:
1. Obtain a comprehensive history in patients with movement disorders, as well as their family members. In most
cases this also requires to obtain a comprehensive general history to evaluate the patient for conditions associated
with their movement disorder.
2. To perform a competent examination that focuses on specific aspects of movement disorders.
3. Develop the ability to differentiate movement disorders from other clinical entities, and develop an appropriate
differential diagnosis within the field of movement disorders.
4. Quantify the symptoms of the more common movement disorders by applying rating scales such as the United
Parkinson Disease Rating Scale (UPDRS), or the Burke-Marsden-Fahn dystonia rating scale.
5. Develop an appropriate plan for diagnostic workup, including general and specific laboratory results, genetic
testing (as needed), and medication trials as indicated by the history and physical examination findings.
6. Choose appropriate pharmacologic or physical therapy for the initial treatment of the disorder in question, and
counsel the patient on prognostic issues, the need for follow-up, and issues related to their specific social situation.
7. Develop long-term pharmacologic strategies in the treatment of patients with movement disorders, aimed at
reducing drug side effects, while maintaining adequate mobility.
8. Recognize and treat medication side effects as they arise.
Page 45 of 76
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Emory University
_____________________________________________________________________________________
VII. Current clinic schedule
AM
PM
Monday
Evatt (Botox)
Freeman
Ataxia clinic (Wilmot, clinic A)
Functional Neurosurgery
Factor
Freeman
Tuesday
DeLong
Factor
Freeman
DeLong
Freeman
Wednesday
Alexander
Freeman (1st and 3rd Wednesday)
Juncos
Functional Neurosurgery
Alexander
Freeman (2nd and 4th Wednesday)
Juncos
Thursday
Factor (Botox)
Testa (1st and 3rd Thursday)
Huntington’s disease clinic (Testa & Greene,
2nd and 4th Thursday)
Freeman (1st and 3rd Thursday)
Wichmann
Friday
[Grand rounds/Resident lecture]
Botox clinic (Evatt every Friday, Greene 1st, 3rd, and 5th Friday,
Freeman 2nd and 4th Wednesday)
Juncos (Tourette/pediatric)
Notes:
1. The clinic schedule may change – resident needs to verify with attendings current clinic time.
2. Prior to starting the rotation, the month=s schedule needs to be confirmed with the respective clinic attendings.
The interaction between residents and attendings should occur several months in advance to the actual rotation
so that clinic patients can be booked appropriately.
3. In general, the resident should attend her/his regular Grady continuity clinic. However, the resident should not
miss the opportunity to attend at least one surgical session, one session of the Huntington=s disease clinic, and
one Botox clinic. This may necessitate rescheduling or swapping the resident=s Grady clinic.
4. The resident is expected to attend the section’s monthly video discussion sessions. The resident should contact
the movement disorder fellow for date, time and location of this meeting.
5. Surgeries generally start around 9:30 AM. The resident is responsible to check for exact dates of surgeries
(call Jim Stanton at 404-712-8485).
VIII. Evaluation
The resident is evaluated by each faculty member at the end of the rotation based on his or her ability to achieve the
above described expectations. To help in this process, the resident is expected to keep a log of the cases seen in the
clinic. Feedback is given frequently by the supervising faculty. A written evaluation is submitted to the residency
program director at the conclusion of the rotation.
IX. Suggested Reading
Watts, RL and Koller WC, eds. Movement Disorders, 2nd edition. New York, McGraw-Hill 2004.
Page 46 of 76
NEUROLOGY RESIDENT HANDBOOK
Emory University
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ROTATION OBJECTIVES
Neuro-oncology
Emory University Hospital Neurology Elective
Emory University School of Medicine
I.
Description: This rotation is designed to give the neurology resident an introductory review of
common CNS malignancies. The resident should expect to gain knowledge of epidemiology, clinical
presentation, diagnosis/pathology, treatment (including adverse effects), and prognosis of common
malignancies.
II.
Rotation Advisor and Faculty:
Rotation Advisor: _____Dr. Anna Janss, Dr. Phuphanich______
Resident may also work with the following faculty members:
Dr Jeffrey Olson, Dr Nelson Oyesiku, Dr Ian Crocker, Dr Hui-kuo Shu, Dr Daniel Brat, Dr Steve Hunter, Dr
Charlie Hao, Dr Chad Holder and Dr Erwin VanMeir
III.
Rotation Environment:
The rotation will take place within the Neuro-Oncology Clinics at Winship Cancer Institute, as well as the
Aflac Cancer and Blood Disorders Clinic of Children’s Healthcare of Atlanta at Egleston. While most time
will be dedicated to outpatient clinics, inpatient consults can also be incorperated into the resident’s
experience.
IV.
Educational Objectives/Expectations:
 The residents will be able to recognize histological and neuroimaging features of common adult/pediatric
neoplasms
 Residents should become involved in workup of newly diagnosed CNS malignancies, understand the
initial evaluation and therapy of tumors as well as be familiar with ongoing workup/management of
established patients.
 Residents are expected to achieve basic understanding of treatment options/modalities for common
adult/pediatric neoplasms
 Residents should learn classification schemes and prognostic indicators for common malignancies
 Residents should learn systemic complication of cancer and treatment ie. Spinal cord complication,
meningeal carcinomatosis , peripheral neuropathy, leukoencephalopathy and paraneoplastic syndrome
V. Daily Schedule
Note: Residents that have continuity clinic on Thursdays are expected to arrange a change of clinic
to Mon or Wed during their neuro-onc rotation. This is to allow the resident to attend the Pediatric
Brain Tumor Survivor Clinic at AFLAC-Egleston.
Monday
AM
8am-2pm On
treatment clinic
Egleston (janss)
Tuesday
AM/PM
8:30-5:00
Established pt
clinic 2nd floor
Winship Cancer
Institute
Hall-E
Wednesday
AM
Time for reading
or review of
path slides and
work with
neuroPage 47 of 76
Thursday
AM
8am-12:30pm
On treatment
clinic (2nd/4th th)
(Janss)
8:30-5 Brain
Tumor clinic at
Friday
AM
Grand Rounds
Resident
Lectures
Independent
Reading
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
pathologist
PM
Reading of
recommended
articles/ review
of slide sets
or review
pathology slides
with
neuropathologist
in preparation
for Tumor
Board
Emory Brain
Tumor Conf –
12:30-2:00 PM
WCI C-3018
Optional:
Survivor Clinic
at Scottish Rite
Children’s
Hosp.
Egleston Neuro
onc Tumor
Board B-52
12:30 (2nd Wed)
PM Procedure
Lumbar
Puncture and
Intrathecal
chemotherapy
Winship
(Phuphanich)
Egleston Brain
Tumor Conf
12:30-1:30 (1st,
3rd, 5th in 6th
floor conf, B-52
2nd, 4th)
PM
2-6pm
Comp.Brain
Tumor Clinic
(1st, 3rd, 5th Th)
1-4pm Janss
2nd/4th
PM
Article/slide set
review
VI. Reading List
Required Reading: (see attached pdf file or Neuro-Onc folder on Yahoo website)
14) __________________________________________________________________
15) __________________________________________________________________
16) __________________________________________________________________
Recommended Reading:
17) Neurologic complications of Cancer
By Jerome Posner Contemporary Neurology Series #45 (F.A. DAVIS)
18) Pathology & Genetics Tumor of the nervous System by Paul Kleihues $& Webster Cavenee (WHO)
19) Cancer Neurology in Clinical practice by David Schiff & Patrick Wen (HUMANA PRESS)
VII.
Evaluation
The resident will be evaluated by ______________________________________
Signatures:
____________________________________
Resident
date
_____________________________________
Rotation Advisor
date
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NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
ROTATION OBJECTIVES
Outpatient Clinics
Emory University School of Medicine
I.
Introduction
This rotation allows the resident to attend a variety of neurology subspeciality clinics with neurology faculty.
II.
Duration
Duration: ½ month to 1 month
III.
Rotation Faculty
Rotation Director: Dr. Jane Gilmore, the Associate Residency Program Director. All Neurology faculty
members may participate in the rotation. Resident must designate at least one faculty member to compile
faculty feedback in order to write a Resident Evaluation at the end of the rotation.
IV.
Educational Objectives and Expectations:
o The resident is scheduled to attend nine half-days of clinic. One half day will be in their own continuity
clinic at Grady, and the remainder will be in different subspeciality clinics per half day, including Ataxia,
Epilepsy, Movement Disorders (including Huntington’s Disease, Tourettes, Botulinum Toxin, Surgical,
as well as general Movement Disorders), Vestibular, Neuro-ophthalomology, Stroke, Neuromuscular
(including ALS, MDA, Dalton, as well as general Neuromuscular), Sleep, Child Neurology, and
Neurobehavior Clinic.
o The resident is expected to be at all clinics on time and actively see and evaluate patients with the
attending.
o Additional reading or study is at the discretion of the faculty.
o If the resident wishes to do a clinic other than what is assigned in the schedule outlined below, they
MUST submit a revised rotation schedule to the program coordinator one month in advance of the start
date of the rotation. All faculty members will be informed of your anticipated participation in their clinic
in advance of your rotation start date.
VI. Daily Schedule
Monday
Tuesday
Wednesday
AM
Levey Neurobehavior
AM
DeLong –
Movement
Disorders
AM
Continuity Clinic
OR
Henry - Epilepsy
PM
Continuity Clinic
OR
Rye - Sleep
PM
Chimowitz - Stroke
PM
Continuity Clinic
OR
Tusa – Vestibular
Thursday
AM
Greenamyre –
Huntington’s (WW)
OR
Evatt – Mvmt. Dis
PM
Continuity Clinic
OR
Hopkins Neuromuscular
Friday
AM
Grand Rounds &
Resident Lecture
PM
Freeman –
BoTox
OR 1st Wed
ALL DAY- Dalton
with Hopkins &
Sladky - MDA
Each ½ day is assigned as above, except Friday morning for Grand Rounds and other conferences.
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Emory University
_____________________________________________________________________________________
IV.
Rotation Environment
The clinics will take place at The Emory Clinic, Wesley Woods, and The Center for Rehabilitation Medicine,
and Grady Hospital.
VIII. Reading List
Required and Suggested Reading assigned at the discretion of the individual faculty.
VII. Evaluation
Each resident will select one or two faculty to write Resident Evaluations at the end of the rotation. Any
additional faculty may fill out evaluations as they see fit. The resident is expected to submit an Attending
Evaluation to the Program Coordinator on their faculty evaluator(s).
Faculty evaluator(s) must be designated by the resident:
Evaluator(s): ________________________________ _________________________________
September, 2003
Page 50 of 76
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
OTHER ELECTIVES
Residents may design electives to address specific interests. The Rotation Objectives are to be defined with
the supervising faculty and approved by the program director. This following form is to be submitted to the
Education Program Office no less than one month prior to the start of an elective rotation.
Residents must:
1.) Decide how they would like to spend their elective time
2.) Designate a faculty member to be their primary elective advisor
3.) Meet with the designated elective advisor to discuss elective objectives, environment, daily schedule,
and reading list, etc.
4.) Submit completed and signed form to Program Coordinator no less than one month prior to the start
date of the elective.
5.) Program Coordinator will contact faculty members to alert them as to the resident’s plan to attend
their clinics, etc. so that the faculty members may plan their patient load accordingly
6.) The Resident’s designated elective advisor will collect feedback from those the resident worked with
during the elective and will submit a summative evaluation on the resident’s performance.
Page 51 of 76
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
ROTATION OBJECTIVES
Emory University Hospital Neurology Elective
Emory University School of Medicine
Dates of elective: start: _____________ end: ______________
I.
Description:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
II.
Rotation Advisor and Faculty:
Rotation Advisor: _______________________________________________________________
Resident will work with the following faculty members:
_______________________________________________________________________________________
_______________________________________________________________________________________
III.
Rotation Environment:
_______________________________________________________________________________________
_______________________________________________________________________________________
IV.
Educational Objectives/Expectations:
 ____________________________________________________________________________________
____________________________________________________________________________________
 ____________________________________________________________________________________
____________________________________________________________________________________
V. Daily Schedule
VI. Reading List
Required Reading:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Recommended Reading:
__________________________________________________________________
VII.
Evaluation
The resident will be evaluated by ______________________________________
Signatures:
____________________________________
Resident
date
_____________________________________
Rotation Advisor
date
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NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
EVALUATIONS
Multiple types of evaluation, including both subjective and objective methods, are used to assess
knowledge, skills, and attitudes. Written evaluations of resident performance (form attached) are submitted
to the Program Director’s office at the conclusion of each rotation. In the event that a resident was
supervised by more than one attending during a rotation, a written evaluation is completed by each attending
who supervised the resident for a period of two weeks or longer. Each resident meets twice annually with a
faculty advisor for a six-month review, and is provided with copies of performance evaluations at time.
First-year resident have their first six-month review with the Program Directors in order to give each new
resident an opportunity to become acquainted with the faculty before selecting an advisor. In the event of an
Unsatisfactory evaluation, the resident is notified immediately by the Program Directors.
Structured oral examinations simulating the American Board of Psychiatry and Neurology
Examination Part II are conducted twice annually, in two different formats. The first Mock Oral Board exam
consists of three clinical vignettes: one pediatric and two adult neurology cases, which are discussed with
three different faculty members. The second Mock Oral Board exam involves a resident performing a livepatient, timed history and examination under the observation of two faculty members. The evaluation forms
used in these examinations can be found on the following pages for review.
All Neurology residents participate annually in the Residency In-Service Training Exam (RITE)
sponsored by the American Academy of Neurology. The exam typically takes place at the beginning of
March. The examination is a day-long written examination consisting of two sessions, each lasting 3 ½
hours. All time away and vacations are to be scheduled such that all residents are available to participate in
the examination.
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NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
RESIDENT/FELLOW EVALUATION
DEPARTMENT OF NEUROLOGY
EMORY UNIVERSITY SCHOOL OF MEDICINE
PGYRESIDENT/FELLOW NAME
EMORY - Clinic
GRADY - Ward
GRADY - Consult
WWHC
PEDS
VAMC
Other:
_________________________
GENERAL COMPETENCIES
PATIENT CARE
Residents must be able to provide patient care that is compassionate,
appropriate, and effective for the treatment of health problems and the
promotion of health.
MEDICAL KNOWLEDGE
Residents must demonstrate knowledge about established and evolving
biomedical, clinical, and cognate (e.g. epidemiological and socialbehavioral) sciences and the application of this knowledge to patient care.
PRACTICE-BASED LEARNING/IMPROVEMENT
Residents must be able to investigate and evaluate their patient care
practices, appraise and assimilate scientific evidence, and improve their
patient care practices.
INTERPERSONAL & COMMUNICATION SKILLS
Residents must be able to demonstrate interpersonal and communication
skills that result in effective information exchange and teaming with patients,
their patients’ families, and professional associates.
PROFESSIONALISM
Residents must demonstrate a commitment to carrying out professional
responsibilities, adherence to ethical principles, and sensitivity to a diverse
patient population.
Page 54 of 76
Exceeded
Competency
EMORY - Consult
Demonstrated
Competency
EMORY - Ward
Needs
Improvement
(circle)
LEVEL OF TRAINING
Failed Not competent
SERVICE :
MONTH / YEAR
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
SYSTEMS-BASED PRACTICE
Residents must demonstrate an awareness of and responsiveness to the larger
context and system of healthcare and the ability to effectively call on system
resources to provide care that is of optimal value.
NARRATIVE COMMENTS
(Note: This section may be used verbatim in letters of recommendation. Please include strengths and areas of improvement.)
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Is this individual where he/she should be at this point in training?
□ Yes
□ No
EVALUATOR’S NAME :
(please print legibly)
PLEASE CIRCLE ONE :
FACULTY
RESIDENT
FELLOW
STUDENT
STAFF
DEPARTMENT :
EVALUATOR’S SIGNATURE : ___________________________________________ DATE: ____________________
Page 55 of 76
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
RESIDENT EVALUATION – PROFICIENCY IN EEG CHECKLIST
DEPARTMENT OF NEUROLOGY
EMORY UNIVERSITY SCHOOL OF MEDICINE
PGYRESIDENT/FELLOW NAME
MONTH / YEAR
LEVEL OF TRAINING
The resident has demonstrated understanding and proficiency in the following areas:
(mark N/A if specific pattern was not seen on any records during the rotation)
______Electrode placement using 10-20 system and acquisition of routine EEG
______Recognize normal waking background in adults
______Recognize normal waking background in children
______Recognize normal sleep activities in adults and children
______Recognize benign EEG changes seen in the elderly
______Distinguish physiological and non-physiological artifacts from cerebral activity (eye blinks, muscle, EKG, 60
cycle, ventilator)
______Identify generalized interictal epileptiform activity
______Identify focal interictal epileptiform activity
______Identify benign variants (rhythmic midtemporal discharges, mu rhythm)
______Identify focal and generalized background slowing and understand clinical significance
Identify the following specific patterns and understand their clinical significance:
______Periodic lateralizing epileptiform discharges (PLEDs)
______Generalized periodic epileptiform discharges (GPEDs)
______Triphasic waves
______Frontally predominant intermittent rhythmic delta activity (FIRDA)
______Burst-suppression
______Recognize focal ictal EEG patterns
______Recognize generalized ictal EEG patterns
______Recognize electrographic status epilepticus
______Differentiate epileptic and non-epileptic seizures by electrographic and clinical presentation
______Prepares concise written reports with clear communication of EEG interpretationand clinical correlation
Signed: ________________________________________Date:__________________
Attending Evaluator: (please print name) _____________________________________
Page 56 of 76
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
ATTENDING PHYSICIAN EVALUATION
EMORY UNIVERSITY SCHOOL OF MEDICINE
DEPARTMENT OF NEUROLOGY
Attending Physician: ______________________________________________________________________
AVAILABILITY
Was usually prompt
Adhered to rounds and conference schedules
Kept interruptions to a minimum
Devoted enough time to rounds and patient care
COMMENTS:
Kept discussions focused on case or topic
Asked questions in an appropriate manner
TEACHING
Used bedside teaching to demonstrate history-taking and examination skills
Emphasized problem-solving (thought processes leading to decisions)
Integrated social/ethical aspects of medicine: cost containment, pain control, etc. as
appropriate
Encouraged team members to read, research, and review pertinent topics
Accommodated teaching to actively incorporate all members of team
COMMENTS:
Always acted in the best interest of the patient
Professionalism
and Patient Care
Displayed a respectful attitude toward patients
Established rapport with team members
Showed appropriate regard for other specialties and health care professionals
Served as a role model
Was enthusiastic and stimulating
Recognized own limitations; was appropriately self critical
COMMENTS:
Page 57 of 76
Excellent
Very Good
SATISFACTORY
Please rate (√) the attending physician on
each of the skills described below:
MARGINAL

Excellent
Very Good
Please rate (√) the attending physician on
each of the skills Described below:
SATISFACTORY
MARGINAL
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
Organization
Fund of
Knowledge &
Continuing
Scholarship
Demonstrated broad knowledge of neurology
Was up-to-date
Identified important elements in case analysis
Used relevant medical/scientific literature to support decision making
COMMENTS:
Provided clear expectations at the beginning of rotation
Provided useful feedback including constructive criticism to team members
Balanced service responsibilities and teaching functions
COMMENTS:
EMORY INPATIENT
EMORY CONSULTS
GRADY INPATIENT
RECOMMENDATIONS:
Please rank order on a scale of
1 (most effective) to 9 (least effective)
the services where you believe this
faculty member would be
most effective:
GRADY CONSULTS
WESLEY WOODS
OUT-PATIENT CLINIC
VA
SUBSPECIALTY ROTATION
(e.g. EEG/epilepsy; EMG/neuromuscular)
OTHER:

THIS EVALUATION WILL BE HELD IN THE STRICTEST CONFIDENCE. The evaluation form will NOT be given
to the attending. Composite information from all evaluations will be abstracted and provided to attendings, in
summary form, annually. Information from this evaluation will be used in determining attending assignments.
Page 58 of 76
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
Emory University
Department of Neurology
MOCK ORAL BOARDS EXAMINATION
Vignette Evaluation
DATE
RESIDENT
EXAMINER
COMPONENTS
CASE #
ADEQUATELY PERFORMED?
Localization
YES
NO
Differential Diagnosis
YES
NO
Diagnostic Plans
YES
NO
Management / Therapeutic Plans
YES
NO
DOCUMENTING STATEMENTS & COMMENTS
GRADE:
PASS
FAIL
SIGNATURE OF EXAMINER
Page 59 of 76
CONDITIONAL PASS
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
GUIDELINES FOR LIVE PATIENT ORAL BOARDS
The purpose of this exercise is to assess the residents’ skill in obtaining a history and performing a
neurological examination. The format is similar to the live patient portion of Part II of the American Board
of Psychiatry and Neurology examination.
Two randomly selected faculty members will evaluate each resident. The resident is responsible for
contacting the attendings and setting up the date and time for the examination. One of the attendings is
responsible for determining where the examination will take place and finding a suitable patient to be
examined who has agreed to participate. The attendings on the inpatient or consultation services at any
hospital will assist in finding patients. The attending examiner may also arrange an outpatient for the exam.
The time allotted for the resident to take the history and do the examination is 30 minutes. The resident
should be informed of the time when 15 and 5 minutes remain. It is suggested the examiners take notes
about the resident’s performance throughout the examination on the back of the attached evaluation sheet.
The team will then leave the patient’s room to discuss the case for approximately 15 minutes, followed by 10
additional minutes where the attendings may ask questions on any topic. It is suggested the questions be
aimed at the resident’s level of training. Finally, the attendings should spend a few minutes giving feedback
to the resident about his/her performance.
Please contact me with any questions or problems about the process.
Jane Gilmore
Jane Gilmore, M.D.
EVALUATION TEAM:
ATTENDINGS:
RESIDENT:
_______________________
_______________________
RESPONSIBILITIES:
RESPONSIBILITIES:
*
*
*
*
*
*
*
*
*
coordinate exam date, place & time w/ resident
find and invite a suitable patient
inform resident when 15 & 5 min remain
provide verbal & written feedback
sign and return evaluation sheet
contact attendings
coordinate exam date, place & time
arrive promptly on scheduled date
initial and verify that evaluation has been
returned
30 minutes – History & Patient Exam
15 minutes – Discussion of Case
10 minutes – Attendings ask Questions
5 minutes – Feedback
Page 60 of 76
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
Emory University - Department of Neurology
MOCK ORAL BOARDS EXAMINATION
Live Patient Evaluation
DATE
RESIDENT
EXAMINERS
COMPONENTS
ADEQUATELY PERFORMED?
History
PASS
CONDITIONAL PASS
FAIL
Examination
PASS
CONDITIONAL PASS
FAIL
Localization
PASS
CONDITIONAL PASS
FAIL
Differential Diagnosis
PASS
CONDITIONAL PASS
FAIL
Diagnostic Plans
PASS
CONDITIONAL PASS
FAIL
Professionalism
PASS
CONDITIONAL PASS
FAIL
Humanistic Qualities
PASS
CONDITIONAL PASS
Comments:
Comments:
Comments:
Comments:
Comments:
Comments:
Page 61 of 76
FAIL
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
Comments:
SUMMARY STATEMENTS & COMMENTS
OVERALL
GRADE:
PASS
CONDITIONAL PASS
EXAMINERS’
SIGNATURES:
FAIL
RESIDENT’S
INITIALS:
Please return completed/signed forms to Pam Julien fax: 404.727.3157 / WMRB 6009
Page 62 of 76
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
TEACHING RESPONSIBILITIES
(Adapted from Lecture Handout prepared by Dr. Kate Heilpern and Dr. Alan Otsuki)
All residents teach, and there is no doubt that the instruction received by medical
students from residents is a significant part of their education. In addition, residents
also teach patients as well as their colleagues, both junior and senior. The word
doctor comes from the Latin docer, which does not mean healer, but rather teacher.
In addition, it is also true that teaching enhances your own learning. Remember that
“ to teach is to learn twice.”
In an effort to enhance your effectiveness in teaching the medical students
assigned to Neurology, the Learning Objectives for the Neurology Clerkship, as well
as the articles “What should a graduating medical students know about neurology?”
is attached for your review. In addition, the following resources are available in the
Neurology Library at Grady.
Residents as Teachers:A Guide to Educational Practice, 2nd Ed., Schwenk and Whitman,
1993.
Preceptors as Teachers: A Guide to Clinical Teaching, 2nd Ed., Whitman and Schwenk,
1995.
Creative Medical Teaching, Whitman, 1990.
Essential Hyperteaching: Supervising Medical Students and Resident, Whitman, 1997.
The Courage to Teach, Parker, PJ, Josey-Bass, Inc., 1998.
Please keep in mind the following points with regard to resident teaching:
Goals and Objectives



Recognize the resident’s responsibility for patient care and teaching:
patients, families, colleagues, medical student, and self
Identify opportunities for teaching
 on the run
 at the bedside, on rounds
 during procedures
 morning report and conferences
 special “teaching moments”
Recognize the special reasons why residents can be good teachers
 availability
 near peer
 novice learner
 role model
 do not ever use e-mail to deliver negative commentary
 do not shift blame to the student (“the student told me he would
check the CT scan/draw the blood/get the records”)
Teaching Responsibilities
(continued):
Page 63 of 76
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
Teaching Recognition Awards:
The medical students at Emory have acknowledged their appreciation of resident
teachers by establishing an Outstanding Resident Teacher Award bestowed annually.
The winner of the award, as well as the select pool of nominees from which the winner is
chosen, is honored at the Senior Graduation Banquet. The Department of Neurology is
fortunate to have had several residents honored by the medical students in this manner
in the past. In addition to the annual teaching award supported and funded by the
medical school, the individual medical school classes have chosen to recognize
additional resident teachers by establishing separate Teaching Recognition Awards. The
Department of Neurology has been fortunate to have its residents honored in this manner
in the past. We are proud of the dedication to teaching that our resident have shown.
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NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
NEUROLOGY CLINICAL CLERKSHIP
Residents will supervise and teach medical students when they rotate onto the neurology service each month.
At the end of each rotation, residents will be asked to write an evaluation on the students they supervised.
Dr. Linton Hopkins is the Clerkship Director. He can be contacted at the Emory Clinic at 404.778-3452
(assisted by Shanna Miller).
GOALS AND OBJECTIVES:

Learn the 12 major symptoms of neurologic disease. Learn how to localize symptoms and
signs to specific places in the brain, spinal cord, peripheral nerves, and muscle.

Perform a competent neurological exam that solves the problems brought out in your history,
i.e. is focused toward the complaint of your patient.

Become familiar with the diagnosis and management of ten chronic neurological disorders that
are common and treatable (such as carpal tunnel syndrome and migraine), and ten neurologic
emergencies (such as TIA, subarachnoid hemorrage and spinal epidural abscess).

Produce a vignette and image every week about the patient and subject you think will be of
most interest to your peers. You will be writing to enhance your own learning as well as that of
your peers.

Consider researching a neurologic topic of interest to you. Submit a ten-page original paper
with at least 5 references to the course director for credit.

Learn the skill of asking about your own performance in a way that invites constructive criticism,
and seek to understand the reasons for the subjective part of your grade. Everyone can
improve in some way. One of your jobs is to find out what we think of you.
VISTING PROFESSORS
Each year the Department of Neurology sponsors a visiting professor noted for both
academic excellence and teaching skill to come and spend time with the residents. Typically, the
visiting professor will spend two days in patient-centered educational activities at Grady and Emory
in addition to delivering Grand Rounds and having dinner with the residents.
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NEUROLOGY RESIDENT HANDBOOK
Emory University
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DISCRETIONARY FUNDS AND SUPPORT
The Department of Neurology provides discretionary funds for each resident to cover travel
expenses to an academic meeting or to purchase textbooks or other approved educational
materials.
The amount of discretionary funds available to residents is determined annually and can not be
accumulated from one year to the next. Funds are available at the beginning of the department’s
fiscal year, September 1, and MUST be spent by June 30 of each academic year.
The discretionary fund is $750.00/resident. Residents may purchase medical books, medical
equipment, a PDA, and other pre-approved educational items. Purchase of computers and
computer equipment with book funds is NOT permitted. You may opt to have the Program
Coordinator order books through Majors online on your behalf at a discounted price. For Majors
book orders, send an email to pjulien@emory.edu which includes the title, author, and ISBN
number of the book(s) you’d like to order. Pam will call you when your order arrives.
INSTRUCTIONS FOR REIMBURSEMENT: The accounting department has very strict guidelines
regarding documentation required for reimbursement. To receive a book fund reimbursement,
submit the following to the Program Coordinator:
1. ORIGINAL RECEIPT(S) taped to a 8 1/2”x 11” sheet of paper
2. copy of PROOF OF PAYMENT, bank or credit card statement, to the Program Coordinator.
Obviously, no proof of payment is necessary for cash purchases.
Funds will be direct deposited into your bank account within four weeks.
Attendance at approved meetings must be anticipated well in advance and coordinated through
the Chief Residents so that adequate call coverage can be provided. Keep in mind that one week
of resident vacation is set aside for attendance at meetings, so meeting attendance should
coincide with scheduled vacation time. Jeopardy may NOT be used to attend meetings.
AAN Membership:
The department also arranges for membership in the American Academy of Neurology for each
resident. This membership is renewed in January of each training year.
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NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
TRANSCRIPTION TIPS
Please complete all transcriptions on the day of discharge if at all possible. Discharge summaries
should be succinct, no more than 1-2 typewritten pages. For the Emory in-patient service, please
list the Ward Attending as the attending for all patients, including the Epilepsy Monitoring Unit
patients. The Epilepsy Monitoring Unit Attending is a consulting neurologist. The Ward Attending
is the patient’s attending of record, and the discharge summary should reflect that fact.






Please use complete words and sentences. Avoid jargon.
Never use abbreviations and avoid contractions.
Speak clearly.
Please spell any words that you think a transcriptionist may not understand. The
transcriptionists are general medical transcripitionists who are not necessarily familiar with
all neurologic terms.
Please spell the names of all people, including your own.
Please include, at the conclusion of the transcription, the name (and addresses, if readily
available) of all physicians to whom a copy of the transcription is to be sent. This should
include, at a minimum, the referring physician and any physicians who are to see the patient
in follow-up.
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NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
TEMPLATE FOR MORNING REPORT PRESENTATIONS
The following template contains the required elements of a complete presentation:

Introductory Statement to orient the listener
Mr. Jones is an 86 year old patient followed by Dr. Evatt for Parkinson’s Disease admitted form the ER last
night with difficulty swallowing and a recent fall.






History
Relevant Physical Examination
Neurological Examination
 Mental Status (includes LOC, speech, language, cognition at a minimum)
 Cranial Nerve and Fundus Examination
 Sensory Examination
 Motor Examination
 Gait
 Coordination
 Reflexes
Anatomical Localization
Differential Diagnosis
Assessment & Plan (includes diagnostic and therapeutic plan)
Imaging studies are ordered to test a specific hypothesis; thus, they are part of the diagnostic plan
and follow rather than precede the derivation of the anatomical localization and differential
diagnosis.
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NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
DEPARTMENT AND MEDICAL SCHOOL POLICIES
Policies regarding vacation, moonlighting, all forms of leave (e.g., family, medical, disability,
etc.), as well as all information pertaining to benefits, may be found in the Housestaff Training
Manual published by the Office of Graduate Medical Education (available on the web at
www.emory.edu/WHSC/MED/GME/index.html). Please be aware that the professional services of
the Emory Employee Assistance Program (EEAP), are available to all residents 24 hours per day.
An overview of the program, listing its services and the appropriate telephone numbers, are found
on the following pages.
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NEUROLOGY RESIDENT HANDBOOK
Emory University
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FACULTY / STAFF ASSISTANCE AND WELLNESS PROGRAM (FSAP)
OVERVIEW & ELIGIBILITY
The Faculty Staff Assistance Program (FSAP) provides professional counseling and consultative services
designed to enhance the health, performance and well-being of individuals and organizational units, while
also fostering a greater sense of community.
In this capacity, it functions as a resource for faculty, staff, physicians, administrators, and their family
members. It also serves as a management support system for leadership.
Services provided by the FSAP are confidential and are rendered in private office locations to ensure the
comfort of the clients that are served.
The program is available to the faculty, staff, and family members of those employed by the Emory
University and Emory Healthcare. House staff members in the Residency Training Program, School of
Medicine are also served by the FSAP.
COMPONENTS
The FSAP staff assists clients with identifying options, strategies and resources for addressing issues and
concerns impacting their ability to live or work in a healthy manner.
Services include professional consultations and interventions for a wide range of individual and
organizational behaviors, issues, and needs provided in three core areas, which include:

behavioral mental health,

organizational dynamics, and

health promotion and wellness
BEHAVIORAL MENTAL HEALTH
The FSAP offers confidential and professional consulting, counseling, education, and referral services,
which cover areas such as family and spousal/ partner relationships, parenting, and eldercare concerns;
alcohol and substance abuse, as well as other addictive behaviors; financial pressures; legal issues;
psychological issues (i.e., depression, anxiety), stress, conflict; career counseling and work-related matters.
Clients are encouraged to call the FSAP before a concern becomes a crisis. Any change, however subtle, in
productivity, competency, attendance or behavior is often the first indicators that help may be needed.
Licensed professional mental health providers committed to client respect and privacy offer behavioral
mental health services in a confidential location.
ORGANIZATIONAL DYNAMICS
The FSAP provides organizational development, assessment and intervention services to enhance the overall
effectiveness of departments, units and/or divisions.
Leadership consultations are conducted via preliminary needs analyses to determine the focus of the
organizational challenge, which may relate to change management, communication difficulties, conflict
issues, and/or strategy planning and development.
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NEUROLOGY RESIDENT HANDBOOK
Emory University
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These process consultation services are custom designed following a comprehensive needs assessment,
involving both leadership and staff members.
HEALTH PROMOTION & WELLNESS
The FSAP also provides services to enhance individual and organizational health and wellness. A
comprehensive program designed to deliver health education and wellness services to Emory departments
and locations complements the many services available through the Emory HealthCare. Further information
about wellness is available by calling 727-WELL.
ACCESSING THE FSAP
FSAP services may be accessed directly by individuals or through supervisory recommendations or referrals.
Individuals seeking services for themselves or a family member are encouraged to call the FSAP directly for
information or to schedule an appointment or consultation.
The FSAP seeks to support emotional health and well-being by working with individuals to address concerns
before they negatively impact the person or their workplace performance. Thus, early consultations and
interventions are strongly encouraged.
While the FSAP does offer crisis intervention and debriefing services for individuals and groups, it
encourages utilization of its services early and often, before a crisis develops or before a change in
productivity, attendance or behavior becomes a debilitating pattern.
LEADERSHIP & THE FSAP
The FSAP is a resource whenever an individual indicates to leadership that a personal concern or problem
exists, even though there may be no immediate or discernible impact on work performance. Leadership is
encouraged to recommend that an individual visit or consult with the FSAP at the first indication of a
behavior change (however subtle or slight) in productivity, competency, attendance or performance.
The FSAP provides consultative services regarding the behavior and group dynamics of Emory’s
departmental units, and the impact on individual and organizational effectiveness. As such, it serves as a
resource of education and information for administrators, managers, supervisors and others in sorting
through organizational, behavioral or performance issues. In addition, the FSAP will assist leadership with
identification of interventions strategies, as well as providing consultation about when and how to
recommend/refer someone to the FSAP.
SUPERVISORY REFERRAL
In certain instances, leadership may determine in consultation with the FSAP that referring an individual to
the FSAP is advisable and necessary. Such referral is generally based upon a demonstrated pattern of
declining productivity, erratic attendance or atypical behavior. To make a referral, a supervisor must first
consult directly with the FSAP. This confidential consultation is designed to review facts, perceptions,
observations and circumstances in order to determine the most appropriate way of proceeding.
All FSAP services are confidential. Clients generally control what they want to share about their situation
and with whom they want to share information. (Faculty Staff Assistance Programs do have a “duty to
protect and warn” under certain prescribed circumstances.)
When an individual comes to the office as a supervisory referral, the clinician will verify to the referring
supervisor that the employee is working with the FSAP. While the FSAP may provide ongoing consultation
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NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
with the supervisor, details or information about the type or nature of services will not be provided except as
authorized by the client.
GENERAL INFORMATION
The FSAP does not provide a shelter or protection from adverse consequences of such acts as erratic
attendance, unsatisfactory productivity or unacceptable behavior. In addition, utilization of FSAP services
may not be held or used against an individual. The program offers an opportunity and a method for
identifying and dealing with the underlying cause(s) of performance-impairing issues.
Individuals who utilize FSAP services may do so at no loss in pay and without using any accrued leave time.
Where a clinical assessment indicates that time away from work is warranted, it may be necessary for an
individual to request and use appropriate leave.
The FSAP is a pivotal and important resource for assessing whether it is appropriate for an individual to be at
work. The FSAP is available to certify, based on clinical review, an individual’s need to be absent from work
or the need for a medical leave of absence. The FSAP also is available to facilitate communications
regarding an individual’s return to work from medical and/or disability leave.
Assessments and short-term sessions with the FSAP’s licensed clinicians are provided at no cost to
employees or family members. The FSAP maintains program and referral linkages with EmoryCare and
EmoryChoice providers, as well as with other community resources to facilitate the appropriate referrals,
when additional services are indicated based upon a client’s clinical needs and/or financial circumstances.
LOCATION
The FSAP is based in the Emory Well House, located on Emory’s main campus at 1735 Lowergate Drive,
directly across from the patients’ and visitors’ entrance to Lowergate Parking Deck. The FSAP also
maintains an office at Crawford Long Hospital in the Byron Building, 549 Peachtree Street, Suite 3518.
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NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
PATIENT TELEPHONE CALL GUIDELINES (EMORY)
1. Make clear to the patient, in a polite way that you are the resident on call and are available
for urgent or emergent issues only.
2. If a patient needs an essential prescription refill (i.e., a neurological medication that they
take on a regular basis), they should be given a four day supply. This should be enough to
bridge until their clinic physician can give them a more complete refill. Under certain
circumstances (holiday weekends or Christmas), they may need an extra day or two. They
should be instructed to call their clinic physician on the next business day.
3. No Narcotics, Refills or Otherwise. Ever! If you have questions about requests for other
drugs with abuse potential (e.g., benzos), discuss it with the attending on call.
4. If they are only calling to leave a message for their clinic physician, they should be
instructed to call back during business hours.
5. Do not promise (or suggest) an expedited clinic visit (e.g., “Dr. DeLong will see you
tomorrow.”).
6. Do not make any major changes in patient management (e.g., changes from dilantin to
tegretol) without explicitly discussing it with the attending n call.
7. Calls from outside physicians should be directed to the attending on call.
8. For non-neurologic issues, the patient should call their primary care physician.
9. Document each phone call on the provided log sheet. Give the log sheet to Shirley Franks
on the next business day.
10. Always inform the patient that it is his/her responsibility to call their clinic physician the next
day to follow-up an evening call.
11. Always call the attending on call with any question.
12. In general, you are an emergency bridge to allow the patient to make it through to the next
business day, when they can call their clinic physician.
13. If it’s a true emergency, they need to go to the emergency room.
Page 73 of 76
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
Neurology Resident Summer Lecture Series
July-August, 2005
7/5/05
(Tues)
7/8/05
(Fri)
7/12/05
(Tues)
7/15/05
(Fri)
7/19/05
(Tues)
7/22/05
(Fri)
7/26/05
(Tues)
7/29/05
(Fri)
8/2/05
(Tues)
8/5/05
(Fri)
8/9/05
(Tues)
8/12/05
(Fri)
8/16/05
(Tues)
8/19/05
(Fri)
8/23/05
(Tues)
8/26/05
(Fri)
8-9am The Neurological Exam
9-10am Intracerebral Hemorrhage
8-9am Acute Stroke
9-10am Coma
8-9am Intro to Neuro-Ophth
9-10am
“
8-9am Neuro-Ophth in the ER
9-10am
“
8-9am Intro to Movement Disorders
9-10am Brain Death
8-9am Neuromuscular Emergencies
9-10am Multiple Sclerosis
8-9am Vestibulopathy/Dizziness
9-10am
“
8-9am Eye Movements
9-10am
“
8-9am Introduction to EEG
9-10am
“
8-9am Adult Epilepsy
9-10am The Pediatric Neuro Exam
8-9am Status Epilepticus/ICU EEG
9-10am Intro to Pharmacokinetics
8-9am Introduction to Statistics
9-10am CSF Analysis
8-9am Brainstem Neuroanatomy
9-10am
“
8-9am Approach to Neuropathy
9-10am Approach to Myopathy
8-9am Dementia
9-10am Intro to Sleep Medicine
8-9am Intro to Neuroradiology
9-10am Intro to Brain Tumors
Dr. Hopkins
Dr. Samuels
Dr. Frankel
“
Dr. Newman
“
Dr. Biousse
“
Dr. Greene
Dr. Samuels
Dr. Benatar
Dr. Gilmore
Dr. Tusa
“
Dr. Tusa
“
Dr. LaRoche
“
Dr. Henry
Dr. Krawiecki
Dr. LaRoche
Dr. Olson
Dr. Benatar
Dr. Khan
Dr. Rye
“
Dr. Glass
“
Dr. Ringholz
Dr. Durmer
Dr. Hudgins
Dr. Brat
Page 74 of 76
Clinic A, 4th Floor
Conference Room
Clinic A, Brown
Auditorium
Clinic A, 4th Floor
Conference Room
Clinic A, Brown
Auditorium
Clinic A, 4th Floor
Conference Room
Clinic A, Brown
Auditorium
Clinic A, 4th Floor
Conference Room
Clinic A, Brown
Auditorium
Clinic A, 4th Floor
Conference Room
Clinic A, Brown
Auditorium
Clinic A, 4th Floor
Conference Room
Clinic A, Brown
Auditorium
Clinic A, 4th Floor
Conference Room
Clinic A, Brown
Auditorium
Clinic A, 4th Floor
Conference Room
Clinic A, Brown
Auditorium
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
Emory University Clinical Neurophysiology Fellows
2005-06 Review of Clinical Electrophysiology
8:00 am - 9:00 am, 3rd floor conference room, Emory Clinic Building A
Date
Topic
Faculty
July 12
July 14
Nerve Conduction Studies
Normal and Non-Epileptiform Abnormal EEG of
Adulthood
Interictal Epileptiform EEG Abnormalities
Diagnostic Ictal Video EEG Recording; Seizure &
Epilepsy Classification
Presurgical Ictal Video EEG Recording &
Electrocorticography
Electrophysiology in the Operating Room
The Needle Examination: Part I
The EEG of Childhood Epilepsy Syndromes
The Needle Examination: Part II
No lecture
Evoked Potentials
Normal and Non-Epileptiform Abnormal EEG of
Childhood
Electrophysiology of Peripheral Neuropathy and Motor
Neuron Disease
Carpal Tunnel Syndrome
Disorders of Neuromuscular Transmission
ICU Monitoring
Normal Pediatric & Adult Sleep Architecture;
Instrumentation for Recording Sleep:
Polysomnography & Actigraphy
Electrophysiologic Correlates of Respiration in Sleep:
Sleep Disordered Breathing
Assessment of Daytime Sleepiness: Multiple Sleep
Latency Testing (MSLT) and Maintenance of
Wakefullness (MWT)
Electrophysiologic Assessment of Parasomnias:
Nocturnal Movement Disorders and Epilepsy
Technical Aspects of EEG & EEG Artifacts
Autonomic Testing*
Radiculopathy
Myopathy
Treatment of Epilepsy with VNS
T. Harrision
A. Koganti
July 19
July 21
July 26
July 28
Aug 2
Aug 4
Aug 9
Aug 11
Aug 16
Aug 18
Aug 23
Aug 25
Aug 30
Sept 1
Sept 6
Sept 8
Sept 13
Sept 15
Sept 20
Sept 22
Sept 27
Sept 29
Oct 4
Page 75 of 76
P. Pennell
T. Henry
T. Henry
C. Epstein
J. Khan
L. Olson
J. Khan
C. Epstein
P. Holt
J. Glass
M. Benatar
M. Benatar
S. LaRoche
D. Bliwise
D. Bliwise
D. Rye
D. Rye
C. Epstein
L. Freedman
J. Khan
T. Harrision
S. Helmers
NEUROLOGY RESIDENT HANDBOOK
Emory University
_____________________________________________________________________________________
NEUROLOGY GRAND ROUNDS SCHEDULE: SEE WWW.NEUROLOGY.EMORY.EDU
ACGME PROGRAM REQUIREMENTS FOR RESIDENCY EDUCATION IN NEUROLOGY
www.acgme.org
See “Program Requirements” for Neurology
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