Dr. Clark: fellow
Dr. Eggenberger: neuro-ophthamology
residency, specialty, subspecialty, fellow in that discipline
- variety in specialty: each center has its own culture, with its own strengths and
weaknesses
- all learn very similar clinical skills
- Cranial Nerves: olfactory, optic, oculomotor (all other eye movements), trochlear (pulls
eye in), adductens/abducens (pulls eye out)
Career Path to Neurology
- bachelors degree and medical school prerequisites
- MCAT and GPA
- medical school applications
- primary applications
- secondary applications
- interview
- acceptance, reapplication or plan B
- DO, MD
Medical School
- year 1-2 classwork
- marathon
- step 1 boards at the end of year 2
- year 3-4 clinic work
- more fun than classwork
- hours less predictable
- prepare for transition into internship/residency
Decisions About a Specialty
- specialist vs. primary care
- proceduralist vs. cognitive
- Iserson’s Getting Into A Residency
- What do I need in a profession?
- What is intolerable?
- lifestyle: individual definition
- neurology is the best
- decide what is important for you, not what others think is important
Residency
- 3-7 years post-medical school
- internship
- residency
- fellowship
- fellowship 1-4 years post-residency
- busy but doable (with balance)
- new duty hour rules
Adult Neurology- Fellowships
- stroke +/- intervention
- epilepsy
- neurophysiology: EMG, EEG, sleep
- MS
- cognitive/dementia
- peripheral nerve
- motor neuron disease
- headache
- movement disorders
- neuro-ophthalmology
- neurocritical care
- pain
Job
- private practice
- hospital employed
- academic research
- area of neurology used to be just diagnoses, no treatment...but new research has
provided more therapies and options
22 year old male with headache following a collision while playing basketball
- over 12 days develops diplopia and right droopy eyelid
- normal MRI
- right eye: pupil is dilated, can’t adduct, can’t infraduct, can’t supraduct
- 3rd cranial nerve palsy
- angiogram (catheter from groin puts dye into blood vessels): showed aneurysm
pushing on cranial nerve 3
- filled aneurysm with metal coils to block it off and form a clot to prevent rupture
69 year old male with pituitary macroadenoma (big benign tumor)
- abrupt severe headache, then diplopia and blur
- diplopia resolved over days
- exam: 20/400 vision in right eye, even worse in left
- left: droopy lid, can’t adduct, can’t supraduct, dilated pupil, blindness
- MRI is read as stable
- acute cavernous sinus syndrome: tumor bled into surroundings and compressed
nerves
Dr. Eggenberger’s Schedule
Monday: MS, botox, vertigo
Tuesday: neuro-ophthalmology (vision problems from brain issue)
Thursday: neuro-ophthalmology