Schedule Overview

Curriculum

PGY2:

1 months elective, 1 month EEG/EMG, 1 month LAC+USC stroke service, 4 months LAC+USC general neurology service, 3 months Keck, 1 month Rancho Los Amigos, 1 month vacation

PGY3:

2 months elective, 1 month EEG/EMG, 1 month LAC+USC general neurology service (senior), 1 month LAC+USC night float (Senior), 3 months Keck, 2 months CHLA, 1 month Rancho Los Amigos, 1 month vacation

PGY4:

3 months elective, 2 months LAC+USC stroke service (senior), 1 month LAC+USC neurology service (senior), 2 months Rancho Los Amigos, 1 month LAC+USC night float (Senior), 1 month LAC+USC pediatric neurology, 1 month psychiatry, 1 month vacation

The program is highly responsive to resident feedback, curriculum distribution is discussed and evaluated on a regular basis to ensure educational value to the residents involved

Education

Teaching faculty are all approachable, and enjoy patient care as well as teaching residents and medical students.

Residents learn directly through patient care responsibilities from the moment they set foot in the hospital. LAC+USC Medical Center is a busy county hospital in Los Angeles with patients who face problems with health literacy, access to care, transportation, and finances. We serve a culturally diverse population and are exposed to a wide variety of pathology at LAC+USC.

  • Thursday didactics: Reserved block from 9AM-1PM, which is protected time for resident learning. PGY2 residents have a dedicated block of lectures from 9-11 am, and PGY3/4 residents have a dedicated block from 11am-1pm, although all residents are encouraged to attend all lectures. Our didactic curriculum includes traditional faculty lectures, as well as the following:
  • Monthly journal club: Two residents pick a research paper of their choice to read and lead powerpoint discussion with faculty moderator
  • Morning report: Neurology consult service presents an interesting case from patients currently on service with faculty/senior resident leading the discussion
  • Monthly Morbidity/Mortality conference: Discussion regarding a case that occurred on service which could have been managed differently, with input from faculty/other senior residents
  • Tuesday Neurology Grand Rounds: Guest lecturers from other institutions who are experts in the field, as well as from within LAC-USC, are invited to share their expertise on current topics in neurology with the neurology department staff and residents, as well as medical students. Residents are also assigned to present cases during Grand Rounds.
  • Epilepsy pre-clinic didactics: Before weekly Friday morning epilepsy clinic, residents are assigned to read and present chapter from epilepsy text with input from a faculty moderator. On the last Friday of the month, the neurophysiology fellow gives EEG conference, reviewing recent interesting EEGs
  • Neuro-immunology pre-clinic didactics: Neuro-immunology journal club, during which the fellow presents a pre-assigned paper to residents with input from a faculty moderator
  • Friday Neuro-radiology rounds: Inpatient teams at LAC+USC review interesting imaging studies with our neuroradiologists, providing clinical information for a multi-disciplinary approach to diagnosis
  • Many subspecialties also hold weekly specialty conferences which welcome resident attendance, including but not limited to: Neuro-vascular conference, Epilepsy consensus conference, DBS academic and consensus conferences, Neurobehavioral journal club, Neurophysiology didactics.

Rotation Facilities

Keck Hospital:

3 neurology residents ranging from PGY-2 to PGY-3, Neurocritical Care Fellow, and NPs. There are two teams at Keck: a Neuro-critical care team, and a Floor/consult team. Keck is a high volume transfer center, and the neurology service cares for critically ill patients with subarachnoid hemorrhages, intracranial hemorrhages, ischemic strokes, status epilepticus, organ transplants, etc. We work in conjunction with neurosurgery to best manage many of these patients. Keck is also an active center for interventional neuroradiology, with patients transferred from across Southern California for advanced neurological care.

LAC+USC General Neurology Service:

1 neurology senior (PGY-3 or 4), 3 neurology juniors (PGY2), and interns from psychiatry. This team serves as the Primary Service for general neurology patients and as the Consult Service for general neurology concerns across the hospital. The neurology junior resident sees emergent consults in the LAC+USC ED and helps to manage general neurology consults. Residents rotate 1 week at a time as night float to cover consults, primaries, and stroke codes overnight.

LAC+USC Stroke Service:

1 neurology senior (PGY-3 or 4), 1 neurology junior (PGY2), and a psychiatry intern. This is a primary service for patients who have had ischemic or hemorrhagic strokes without critical care needs, and consult service for stroke/ICU consults in the hospital. Neurology junior resident runs stroke codes in LAC+USC ED (a certified primary stroke center).

CHLA Pediatric Neurology:

1-2 adult neurology PGY-3 along with 2 pediatric neurology fellows and pediatric psychiatry fellows, overseeing a team of pediatric residents and interns. CHLA offers comprehensive training in pediatric neurology within one of the premier children’s hospitals in the nation, in the heart of Los Angeles. On the CHLA rotation, residents work with pediatric neurology fellows and attendings with experience across the full spectrum of pediatric neurology subspecialties. The unique experience provides a new perspective on many diseases that extend into adulthood, and is an integral part of the training program.

Rancho Los Amigos National Rehabilitation Center (RLA):

The RLA neurology service efficiently evaluates and treats patients for a variety of neurological conditions including subacute stroke, demyelinating disease, and epilepsy. It offers a unique opportunity to experience the role physical, occupational, and speech therapists play in the recovery of those with neurologic conditions. Residents participate in interdisciplinary rounds to address patient needs holistically, and attend a variety of sub-specialty clinics, including dementia and botulinum toxin injection clinic. RLA is also home to the LAC EMU, where patients with refractory epilepsy undergo long term EEG monitoring, and work up for possible surgical intervention.

Weekly Continuity Clinic:

One half-day of clinic a week where residents have continuity of care and manage their own patients throughout the duration of residency. Residents learn to manage chronic neurologic conditions, are active in designing treatment plans, and get to follow patients’ response to treatment. Attending physicians in clinic include headache, neuromuscular, neuro-immunology, and movement disorder specialists, among others.

Ambulatory Experiences:

Epilepsy Clinic: Provide care for patients with intractable epilepsy and refer patients for epilepsy surgery with Epilepsy Monitoring Unit as part of presurgical work up.

Neuro-immunology Clinic: Learn how to manage patients with MS/NMO, as well as other neuro-immunologic diseases.

Neuromuscular Clinic: Manage patients with a wide variety of neuromuscular conditions, ranging from peripheral neuropathy to Myasthenia Gravis to Guillain-Barre, ALS and more.

Neuro-oncology Clinic: Work directly with the neuro-oncology specialist on management of patients with primary neuro-oncological tumors.

Jail Clinic: Provide care to patients from local jails with neurologic conditions, offering a unique experience and perspective of psychosocial issues combined with neurological disease.

Botulinum toxin injection clinic: Work side by side with movement disorders specialists, injecting toxin for medical treatment of hemifacial spasm, dystonia, and spasticity.

Keck Medicine of USC clinics: Attend and see patients with USC faculty in their private sub-specialty clinics, including multidisciplinary ALS clinic, DBS surgeries and programming sessions, and Headache procedure clinic