Clinical Program

• 18 months of internal medicine and other clinical rotations, including psychiatry, neurosurgery and neuroradiology (see PGY-1 and PGY-2);
• 24 months of clinical neurology, including at least three months of pediatric neurology and six to 12 months of senior resident training, and;
• 18 months of clinical or research rotations related to neurology, including neuropathology, neuromuscular/EMG, Epilepsy/EEG, research and several elective blocks.
• Rotation-specific objectives have been developed for all rotations.
• University of Calgary Residency programs follow a lunar calendar of 13 four-week blocks per year.

PGY-1 and PGY-2

A four-block rotation of ward- and clinic-based neurology is undertaken in the first year to allow the resident to bond to the neurology program and his or her new career. There is also exposure to acute stroke through a Night Float rotation where the resident is paired with a Stroke Fellow.  The learning objectives for these four blocks are that the resident learns to perform a complete neurological history and physical examination, interprets the findings appropriately and formulates the basic aspects of a neurological differential diagnosis including anatomical, syndromic and pathophysiological diagnoses.

PGY-1 and -2 comprise eighteen blocks of non-neurology rotations, including internal medicine, psychiatry, surgery (neurosurgery), radiology (neuroradiology) and emergency medicine. Twelve months of internal medicine are required by the Royal College and include general medicine ward service and ICU/CCU and six blocks of elective rotations, such as general medicine consult service, rheumatology, infectious disease, etc. Internal medicine rotations are tailored to provide the resident with a strong background in medicine useful in subsequent neurology training. Four blocks of PGY-2 are devoted to clinical neurology. In addition to fulfilling the neurology objectives noted above, training in the PGY-1 and PGY-2 years is meant to fulfill the objectives of basic clinical training as outlined by the Royal College: to give the resident a degree of independent responsibility for clinical decisions; an opportunity for further development of the skills required in making effective relationships with patients; the consolidation of competence in primary clinical and technical skills across a broad range of medical practice; and an understanding of the nature of the relationship between a referring physician and a consulting specialist.

PGY-3

PGY-3 provides core training in clinical neurology. Neurology inpatient experience is obtained at the Foothills Medical Centre and the South Health Campus. During the inpatient general neurology rotations, the resident is responsible for the primary care of inpatients on the neurology ward, the assessment of patients in the emergency department and inpatient neurological consultations. During the stroke rotations in PGY-3 to -5, the resident manages acute stroke and participates in the stroke fellow rota. Outpatient experience is emphasized in this program and clinical rotations which are completely clinic-based are scheduled. Clinics are available in General Neurology and several subspecialty areas, which are listed below. For most residents, rotations in neuropathology, neuromuscular/EMG, epilepsy/EEG comprise the balance of the PGY-3 rotations.

PGY-4

Most PGY-4 residents undertake a three- to six-block period of clinical or basic neuroscience research (see below).  PGY-4 also includes three or four blocks of adult neurology and three blocks of pediatric neurology.  Residents embark on their longitudinal neurology clinic at the start of this year (see below). During the latter part of the year, the resident is expected to assume greater independence in the management of patients and more responsibility for teaching and supervising junior residents and clinical clerks. 

PGY-5

The PGY-5 resident spends a minimum of seven blocks as a senior neurology resident/junior consultant in inpatient and outpatient settings. He/she continues the senior resident's longitudinal clinics; patients are evaluated and followed by the senior resident at arm's length from the attending neurologist preceptor.

In PGY-5, the resident is expected to assume greater independence in the management of patients and more responsibility for teaching and supervising junior residents and clinical clerks. The resident also has the opportunity to participate in the teaching of second year medical students during the neurosciences portion of the medical school curriculum.

For the other six blocks, the resident may select elective rotations from a number of different areas including EEG, neuro-ophthalmology, pain, neuro-rehabilitation or community neurology, or choose to spend further time in electromyography, neuromuscular disease, neuroradiology, neurosurgery or psychiatry. Special requests for other options will be considered on an individual basis.