Neurology

Our Program

Our program is a 4-year categorical residency, that includes a PGY-1 year of internal medicine training. The Neurology PGY-1 year is identical to that of the first-year residents in the Internal Medicine Residency Program UTMB Internal Medicine Residency Home at UTMB with the exception of two months of inpatient neurology experience for neurology interns.
Each year we take 6 new neurology residents into our program. Most of the training takes place at our Galveston campus, but in addition to our Galveston campus residents rotate at MD Anderson Cancer Center and Texas Children’s Hospital in Houston. UTMB prides itself in being a tertiary academic center seeing complicated cases referred from other hospitals in south east Texas. UTMB Galveston is a comprehensive stroke center, and one of the few institutions in the country with a dedicated neuro-critical care unit. During the inpatient blocks, residents rotate in the neuro-critical care unit, vascular neurology service, non-vascular wards service, neurology consult service and epilepsy monitoring unit. Outpatient clinics include specialized clinics in movement disorders, neuromuscular medicine, stroke clinic, epilepsy clinic and general neurology clinic.
This year occurs exclusively at UTMB Galveston campus. The aim of this year is to build a strong foundation in medicine, so that the incoming resident can evaluate and manage basic medical conditions from the common chronic and benign to the critical and acute. Interns have rotations in emergency medicine, Medical ICU, cardiology, general medicine wards, general medicine clinics and have 2 months of inpatient neurology service. In addition, interns have many months of electives from which they can tailor their general medicine experience. At the end of intern year, all neurology interns undergo a Neurology “boot camp” where they get introductory lectures in neurology about common topics and neurologic emergencies as well as neurologic procedures. Please see below for the internal medicine website.

UTMB Department of Internal Medicine
The second year (PGY-2) of neurology residency is designed to build a strong foundation in the clinical practice of neurology. The main emphasis of the year is to provide residents with an immersive hands-on clinical experience to manage patients presenting to the emergency room or admitted to the hospital with a variety of neurological diseases. Throughout the year, residents have a weekly half day continuity clinic where they have the opportunity to evaluate “their own” patients.  They begin following patients in their continuity clinic and build long-term relationships with patients with chronic neurologic conditions.
Residents have night float coverage for 4-6 weeks during this year and take a 24-hour call about 2 days per month.
PGY-2 Rotations (click for details below):
Resident PGY2 Rotation Details

Stroke/Vascular Neurology Service

Stroke/Vascular Neurology Service

This service is staffed by stroke/vascular neurology trained faculty, and primarily admits patients with stroke and other vascular neurological pathologies. In addition, the team also provides coverage for stroke consults in hospital and manages acute stroke alerts. The service is comprised of one senior PGY-3 resident, one junior PGY-2 resident and anywhere from one-two interns from neurology and internal medicine. The average census is between 10-14 patients.

MD Anderson Cancer Center

MD Anderson Cancer Center

Located in the Texas Medical Center, MD Anderson Cancer Center is one of the premier and most-well reputed cancer hospitals in the country. Our Neurology PGY-2 residents spend 3 months of their PGY-2 year at MD Anderson on the acute neurology consult service, and the inpatient neuro-oncology service. Residents see a wide variety of extremely rare neurologic conditions here, and many patients are on experimental never tried before therapies. Residents often publish many case reports and case series of rare diseases seen here on the neurology consult service.

Night Float

Night Float

Residents spend between 4-6 weeks on night-float on Galveston campus. The shift starts at 5 pm and ends at 6:30 am the next day. On this service the overnight resident sees new consults and admission to neurology in the hospital, and also takes care of patients already admitted to the neurology floor and ICU. In the morning the resident presents the overnight cases in morning report. Residents often report that night float was their best learning experience.

Neuro-critical care unit (NCCU)

Neuro-critical care unit (NCCU)

Established in 2013 and moved to the new Jennie Sealy Hospital in 2016, our 14-bed neuro critical care unit is one of the few dedicated neuro ICUs in the country. The NCCU serves both neurology and neurosurgery patients. The neurology resident primarily sees the neurology patients in the ICU, many of whom present with large strokes requiring surgical intervention, intracerebral hemorrhages, status epilepticus, neuromuscular disorders with respiratory failure in addition to others. This service comprises of a NCCU attending, neuro critical care fellow and one neurology resident PGY-2 or 3.

Non-vascular Ward service

Non-vascular Ward service

This service comprises of a neurology attending and a PGY-2 or 3 resident. The service admits a wide variety of neurological cases but mainly focuses on non-vascular neurologic diseases such as epilepsy, neuro-infectious diseases, neuro immunological disorders, GBS, Myasthenia Gravis in addition to other rare neurologic conditions. The resident also takes care of the patients admitted tour 4 bed epilepsy monitoring unit and staffs them with an epilepsy trained neurology attending.

Consult service

Consult service

The neurology consult service sees acute neurology consults in the emergency room and in hospital consults at the Galveston Campus. The team comprises of one senior resident (PGY-3 or 4), a PGY-2 junior resident and anywhere between 1-2 interns from internal medicine and neurology. The team serves as the primary admitting team from the emergency room and sees acute neurology consults from different services.

Elective

Elective

A wide variety of elective opportunities are available for residents to avail including:

Neuroradiology

Neuroendovascular/Neuro-IR 

EEG 

EMG 

Ophthalmology/neuro-ophthalmology 

Neurocognitive/neuropsychology 

Pain medicine 

Neurorehabilitation 

Neuropathology 

Research 

Subspecialty clinic

Subspecialty clinic

Residents rotate through multiple subspecialty clinics including neuromuscular clinic, epilepsy clinic, movement disorder clinic with DBS clinic, neuro-immunology/MS clinic and dementia clinic. In addition, residents learn clinic procedures such as, Botox for chronic migraine, EMG guided Botox for muscle spasticity related to stroke or MS, trigger point injections, occipital neuralgia block.
The third year (PGY-3) is designed to build upon the foundation formed in second year and to further develop clinical skills learnt from the year before. Residents now act in a more supervising role; where they act as junior faculty on various services and supervise rotating medical students, junior residents, and interns. Increased elective time is designed to give residents ample time to experience different subspecialties. Residents do apply for fellowship in this year.
PGY-3 Rotations (click for details below):
Resident PGY3 Rotation Details

Subspecialty Clinic

Subspecialty Clinic

Residents rotate through multiple subspecialty clinics including neuromuscular clinic, epilepsy clinic, movement disorder clinic DBS clinic, neuro-immunology/MS clinic and dementia clinic. In addition residents learn clinic procedures such as Botox for chronic migraine, EMG guided Botox for muscle spasticity related to stroke or MS, trigger point injections, occipital neuralgia block etc.

Electives

Electives

A wide variety of elective opportunities are available for residents to avail including:

Neuroradiology

Neuroendovascular/Neuro-IR

EEG

EMG

Ophthalmology/neuro-ophthalmology

Neurocognitive/neuropsychology

Pain medicine

Neurorehabilitation

Neuropathology

Research

Stroke Senior

Stroke Senior

This service is staffed by stroke/vascular neurology trained faculty, and primarily admits patients with stroke and other vascular neurological pathologies. In addition, the team also provides coverage for stroke consults in hospital and manages acute stroke alerts. The service is comprised of one senior PGY-3 resident, one junior PGY-2 resident and anywhere from one-two interns from neurology and internal medicine. As stroke senior, the resident acts as junior faculty on the neurology stroke service, and oversees and supervises junior residents, interns, and rotating medical students. In addition, the senior resident attends to acute stroke alerts thought the hospital in the morning, and supervises junior residents seeing acute stroke alerts in the afternoon.

Non-Stroke Wards and EMU

Non-Stroke Wards and EMU

This service comprises of a neurology attending and a PGY-2 or 3 resident. The service admits a wide variety of neurological cases but mainly focuses on non-vascular neurologic diseases such as epilepsy, neuro-infectious diseases, neuro-immunological disorders, GBS, Myasthenia Gravis in addition to other rare neurologic conditions. The resident also takes care of the patients admitted to the Epilepsy Monitoring Unit and staffs them with an epilepsy faculty.

Consult Senior

Consult Senior

The neurology consults service sees acute neurology consults in the emergency room and in hospital at the Galveston campus. The team comprises of one senior resident (PGY-3 or 4), a PGY-2 junior resident and anywhere between 1-2 interns from internal medicine and neurology. The senior resident on the neurology consult service supervises the junior residents, interns and rotating medical students and acts as junior faculty on the service. The team serves as the primary admitting team from the emergency room and sees acute neurology consults from different services.

Neuro-Critical Care Unit (NCCU)

Neuro-Critical Care Unit (NCCU)

Established in 2013 and moved to the new Jennie Sealy Hospital in 2016, our 14-bed neuro critical care unit is one of the few dedicated neuro ICUs in the country. The NCCU serves both neurology and neurosurgery patients. The neurology resident primarily sees the neurology patients in the ICU, many of whom present with large strokes requiring surgical intervention, intracerebral hemorrhages, status epilepticus, neuromuscular disorders with respiratory failure in addition to others. This service comprises of a NCCU attending, neuro critical care fellow and one neurology resident PGY-2 or 3.

Night Float

Night Float

PGY-3 residents spend between 2-4 weeks on night-float on Galveston campus. The shift starts at 5 pm and ends at 6:30 am the next day. On this service the overnight resident sees new consults and admissions to neurology in the hospital and takes care of patients already admitted to the neurology floor and ICU. In the morning the resident presents the overnight cases in morning report. Residents often report that night float was their best learning experience.
The fourth (PGY-4) year of neurology residency is designed to further blossom the clinical, research and leadership skills gained over the previous three years of residency. Residents solidify their career plans and work on dedicated research goals. They also take an active role in junior residents and student education. Two residents are nominated by the department to serve as chief residents, as well as 2 residents are awarded the prestigious Texas Alzheimer’s Research Care Consortium (TARCC) fellowship in dementia research. PGY-4 residents do one 12-hour call per month. In addition, residents take an active role at St. Vincent’s free neurology clinic, taking care of under-cared and uninsured population.
PGY-4 rotations (click for details below):

Resident PGY4 Rotation Details

Night Float

Night Float

PGY-4 residents spend between 1-2 weeks on night-float on Galveston campus. The shift starts at 5 pm and ends at 6:30 am the next day. On this service the overnight resident sees new consults and admission to neurology in the hospital and takes care of patients already admitted to the neurology floor and ICU. In the morning, the resident presents the overnight cases in morning report. Residents often report that night float was their best learning experience.

Psychiatry

Psychiatry

This block is spent on the inpatient psychiatry service at the Galveston campus. Resident’s consult on and manage patients with acute psychiatric illness.

Inpatient Pediatric Neurology at TCH

Inpatient Pediatric Neurology at TCH

In this block residents rotate at Texas Children’s Hospital in the Texas Medical Center (TMC), and attend to all the care of children with neurologic disease.

Outpatient Pediatric Neurology

Outpatient Pediatric Neurology

Residents evaluate children with neurological diseases due to genetic syndromes, epilepsy, mitochondrial diseases in addition to others. This rotation mainly occurs at the Victory Lakes Clinic in League City which is a 30-minute drive from Galveston campus.

Consult Senior

Consult Senior

The neurology consults service sees acute neurology consults in the emergency room and in hospital at the Galveston campus. The team comprises of one senior resident (PGY-3 or 4), a PGY-2 junior resident and anywhere between 1-2 interns from internal medicine and neurology. The senior resident on the neurology consult service supervises the junior residents, interns and rotating medical students and acts as junior faculty on the service. The team serves as the primary admitting team from the emergency room and sees acute neurology consults from different services.

Subspecialty Clinic

Subspecialty Clinic

Residents rotate through multiple subspecialty clinics including neuromuscular clinic, epilepsy clinic, movement disorder clinic DBS clinic, neuro-immunology/MS clinic and dementia clinic. In addition residents learn clinic procedures such as Botox for chronic migraine, EMG guided Botox for muscle spasticity related to stroke or MS, trigger point injections, occipital neuralgia block etc.

Elective

Elective

PGY-4 residents get approximately 4-6 months of elective time.