The PGY-4 year allows residents to broaden their clinical experience with elective rotations and consolidate and own their clinical skills while overseeing the ward services at Tufts MC and Beth Israel Lahey Health. This year prepares our residents to perform as independent neurologists with strong leadership skills. The senior resident will be responsible for the inpatient service under the supervision and support of the attending physician. In addition, they will complete the required rotation in pediatric neurology and psychiatry.
This is in addition to 8-9 weeks of continuity clinic and 4 weeks of vacation. There is an additional 8-9 weeks dedicated to elective time to refine their clinical skills and complete research projects.
Continuity Clinic
Our program has moved from the half-day per week continuity clinic model to ambulatory weeks with a 5+1 schedule. Continuity clinic is scheduled on 3 days, constituting 5 continuity clinic sessions (3 morning and 2 afternoon sessions/week). On the 2 other days, the residents are scheduled for sub-specialty neurology clinics. This model is being adopted by many programs for its proven effect in improving residents’ education. We have adopted the use of Telehealth visits for select patients at both Tufts MC and BI-Lahey Health.
Electives
Elective rotations are available at our institutions in all major neurologic subspecialties and related medical, surgical and radiologic fields. In addition, elective time can be spent on clinical or basic research projects.
Call Schedule
Our program implements a night float system, which promotes good sleep hygiene, decreases burnout and complies with work hours under ACGME rules. Night coverage takes place at Tufts MC and at Lahey Hospital & Medical Center.
A 24-hour traditional call is still in place on Friday, covered almost exclusively by the NCCU resident at Tufts MC, to maximize continuity of care. Similarly, weekend shifts from 7 am–7 pm are typically covered by the junior ward residents, with each resident covering 2 weekends and having 2 free weekends over 4 weeks.
Ward senior resident at Tufts MC takes home calls and rounds on the weekends with the junior resident and attending for 2 weekends of each 4-week period.
Teaching
As part of our dedication to clinical neurology education, emphasis is placed on the teaching role of the resident. The ward and consult services typically have 2–4 medical students who derive the bulk of their clinical neurology knowledge from teaching provided by our residents. More formal teaching opportunities are also available, including the instruction of small groups of second-year medical students during their neuroscience course each fall.
Academic Half Day
Emerging from our perception of residents’ education, we have instituted an Academic Half Day every Friday afternoon from 1-5 pm. This is a protected educational time for all the residents, during which all our residents will meet on one of our 2 sites (Tufts MC or Lahey Clinic & Hospital). Conferences are based on a yearlong curriculum, composed 4 hours of weekly interactive educational experience, shared between faculty lectures, resident-run teaching sessions, board review questions, case-based education with evidence-based practice topics and clinical simulation sessions.
In addition to the Friday Academic Half Day, we have a resident-oriented daily lecture scheduled on both sites, which includes:
- Morning reports by the night float resident 2 times per week
- Neuroscience ground rounds once weekly
- Weekly neurophysiology lectures
- Clinical pathology case conferences
- Professor rounds (the floor team selects an interesting case to present to Dr. Sabin or Dr. Gross and enjoys the quality time of diagnostic approach education)
- Neuroradiology conferences
- Neuro-Oncology conferences
Journal Club
In addition to our weekly didactics, we instituted a monthly gathering where 1 of our faculty members will host a journal club at his/her place. This has shown to be a great experience for learning and socializing outside the work environment with great quality topics discussed, amazing food provided by the faculty and invaluable time spent together to relax. Unfortunately, this has been on hold due to the COVID-19 pandemic.
