Welcome to our Residency Program

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Residents Schedule

Call Structure

Short call and night float system

No 24 hour calls

No in-house night float for R3s

7:00 AM – 7:30 AM	Sign-out / Pre-rounding
7:30 AM – 8:00 AM	Morning report
8:00 AM – 12:00 PM	Attending rounds
12 noon – 1:00 PM	Noon conference
1:00 PM – 4:00 PM	Afternoon work
4:00 PM – 7:00 PM	Short call
7:00 PM – 7:00 AM	Night float

ROTATIONS:
The year is divided into 13 four-week blocks (52 weeks per year). Each year, each resident gets one block (two half-blocks) of vacation time. The remainder of the year is distributed as described below for each year of training.

Neuro R1
5.5 blocks ward (each session 1.0-1.5 blocks long to mitigate burnout)
1.0 block psychiatry
1.5 blocks night float (done as three half-blocks)
1.0 block OPD (done as two half-blocks)
0.5 blocks OPD elective (headache, behavioral neurology, or assorted clinics)
2.5 blocks elective time (neuroradiology, clinical neurophysiology, interventional stroke, PM&R, neurocritical care, pain management, clinical research)

Neuro R2
3.0 blocks consult
1.0 blocks pediatric neurology
1.5 blocks night float (done as three half-blocks)
1.0 block OPD (done as two half-blocks)
0.5 blocks OPD elective (headache, behavioral neurology, or assorted clinics)
5.0 blocks elective (pain management, EMG, epilepsy monitoring, neurocritical care, movement disorders, clinical research, et al.)

Neuro R3
2.5 blocks ward senior
2.5 blocks consult senior
2.0 block pediatric neurology
2.0 blocks OPD
0.5 blocks OPD elective (see above)
2.5 blocks elective (see above)

One half-day per week is spent in continuity clinic across all 3 years. Residents may not miss clinic for more than four consecutive weeks. Residents are excused from continuity clinic only when on vacation or on night float. The chief residents each do an extra half-block as either ward or consult senior.

ON CALL SCHEDULE:
Our program utilizes a night float system. Night float services are provided by the R1 and R2 residents (1st and 2nd year of neurology training). The night float resident works 6 nights per week for two weeks at a time, covering neurology consultations for a 12-hour overnight shift each night for 6 consecutive nights. The one night per week that is not covered by the night float resident will be covered on a rotating basis by R1 and R2 residents who are not on night float (no more than once a month per resident, on average).

Daytime coverage on weekends and holidays will be provided by the residents who are on service only; this will minimize errors in transitions of care. Residents on the inpatient teams work a 6-day week, covering a 12-hour day shift on either Saturday or Sunday each week. This allows residents who are not on service to have their weekends free.

On weekdays, residents covering inpatient services take turns providing short-call coverage (4:30-7:30 PM) to allow the rest of the inpatient team to leave at a reasonable time each day Monday through Friday, with just one designated resident staying each evening late enough to sign off to the night float resident.

Senior residents (R3’s) provide on call coverage from home, serving in a supervisory capacity, fielding questions and providing support to the in-house on call residents. The number of allowed phone calls is capped to ensure the senior has adequate time to rest (all further phone calls are directed to the attending on call). The two senior residents on service split the weekend, coming in on one weekend day each week to help run morning report and round with the team; the remainder of the day is spent providing supervision from home.

This schedule is in abidance with New York State Department of Health Part 405 Regulations as well as the SUNY Downstate Institutional Work Hours Policy and ACGME Program Requirements for Graduate Medical Education in Neurology. Resident work hours never exceed 80 hours per week averaged over a four-week period, including inpatient, outpatient, and educational activities. In addition, residents always have a minimum of 8 hours off between work shifts, and at least one 24-hour period off each week.

MOONLIGHTING:
Moonlighting is prohibited for 1st and 2nd year neurology residents. Senior residents (R3’s) who no longer do in-house call duties must seek approval from the Program Director and Chair if they wish to moonlight. All moonlighting hours will need to be logged in New Innovations and will count toward the work hours limits above. Moonlighting is a privilege that may be revoked should it interfere with resident learning. Residents on J1 visas may not moonlight under any circumstances.

HOSPITAL SITES:
Our residents' required adult neurology rotations are exclusively at the OBH system. Inpatient adult neurology rotations are entirely at OBH-Brookdale Hospital, located at 1 Brookdale Plaza, Brooklyn, NY 11212. Weekly continuity clinics are also at this location. Some subspecialty clinics are located at OBH-Kingsbrook Jewish Medical Center, located at 585 Schenectady Avenue, Brooklyn, NY 11203. No more than 1 month per year is spent at the Kingsbrook site. Three required months of pediatric neurology training are split between OBH and Maimonides Children's Hospital (a Downstate affiliate; the only dedicated children's hospital in Brooklyn), located at 4802 10th Avenue, Brooklyn, NY 11219.