Adult Rotations

Advanced Stroke

During this elective you will evaluate new consultations with complex cerebrovascular disorders in addition to seeing hospital follow-ups and gaining exposure to managing complications of stroke (i.e., spasticity, epilepsy).  You will gain competency in the utilization of botox for post-stroke spasticity, as well as gain exposure to transcranial doppler performance and interpretation, as well as catheter angiographic procedures for cerebrovascular disease.


Child Neurology Inpatient

Residents on this rotation will learn the management of common childhood neurological disease and be able to manage adult patients who acquired their neurological problems during childhood. You will be exposed to a variety of neurological disorders in an inpatient setting or consultation including epilepsy (new onset or febrile), intractable epilepsy (adjusting medications and monitoring), infections such as meningitis or encephalitis, inflammatory diseases, spinal cord diseases such as transverse myelitis, headache, brain tumors, neuro-degenerative disorders, cerebral palsy and more. You may also manage patients in an emergency or critical care setting while on this rotation.


EEG

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While on this rotation, residents will develop competency in the management of patients with epilepsy. You will be granted full exposure to the in depth management of epilepsy patients. This includes inpatient evaluation and management through the epilepsy monitoring unit and epilepsy consult service. You will be trained in the interpretation of electroencephalograms (EEG) and evoked potentials along with being involved with the selection of patients for surgical procedures in the management of their epilepsy. Residents are required to do two separate months on this rotation, one as a PGY-2 and another as a senior resident. You may also take additional months as an elective.


Epilepsy Monitoring Unit (EMU)

This rotation is combined with the EEG rotation with an alternating schedule for the EMU lab and EEG lab. Usually, mornings are spent in the EMU lab while afternoons are spent in the EEG lab or the continuity of care clinic. In addition to the required months, many residents elect to spend additional time in the EMU.


External & Outside Rotations

Residents are afforded the opportunity for rotations outside our department in areas including Internal Medicine, Internal Medicine ICU, Internal Medicine Wards and Psychiatry.


Headache

During this elective, you will gain exposure to complex outpatient headache consultations and gain competency in outpatient headache procedures.  You will work with headache subspecialty faculty, as well as rotate through the University of Kentucky Orofacial Pain Clinic and Neuroophthalmology clinics.  Rotators are able to achieve competency on utilization of pericranial nerve blocks and onabotulinumtoxinA injections for chronic migraine during this experience.


Multiple Sclerosis

You will work directly with our multiple sclerosis faculty in the evaluation of complex outpatients with suspected or confirmed multiple sclerosis, in addition to a variety of other inflammatory and infectious illnesses of the central nervous system.  You will gain competency in the outpatient management of inflammatory and infectious neurologic diseases along with comfort in managing the spectrum of novel immunomodulatory agents for these disorders.


Neurocritical care

This required PGY1 and 2 experience is designed to provide you with early exposure to neurologic and neurosurgical emergencies in a controlled environment under direct supervision.  During this rotation you will work directly with neurocritcal care attendings and care for patients with common and uncommon neurologic emergencies (i.e., myasthenic crisis).  This rotation will not require either night or weekend duty.


Neurodegenerative

This popular rotation allows you to develop proficiency in the outpatient management of complex cognitive-behavioral and movement disorders working directly with corresponding sub-specialty faculty.  In addition to gaining competency in the management of common and uncommon cognitive and movement disorders, you will also spend time observing outpatient neuropsychological testing to learn the nuances of interpretation of these reports.


Neuroimaging

This rotation will give residents the knowledge to recognize the characteristics of normal and abnormal images of brain and spinal cords on CT and MRI studies. These tools are valuable when evaluating patients with neurological disorders. It is imperative for residents to understand the technical aspects of these studies along with being able to interpret and describe the results to the patient. During this rotation, you will be exposed to different modalities of imaging including CT, MRI, MR, Spectroscopy, and cerebral arteriogram.  During this rotation, you will be directly supervised by neuroradiology faculty.


Neurology Consultation

This rotation is essential when learning to provide timely, effective and professional neurological consultations. You will provide consultations to both hospitalized and ED patients during this rotation. You will act as the interface for the neurology department and other departments. This exciting rotation allows you to be the primary neurologist for referring physicians which then allows you to put to work the knowledge gained in your previous years of residency. Conditions you may see include cerebrovascular diseases, inflammatory diseases, meningitis, encephalitis, spinal cord diseases, paroxysmal disorders such as seizures and dystonia and cranial neuropathy just to start. 


Neuromuscular Rotation

This rotation allows residents to develop competency in the management of patients with neuromuscular disorders by allowing complete exposure to a wide array of neuromuscular diseases and their treatment. You will also gain experience with electrophysiology and spend considerable time in the EMG lab performing and interpreting EMG/NCV studies. Due to the importance of this rotation in the overall training program for a resident, we typically require three months spent on this rotation although you can decide at what point you take these three months.


Neuro-oncology

During this elective you will gain exposure and competency in the multidisciplinary management of adult and pediatric neuro-oncology.  You will work directly with adult and pediatric neuro-oncologists to evaluate new consultations and established patients with suspected or proven CNS malignancy.  In addition, you will spend time observing radiation oncology to learn the basics of this therapy to gain comfort with when to refer and what complications to expect.


Neuro-ophthalmology

Residents on this rotation become competent at assessing and managing patients with neuro-ophthalmic diseases including emergencies. You will be exposed to patients who have developed visual disorders as a result of neurologic disease. You will become proficient in performing bedside examinations and eliciting signs that have localizing and diagnostic value. You will see many conditions on this rotation including but not limited to optic neuritis, glaucoma, disc pallor, optic atrophy, Horner's syndrome, migraine, and hallucinations.


Neuropathology

Residents will enhance their knowledge of pathologic correlates of common neurologic disorders on this rotation. This rotation allows for intensive, independent studying in the basic neurosciences where you can review and refresh basic skills in neuro-anatomy and pathology. You should view this time as a critical learning time to solidify your basic foundation in the neurosciences along with preparing for the board examination. You will be tasked with assisting the supervising attending in arranging daily slide review sessions and you will also complete the independent study slide carousel and neuro-pathology self-study curriculum.


Night Ward Cross Cover

This rotation will allow the resident to be trained in the effective, ethical, patient-centered care for patients with neurological disorders in inpatients, emergency and intensive care settings. While on this rotation you will be exposed to a breadth of neurological disorders including epilepsy, infections, myasthenia gravis, multiple sclerosis, spinal cord diseases, headache, brain tumors, and advanced neuro-degenerative disorders. You will also manage patients in an emergency or critical care setting where you may see diseases such as status epilepticus, encephalopathy, severe CNS infections, and patients with pulmonary insufficiency.


Outpatient Epilepsy

Students on this rotation will develop competency in outpatient management of patients with epilepsy. You will be exposed to a wide array of complex epilepsy cases seen in the neurology clinic and their investigation and treatment options. You will also be introduced to various clinical trials in the management of refractory epilepsy. You will begin to understand the most optimal methods to manage unique challenges in cases of refractory epilepsy and practical issues of women with epilepsy. 


UK Medical Center Continuity of Care Clinic

The UKMC continuity of care neurology clinic will train residents to be competent in the provision of effective, ethical, patient-centered longitudinal care for patients with neurological disorders in an outpatient setting. You will be exposed to a variety of very diverse adult patient population across all backgrounds. You will have the opportunity to assume primary care for patients beginning in your PGY-2 year and continuing until graduation. As you progress through the program, you will assume increasing levels of responsibility and independence in patient care decision making.


UK Medical Center General Neurology Ward (inpatient)

During this rotation, you will be exposed to a wide range of neurological disorders in an inpatient, emergency and intensive care setting. Along with seeing including severe exacerbations of epilepsy, myasthenia gravis, multiple sclerosis, transverse myelitis and more; you will also manage patients in an emergency or critical care setting that may have status epilepticus, pulmonary insufficiency, acute polyneuropathy, and severe CNS infections. 


UK Medical Center Vascular Neurology (inpatient)

This rotation will allow the resident to develop competency in the management of patients with cerebrovascular disease, both pre and non-surgical. The array of cerebrovascular disease you may be exposed to includes acute ischemic infarct, post tPA management of stroke, transient ischemic attack, arterial dissection, hypertensive encephalopathy and more.


VA Medical Center Continuity of Care Clinic

Because you will be working at the VA Medical Center, your patient population will predominantly be adult male veterans on this rotation. This will allow you to be exposed to a wider variety of neurological disorders that are typically seen in the veteran population. You will begin to provide primary care in your PGY-2 year and continue until graduation from the program. As you progress in your training, you will assume higher levels of responsibility for your patients. The diseases you may see on this rotation will include headache, backache, peripheral neuropathy, post-stroke care, post-concussion care, epilepsy (including post TBI), essential tremors, vertigo, spinal cord diseases and more.


VA Medical Center General Neurology Ward

You will be providing effective, ethical, patient-centered care for patients with neurological disorders in inpatient, emergency and intensive care settings in a predominantly adult male veteran patient population on this rotation. You will be seeing conditions that include acute ischemic stroke, seizures and epilepsy, neurological complications from brain injuries, advanced degenerative disorders such as ALS and Parkinson's, brain tumors, and more. 

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