The internship at the Department of Internal Medicine at Weill Cornell Medical College (WCMC) is integrated with the neurology program (meaning that we are a four-year categorical program), and thus does not require a separate application. The PGY-1 Medical Internship Year is automatic upon matching with us.
The preliminary year offers top-notch training in internal medicine with our highly prestigious and competitive Internal Medicine Residency Program. The following is an approximate breakdown of the rotations during this year:
The PGY-2 year provides the resident with training focused on the care of inpatients, while developing skills necessary for outpatient neurology practice. The following is an approximate breakdown of the rotations during this year:
On the neurology wards at NewYork-Presbyterian Hospital, PGY-2 trainees act as residents and supervise the interns from neurology and psychiatry, and are responsible for the overall functioning of the inpatient services, including presentation of all new admissions to the attending staff. PGY-2 residents are supervised by the senior resident (PGY-4), stroke fellow, and ward attending on service. PGY-2 trainees also assume formal teaching duties for third and fourth year medical students.
Experience managing critically ill patients with neurologic disease is provided in the state-of-the-art Neurological ICU at Weill Cornell (including a portable CT scanner), where neurology residents rotate together with neurosurgery and anesthesiology residents to provide comprehensive care. Residents care for patients with acute ischemic and hemorrhagic stroke, subarachnoid hemorrhage, status epilepticus, CNS tumors, Guillain-Barre syndrome, and a host of other neurological emergencies. During this rotation, neurology residents are taught several diagnostic and therapeutic procedures, including transcranial Doppler ultrasonography, intracranial pressure monitoring, central venous catheterization, and arterial line placement.
PGY-2 residents serve as junior residents on the NYPH Neurology consult service, working closely with attendings and supervised by PGY-3 residents at all times. In addition, PGY-2 residents also rotate on the Neurology Consult Service at MSKCC, supervised by a neuro-oncology fellow, and attending.
PGY-2 trainees receive an introduction to clinical neurophysiology during the EEG selective. Residents follow a curriculum to learn the basic science behind EEG and its applications and limitations. Residents learn to interpret standard and continuous EEGs with the clinical neurophysiology fellows and faculty and observe intraoperative monitoring.
Beginning in the PGY-2 year and continuing throughout their training, every resident follows a group of outpatients in a weekly attending-supervised neurology clinic. The primary Neurologist is the resident, whereas the attending serves as a supervisor only. In addition to continuity clinic, PGY-2 through PGY-4 residents participate in an ambulatory neurology rotation. The ambulatory neurology rotation is designed to provide the resident with exposure to both general neurology as well as subspecialty neurology in outpatients. The resident on the ambulatory rotation provides care to patients in the various specialty clinics, including: epilepsy, neuromuscular disease, memory disorders, movement disorders, neuro-ophthalmology, multiple sclerosis, sleep, and a lumbar puncture clinic.
Each PGY-2 resident has approximately 8 weeks of elective time during their second year, which they can spend doing clinical rotations or research.
The PGY-3 year provides the resident with training focused on consultative neurology and outpatient neurology. The following is an approximate breakdown of the rotations during this year:
• 18-20 weeks on the NewYork-Presbyterian/Weill Cornell Neurology consult service (combination of days and nights). PGY-3 residents are responsible for running all stroke code activations.
• 10-12 weeks as senior resident on the Memorial Sloan-Kettering Cancer Center neurology consult service.
• 1 week on the NYPH Neurological ICU
• 3 weeks of ambulatory neurology, including formal training in Electromyography (EMG) and Nerve Conduction Studies (NCS)
• 2 weeks of dedicated Research time
• 6-8 weeks of elective time
• 2-5 weeks of inpatient pediatric neurology
• 4 weeks of vacation
The consult services at both hospitals (NYP/Weill Cornell and MSKCC) provide the residents with exposure to a broad range of neurologic diagnoses, including neurologic emergencies. The acute stroke protocol is in place at NYP/Weill Cornell; the PGY-3 consult resident performs all initial evaluations and directs care under the supervision of the stroke fellow and attending. A brain resuscitation protocol is also in place in which the PGY-3 consult resident assesses all post-cardiac arrest patients for the utility of therapeutic hypothermia, in conjunction with the medical and neurocritical care fellows. Teaching rounds occur daily with the general neurology service attending and the stroke service attending.
At NYPH, the consult service consists of a day team of two PGY-3 neurology residents and up to three PGY-2 residents (neurology and medicine residents), one neurology intern, as well as medical students, and is supervised by general and vascular consult attendings. There is a night float system in place, with the night team consisting of a PGY-3 neurology resident and a physician assistant.
The PGY-3 neurology resident’s role overnight is to do consultations and admissions only; all patients on the floor service are covered by the physician assistant. There is no 24-hour call for consult residents at NYP/Weill Cornell; the maximum shift duration is 12 hours.
PGY-3 trainees continue their introduction to clinical neurophysiology during the EMG/NCS selective. Residents follow a curriculum to learn the basic science behind EMG and NCS and its applications and limitations. Residents learn to interpret EMG/NCS with the neuromuscular fellows and faculty either at the Weill Cornell Peripheral Neuropathy Center or New York-Presbyterian Hospital. Residents may learn to perform EMG in addition to NCS and skin biopsies.
The PGY-4 year provides the resident with training focused on preparation to become an attending neurologist by functioning as ward chief. They no longer work nights or 24 hour shifts, and do not rotate on the consult service at NYPH or MSKCC. In addition, the PGY-4 year provides in-depth training in pediatric neurology. The following is an approximate breakdown of the rotation during this year:
Senior residents assume broad responsibility for patient care on each hospital's clinical service, including the supervision and teaching of junior residents, interns, and students. Their role in the New York-Presbyterian Hospital Vascular Service is to provide supervision to the PGY-2 resident and interns, as well as to formulate daily plans on the patients. The PGY-4 residents work in conjunction with the General Neurology attending and physician assistant to provide care to patients on the General Neurology Service at New York-Presbyterian Hospital.
During the General Neurology Service rotation, they are also responsible for leading Morning Report. Likewise, they supervise the consult team consisting of PGY3 and PGY2 residents at Memorial Sloan Kettering.
During the pediatric neurology rotation, senior residents assume equal responsibility as the pediatric neurology fellow. Working closely with the attending pediatric neurologist, residents manage patients in the neonatal and pediatric intensive care units and in the pediatric inpatient unit, which includes continuous EEG monitoring beds. In addition, residents see patients in two weekly pediatric neurology clinics each week.
The fourth year neurology residents have dedicated elective time during their final year, with options to pursue Global Health experiences.