Johns Hopkins Pediatric Neurology Residency

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The Pediatric Neurology residency at Johns Hopkins is designed to train a physician in academic and clinical pediatric neurology. The program stresses the development of competence in several areas including clinical neurology (with inpatient, outpatient and consultative experiences), neurosurgical problems and the scientific basis of neurology. Furthermore, the program allows pediatricians with diverse backgrounds and interests the opportunity to develop areas of special competence in specific clinical or research areas. All residents are requested to participate in research projects under the mentorship of a full-time member of the faculty.

THE INPATIENT SERVICE

The inpatient service team is responsible for providing primary and consultative care for children with neurological and neurosurgical problems through the Children's Center which is divided into age appropriate wards. The inpatient team is composed of a pediatric neurology attending physician, a pediatric neurology senior resident and at least one junior resident from pediatric neurology, adult neurology or rehabilitation and physical medicine. There are approximately 600 clinical neuroscience admission to the Johns Hopkins inpatient service per year. An additional 5 to 15 pediatric patients are followed in consultation each day. All inpatient admissions are followed by pediatric residents to which we have a strong teaching relationship.

THE OUTPATIENT SERVICE

The pediatric neurology outpatient clinics are Johns Hopkins include those for general child neurology problems and specialty clinics in epilepsy, movement disorders, and neuromuscular diseases. Faculty also are active participants in the neonatal follow-up, HIV, genetics, oncology, psychiatry and pediatric neurosurgery clinics.

In each clinic, the resident is assigned to an attending for whom a panel of patient has been scheduled. A mixture of new and follow-up patients are interviewed, examined, and discussed with the attending. All pediatric neurology residents have a weekly continuity clinic which they attend year-round for all three years of the residency.

During the three-year program, one year is spent in clinical pediatric neurology, one year in adult neurology and one year in electives. Time spent in each of these areas is distributed over the duration of the training program in order to provide a continuum of exposure to clinical neurological problems. Adult neurology training is divided relatively equally between consultative and ward services. Elective time may be spent either learning clinical subspecialties or developing a more in-depth knowledge of a clinical or research area. A typical program is outlined below, but may be modified depending on the background and interest of the trainee.

The FIRST YEAR:

During the first year, the resident develops clinical skills in adult and pediatric neurology. The physician will spend 6 months as a resident on the adult neurology wards at The Johns Hopkins Hospital (JHH) and The Johns Hopkins Bayview Medical Center (Bayview), 4 months on the pediatric Neurology service at JHH and one month on the general consultation service at Sinai Hospital.

The SECOND YEAR:

The second year of the program involves subspecialty electives and rotation in both pediatric and adult neurology. Typically, a resident spends 1 month on neuropathology, 1 month on electroencephalography, 1 month on neuromuscular, 3 months on adult (inpatient and consults), 3 or 4 months on pediatric neurology as the senior resident, and several months in other electives (neuroradiology, neuro-ophthalmology, neurophysiology, etc.) Rotations are available to develop skills in learning disabilities, mental retardation, neurorehabilitation, developmental pediatrics or in basic research techniques in laboratories within JHH or at the Kennedy Krieger Institute.

The THIRD YEAR:

In the third year, the senior resident supervises the pediatric neurology inpatient service for 4 months, and spends 1 month on child psychiatry, neuropathology, EEG and neurophysiology. The remaining months are spent on elective rotations.

RESEARCH OPPORTUNITIES

An important part of the program is exposure to and participation in clinical or basic neuroscience research efforts. All residents are encouraged to become involved in a project during their three years of training. In the third year, results of the resident's efforts are presented at a special neurology Grand Rounds. Research seminars are held on a regular basis under the auspices of the Departments of Neurology, Neurosurgery, Neuroscience, and Pediatrics. In order to improve the resident's neuroscience background, trainees are urged to participate as teaching assistants in the School of Medicine's neuropathology and neuroscience courses.

CONFERENCES

All residents are encouraged to attend conferences that have been designed to keep them informed of major developments in both the basic and clinical neurosciences. A wide variety of conferences, lectures, courses and seminars are available through the Department of Neurology, Neurosurgery, Neuroscience, Pediatrics and Psychiatry. Ward attending rounds are held daily with didactic sessions at least three times weekly on both the adult and pediatric neurology services. Noontime conferences on clinical and research topics are held daily throughout the year. For the first two months of the residency, major topics of clinical interest to the first-year neurology resident are discussed. During the remainder of the year, these conferences include regular discussion of movement disorders, cerebrovascular disease, seizures, neuromuscular disorders, neuropathology (clinical-pathological conference), and neuroradiology. A weekly research seminar reviews ongoing projects within the department and the institution. Other regular weekly conferences are devotes to pediatric neurology, pediatric neuro-oncology, adult neurology, neuroradiology, neuro-ophthalmology, neurovirology, nerve and muscle, vascular disease and neuro-vestibular issues. Topics of conferences at Bayview include sleep disorders, clinical neurophysiology, neuroradiology, neurotoxicology and aging. Conferences in many other areas are held under the auspices of psychiatry, neurosurgery, pediatrics and other clinical and basic science departments.