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Program Structure

The residency program accepts 7 adult-neurology residents yearly however there are an additional 5 pediatric-neurology residents which rotate on the adult services for a total of 12 residents per year.

Outpatient Experience

All residents will have a weekly longitudinal outpatient clinic, allowing for the opportunity to follow patients for the full three years of their residency. In the outpatient setting, residents will evaluate and plan management of patients, much as they do on the inpatient service. Residents are paired with a teaching attending, who is devoted to supervising their activities, and they follow the patients together as a small group practice. The Shapiro Clinical Center provides state-of-the-art facilities for teaching in an outpatient setting.

During the PGY-2 year, residents will have a pediatric neurology clinic at Children's Hospital. In subsequent years, they may choose either to continue at Children's Hospital or to take weekly adult neurology clinics. Additional opportunities to take outpatient subspecialty clinics are available during the electrophysiology, neuropathology, and elective rotations. The subspecialty clinics will allow the residents to focus on specific aspects of neurology that are of special interest to them.

Inpatient Experience

The inpatient program is divided into ward and consult rotations during the first two years, which are supervised by Chief Residents in the third year of the program. The neurology inpatient wards at both Beth Israel Deaconess Medical Center and Children's Hospital are run on a full-time staff model, where the ward team includes the first-year residents under the supervision of a Chief Resident and a teaching attending. Residents take major responsibility for evaluation and management of all patients, with the support of the attending staff. Beth Israel Deaconess is a single hospital, but operates from two sets of buildings, on opposite sides of Brookline Avenue (East Campus and West Campus). The Neurology/Neurosurgery Ward and Neurology/Neurosurgery ICU are located on West Campus, along with the Emergency Department and most of the acute medical and surgical services, and the Psychiatry Ward. The East Campus houses some medical and surgical specialties and obstetrics/gyencology, as well as most of our outpatient facilities, including the Neurology Outpatient Offices in the Shapiro Clinical Center. The Department of Neurology provides consultation services on both campuses.

First year

During the first year, residents primarily take responsibility for neurology ward inpatients and the NeuroICU at Beth Israel Deaconess Medical Center and the neurology ward at Children's Hospital, with occasional coverage of consultations on call nights. In addition, there are rotations in neurosurgery, neurorehabilitation, and electrophysiology, during which the residents will learn the principles of electroencephalography and epilepsy; electromyography and neuromuscular disease; and sleep medicine.

The BIDMC neurology rotations comply with all the ACGME and AAMC policies limiting duration on call and work week. Night call on the neurology wards at BIDMC is covered from Sunday through Thursday by a dedicated night resident rotation, to insure that ward residents get adequate sleep and time off. Night call on Friday and Saturday nights is covered by the resident on call that day, who is able to go home immediately after rounds the following morning and is off for the remainder of the weekend. Residents take Night Call rotations at BIDMC during the latter half of the first year and the first half of the second year. Night call at Children's Hospital during the first year is every fourth night. Neurosurgery night call is every fourth night, and the electrophysiology and neurorehabilitation rotations have no night call.

Second year

During the second year, residents primarily rotate through consult services on both the East and West Campuses of Beth Israel Deaconess Medical Center and Children's Hospital. Resident's complete a rotation in the Beth Israel Deaconess Emergency Department, with the opportunity to participate in emergency evaluation of patients with neurological complaints. In addition, there is a rotation in neurological intensive care medicine at Children's Hospital which covers the Neonatal ICUs at Children's, Beth Israel Deaconess and Brigham and Woman's Hospital.

Second-year residents participate in the night resident rotation during the first six months of the PGY-3 year. Emergency Department coverage has no overnight call, but includes some weekend days. The resident on the Children's Intensive Care rotation takes night call from home and in house call every fourth night when on the Children's Neurology Consult Service.

Third year

Third-year residents rotate through Beth Israel Deaconess Medical Center as Clinical Chief Resident on either Stroke or General/Epilepsy Service. During that time, they are in charge of the neurology inpatient service, supervising the ward and consult residents, interns and medical students rotating through the neurology service. Residents also take Neuropathology in the third year, during which they prepare Neuropathology Conferences and take an individual tutorial that systematically examines the pathological basis of neurological disease. There is also a rotation on the Psychiatry inpatient ward service. The remainder of the third year includes outpatient clinic electives and elective time for a research or teaching project. Electives can range broadly in a wide variety of academic pursuits on the Harvard Longwood Campus. There is the opportunity to a one month off campus as well. In addition, each resident will be expected during the third year to spend one term as a teaching assistant in the Human Nervous System and Behavior course in Harvard Medical School.

Some residents will be awarded the opportunity to engage in a long term research project through the NIH Research Education R-25 Grant, which provides 6 months of research time in the PGY4 year, as well as an additional year of post residency funding for continued laboratory research.

Two of the third-year residents will be chosen as Administrative Chief Residents, and they will share the responsibility for preparing the night call and Grand Rounds schedules.

Sample Schedule



PGY2 PGY3 PGY4
July General Neuro Service West Consult Emergency
August Stroke Service Elective/Vacation General Chief
September Neurosurgery Children's ICU Consult Elective/HMS Teaching
October Rehab/Vacation Emergency/Nightfloat Vacation/Elective
November ICU Elective Elective
December Children's Wards Nightfloat/Elective Stroke Chief
January Stroke Service West Consult Psychiatry
February Vacation/Nightfloat/EP East/Emergency Elective
March Electrophysiology Elective Neuropathology
April Nightfloat/Rehab Emergency/Vacation Stroke Chief
May ICU Children's Consult Vacation/Elective
June General Neuro Service East Consult General Chief