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ELECTIVES DURING RESIDENCY
The range and abundance of electives during neurology residency allows residents to explore many areas of neurology in greater depth. The total elective time is 6 months spread over the 3 years of training, with close to 4 months occurring during the PGY-4 year. Many structured and popular electives are available but residents have also designed their own personal electives depending on their interests.
Electives are commonly done for clinical activities, but may be used for research projects (basic science or clinical) or writing projects (e.g. case reports, literature reviews for publication).
Examples of clinical electives:
- General neurology/Ambulatory neurology: residents may hone their ambulatory neurology skills via a rotation with the Columbia Neurology group seeing patients in a supervised setting. Educational activities are broadened by also seeing patients in the dementia, multiple sclerosis, neuro-otology, and neuro-oncology practices.
- Interventional neuroradiology or interventional vascular neurology: three active interventional faculty are available with training in neurology, radiology and neurosurgery. Residents on this rotation care for patients before and after procedures and assist in the angiography suite during cases. This rotation takes advantage of the broad range of diseases at CUMC, including acute ischemic stroke, subarachoid hemorrhage and vaso-spasm, AVM's, carotid stenosis, and tumor embolization.
- Aging and Dementia: this outpatient elective allows for a broad exposure of all aspects of neuro-behavioral disturbances by seeing patients with faculty with a broad range of interests. Residents care for patients with Alzheimer's disease, Fronto-temporal dementia, Lewy body disease, vascular dementia, and Huntington's disease. Residents will also participate in inpatient consults with the service which includes typically an evaluation of rapidly progressive dementias such as paraneoplastic and prion diseases. Residents on this rotation also have the unique opportunity to attend the multidisciplinary Huntington's Disease Clinic, run by Dr. Karen Marder. Interested residents can also observe neuropsychological testing, and accompany faculty on home visits.
- Neuro-ophthalmology: the Department of Ophthalmology has 3 neuro-ophthalmologists on staff with an active clinical practice seeing a variety of diseases. Residents on this elective evaluate patients in the faculty practice and present to the supervising faculty, and have an additional chance to attend weekly neuro-ophthalmology clinic along with ophthalmology residents to gain a broader understanding of diseases in the orbit and central nervous system.
- Multiple sclerosis and neuroimmunology: residents have the option to broaden their education in neuro-immunology that starts with ambulatory neurology at CUMC, and is highlighted with attending MS clinics at the Cornell campus. This rotation may be performed under the supervision of Dr. Claire Riley seeing patients in the faculty practice and clinic, though residents have also performed this elective at away sites including Mount Sinai and Cornell.
- Neuroradiology: a popular rotation at CUMC, particularly for PGY-2 residents, where neurology residents assist in the reading of neuro-radiological films including CT, myelography, MRI, and PET under the supervision of a diverse group of faculty. While on this rotation, residents can often observe LPs and myelograms done under fluoroscopy.
- Movement disorders/ (Huntington Disease clinic- this is usually done as part of the dementia elective with Dr. Marder, as she runs that clinic): residents may take advantage of the world class movement disorders faculty at CUMC to see a broad range of diseases. Residents will evaluate and participate in treatment of patients with Parkinson's disease at all stages, as well as other adult and pediatric movement disorders. This elective is complemented by Tuesday morning video rounds and CPC with Dr. Stanley Fahn, Botox clinic, and Huntington's disease clinic.
- Neuropathology: this is a 2 weeks rotation where residents will have the chance to review cases from the operating rooms and outpatient practices. Faculty in the department have a broad range of expertise, from muscle diseases, to brain neoplasms and neuro-degenerative diseases. Other highlights of this rotation include brain cutting and the interactive neuropathology and neuroscience curriculum developed in conjunction with the medical school for students and post-doctoral fellows. On this rotation, residents also have the opportunity to look at frozen section specimens directly from the OR.
- Headache: the headache center at Columbia has two offices where residents will see patients with Drs. Chou and Cesar. Emphasis will be on management and treatment of complicated headache syndromes, as well as exposure to the use of Botox for the treatment of migraine. This elective is complemented by the resident headache clinic. Depending on residents interest, this elective may also be organized with sister New York City institutions such as Albert Einstein and Mount Sinai.
- Neuroethics: this important educational opportunity is approached through a combination of lectures, small group case presentation and discussion sessions facilitated by center for bioethics (CFB) faculty, interdepartmental conferences, and a syllabus of essential and reference readings for self-directed learning. In addition residents are actively involved in performing and presenting ethics consultations.
- International electives: formal away electives are available for residents in traveling overseas during their clinic-free elective of one month duration. Residents may rotate with university affiliates in Durban, South Africa and have in the past also rotated at the Queen's square in London. Formal electives in the Dominican Republic are currently being planned.
- Continuous EEG: this elective allows those residents with an interest in EEG/epilepsy to spend dedicated time reading continuous EEGs with the epilepsy fellow on the cEEG rotation. This includes the monitoring of critically ill patients that are being followed both on other services (with neurology consulting) as well as in our own NICU. Other opportunities while on this rotation include attending the various other epilepsy conferences, as well as reading routine EEGs if desired.
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