Curriculum

Neurology Residency Curriculum at MUSC

The neurology training program at MUSC is fully accredited by the Accreditation Council for Graduate Medical Education (ACGME) for training and Board Certification in Neurology. We offer inpatient services in adult neurology at the MUSC University Hospital and at the nearby Ralph H. Johnson Department of Veterans Affairs Medical Center (VAMC).

Program Structure:

Our residency program is meticulously designed to cultivate outstanding physicians in clinical neurology and/or clinical neuroscientists and educators in academic settings.

It spans four years, including an integrated PGY1 year of medicine. This means that successful applicants are automatically granted a PGY1 medicine position without the need for an additional application or interview.

During the PGY1 year, residents spend 3 months dedicated to neurology, ensuring a smooth transition from internship to the PGY2 year.

Additionally, PGY1 residents complete a 1-month psychiatry rotation.

We offer 8 PGY-1 positions annually.

Service Structure:

General Neurology & Stroke Services

MUSC offers two primary Neurology services at the University Hospital: General Neurology and Stroke Neurology.

Each service team consists of a senior PGY3/4 neurology resident, a junior PGY2 neurology resident, and typically an internal medicine or psychiatry rotator. Additional PGY1 neurology residents join the team in most blocks.

Responsibilities involve evaluating patients in the Emergency Department, handling referrals from Neurology specialty clinics, and managing referrals from external physicians.

Patients are admitted to a dedicated Neurology/Neurosurgery wing, which includes an active Epilepsy video monitoring unit.

Collaborations with Physical/Occupational/Speech therapy, Case Management, and Social Work enhance patient care within the Neurology/Neurosurgery subspecialties.

Charleston VA Neurology Inpatient Service

At the Ralph H. Johnson Department of Veterans Affairs Medical Center in Charleston, our neurology team provides both inpatient and outpatient care.

The inpatient team includes a senior PGY3/4 resident and a junior PGY2 neurology resident.

In addition to inpatient services, there are opportunities for residents to participate in outpatient subspecialty clinics.

Neurology Consultation Service

At MUSC, we have two specialized consult teams within our neurology department.

The first team focuses on general neurology consults. The team evaluates patients, provides recommendations, and collaborates with other specialists as needed.

The second team manages acute stroke alerts, which are commonly referred to as “Brain Attacks.” These urgent cases require immediate attention and intervention. Additionally, the team handles non-emergent stroke consults, addressing less critical situations related to strokes.

Each team consists of one to two senior neurology residents, along with off-service rotators from both the Psychiatry and Internal Medicine departments.

Pediatric Neurology Service

Inpatient Consultation Service and Outpatient Clinic.

At MUSC Shawn Jenkins’ Children’s Hospital, our adult neurology residents actively participate in a four-week rotation that includes both the Pediatric inpatient consultation service and the outpatient clinic.

During their PGY2 and PGY3 years, residents work alongside pediatric neurology residents, gaining diverse exposure. This exposure ranges from Neonatal and Pediatric Intensive Care Units to the Epilepsy monitoring unit at the Children’s Hospital on campus.

In their PGY4 year, residents spend an additional four weeks focused specifically on outpatient pediatric neurology.

Continuity Clinics

In addition to inpatient, pediatrics, and consultation services, each resident manages their own panel of patients in a longitudinal neurology clinic.

The Resident General Neurology Clinic spans from PGY2 to PGY4 and allows patients previously seen during inpatient stays or Emergency Department evaluations to follow up with our residents, fostering continuity of care and patient-physician relationships.

These clinics, located at both MUSC Rutledge Tower and at the Ralph H. Johnson Department of Veterans Affairs Medical Center.

Outpatient Rotations

Behavioral Neurology: Residents gain experience in assessing and managing neurological conditions related to behavior, cognition, and psychiatric symptoms. This rotation covers disorders such as dementia, Alzheimer’s disease, and other cognitive impairments.

Epilepsy: During this rotation, residents focus on epilepsy diagnosis, treatment, and management. They participate in evaluating patients with seizures, interpreting EEGs (electroencephalograms), and learning about antiepileptic medications.

Movement Disorders: Residents learn about movement disorders such as Parkinson’s disease, essential tremor, dystonia, and Huntington’s disease. They gain exposure to both outpatient evaluation and long-term management.

Neuromuscular: This rotation involves assessing and treating neuromuscular disorders, including peripheral neuropathies, myopathies, and motor neuron diseases. Residents learn about nerve conduction studies, electromyography (EMG), and muscle biopsies.

Other Elective Opportunities:
- MS/Neuroimmunology: Residents explore multiple sclerosis (MS) and other autoimmune neuroinflammatory conditions. They learn about disease-modifying therapies and patient management.
- Headache: Residents evaluate and manage patients with various headache disorders, including migraines, tension headaches, and cluster headaches.
- Neuro-oncology: This rotation focuses on brain and spinal cord tumors. Residents participate in tumor board discussions, imaging interpretation, and treatment planning.
- Neuro-ophthalmology: Residents learn about visual disturbances related to neurological conditions, including optic neuritis, papilledema, and other optic nerve disorders.
- Neuro-otology: Residents explore disorders of the inner ear and vestibular system, including vertigo, Meniere’s disease, and benign paroxysmal positional vertigo (BPPV).
- Sleep Medicine: Residents gain insights into sleep disorders, such as obstructive sleep apnea, insomnia, and restless legs syndrome.
- Neuro-endovascular Surgery: This elective covers minimally invasive procedures for vascular disorders, including aneurysms and arteriovenous malformations (AVMs).
- Neuroradiology: Residents learn to interpret neuroimaging studies (MRI, CT, angiograms) and collaborate with radiologists.
- EEG (Electroencephalography): Residents gain proficiency in reading EEGs to diagnose and manage epilepsy and other neurological conditions. Although 4 continuous weeks of EEG are part of our core rotations in the PGY2 year, residents can choose to pursue further training in their PGY3 and PGY4 years.
- EMG (Electromyography): This rotation focuses on assessing peripheral nerve and muscle function using EMG studies.

Night Float Call System

Our call system ensures coverage from 5:30 p.m. to 7:00 a.m., with one PGY3/4 and one PGY2 neurology resident available for admissions and consults at MUSC and the VAMC.

Wellness & Education

The Medical Education and Wellness Rotation is intentionally crafted to enrich residents’ educational experience and promote their overall well-being. During this rotation, residents engage in several key activities:

Medical Student Education: Residents actively participate in medical student education. They have the opportunity to give lectures, facilitate simulation labs, and lead exam workshops. By teaching and mentoring medical students, residents enhance their own understanding of neurology while contributing to the learning environment.

Wellness Support: Prioritizing wellness is crucial for residents’ long-term success. During this rotation, residents allocate time for personal wellness activities. This might include attending medical appointments, exercising, reading, or pursuing other hobbies. Taking care of their physical and mental health ensures that residents can perform at their best.

Individual Academic Pursuits: The rotation also serves as a platform for individual academic growth. Residents can dedicate time to research projects, scholarly activities, or independent study. Whether exploring a specific topic, conducting literature reviews, or collaborating with faculty, this rotation fosters intellectual curiosity and professional development.