Rotation Structure

This service covers our La Jolla Hospitals — the VA (UC San Diego campus) and Jacobs Medical Center with its adjoining Thornton and Sulpizio Cardiovascular Hospital. The two hospital complexes are less than five minutes drive apart. The medical center is currently constructing a footbridge to connect the two.

The La Jolla team consists of 1 senior and 2 junior residents with a stroke NP, psychiatry resident and medical students. Residents work as one team, rounding with both the stroke service and a general neurology service. Teams function as both primary and consultative services for the ED and hospital. Typical hours are from 7:00 a.m. to 6:30 p.m. 1 day is off allotted per week.

This is a busy but rewarding rotation that hones resident skills in both "bread and butter" neurology as well as complex tertiary cases and critical care transfers.

This service covers the UC San Diego Medical Center, Hillcrest Hospital.

The Hillcrest service consists of 1 senior and 1 junior resident with a stroke NP, psychiatry resident and medical students. Residents act as one team that rounds with both a stroke service and a general neurology service . The team functions as both primary and consultative services for the ED and hospital.

After hours, the Hillcrest team also acts as a consultative service for Neurocritical Care. Typical hours are from 7:00 a.m. to 6:30 p.m. 1 day off is allotted per week.

Historically the San Diego County Hospital, the hospital continues to serves as a safety net for the underserved and UC San Diego's level 1 Trauma Center. The service is known for its fascinating diverse and often rare neurologic caseload given the hospitals unique catchment.

Residents rotate on the NCC service in their PGY 2 and 3 years. The NCC service consists of an anesthesia, neurology, internal medicine and NCC NP. The care of patients is closely overseen by neurology/anesthesia trained neurointensivists and a fellow.

The unit is a closed unit, with primary responsibility of critically ill neurologic and neurosurgery patients. This is a Q4 (24 hr) call schedule when averaged over the one month block. neurology residents have protected time for clinic and didactics. Typical hours at 6:30 a.m. to 6:30 p.m.

Residents become comfortable with a wide array of complex neurologic pathology (eg ICH, complex ischemic stroke, status epilepticus) as well as ultrasound and continuous EEG. Residents partake in procedures including arterial, central lines and lumbar puncture.

A dedicated night float is in place with one resident covering the La Jolla Wards, and the other covering Hillcrest Wards. Residents are responsible for general and stroke inpatients as well as any overnight consults or admissions. The Neuro-ICU and EMU are not covered by the float resident. Night float is in 2 week blocks, 6 shifts on, one shift off (Sunday). A senior resident/stroke fellow and attending acts as backup for all matters during the night for the junior residents. Hours are from 6:30 p.m. to 7:00 a.m.

Residents will rotate in various subspecialty clinics (e.g. Dementia, Headache, Movement) to further their breadth of neurology and explore possible subspecialty interests. A one-half day is dedicated to being the primary provider of the urgent care needs of the VA. Residents will further their skills in general neurology and can gain experience in lumbar punctures and unique procedures like migraine botox injections. Typical hours are 8:00 a.m. to 5:00 p.m.

Residents have a one-half day afternoon continuity clinic once a week at either Hillcrest (Thursday) or the VA (Wednesday) on an alternating basis. Residents are the sole providers for their patient panel which provides a great opportunity to see the spectrum of neurologic disease over time. New and continuity patients are seen at this clinic and residents get the opportunity to bring patients from the inpatient realm and subspecialty clinics into their panel. Residents on night float and vacation are excused from clinic.

This is an outpatient based rotation during PGY 2 and PGY 3 years. Residents work one on one with the attending and fellows and will become comfortable with fundamental electrophysiology and EEG interpretation in our dedicated monitoring unit. Hours are typically 8:00 a.m. to 5:00 p.m.

Neurology residents will rotate at Rady's Children's for their pediatric residency requirement. Here residents uniquely function as "fellows", and round with the pediatric team and pediatric neurology attending. A home call system is implemented.

Residents have 8 total months of elective to explore interests in neurology, there is much flexibility in options – see Electives. Geriatric-psychiatry is done during this block.

Residents participate in a number of dedicated educational experiences during their time at UCSD to further bolster their clinical training including:

• Grand rounds
• Resident lead "Professor rounds
• Dedicated rotating didactics and journal club lead by faculty
• Noon Report and Neuro-Localization didactics
• Faculty guided subspecialty and research mentorship
• Neurologic simulation center training
• Neuropathology, Neuroradiology, and subspecialty conferences throughout UCSD's campus
• Quality improvement projects