Goals and Objectives of Each Post-Graduate Year (PGY)

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PGY-2

The goals of the PGY-2 experience are focused on the acquisition of clinical skills and medical knowledge, with an emphasis on clinical localization in neurology, hospital-based practice, introduction to ambulatory care, and the evaluation and management of neurological emergencies.

Objectives

  1. To be able to take an accurate neurological history and perform a competent neurological examination, appropriate to the symptoms and patient, including both adults and children [MK, CS].
  2. To provide an accurate localization and differential diagnosis for common neurological problems, and to distinguish between neurological emergencies and less urgent problems [CS].
  3. To be able to evaluate and treat common neurological problems, both emergencies and chronic problems [CS, ICS]:
    • Neurological emergencies: coma/mental status change, stroke, seizure, spinal cord disease
    • Common neurological problems in the ambulatory setting: headache, back/neck pain, dizziness, peripheral neuropathy, memory difficulties
    • Acquire initial experience in the assessment and treatment of specific neurological diseases: epilepsy, multiple sclerosis, Parkinson’s disease, neuromuscular disease, dementia, infectious diseases relevant to neurology, and neuro-oncology
  4. To develop history-taking and neurological examination skills in child neurology [CS].
  5. To begin to acquire and understand the fundamental principles of neuroanatomy and neurophysiology underlying the practice of neurology [MK].
  6. To learn the appropriate indications for ordering specific neurodiagnostic laboratory tests, including lumbar puncture/cerebrospinal fluid analysis, neuroimaging studies of the brain and spinal cord, electroencephalography (EEG), electrodiagnostic and neurophysiological studies (EMG, NCS, evoked potentials) [MK, CS].
  7. To develop competence in the performance of basic neurological procedures, including [CS]: lumbar puncture, basic interpretation of neuroradiological studies, and obtaining informed consent.
  8. To develop and improve the interpersonal and communication skills, both written and oral, necessary to [ICS]:
    • transmit an accurate neurological history and exam to other physicians;
    • provide competent counseling to patients and families;
    • provide competent teaching to medical students and peers.
  9. To develop and improve professional habits of punctuality, responsibility, honesty, integrity, compassion, cultural sensitivity, knowledge-seeking, and self-improvement [P].
  10. To learn to interface with other members of the healthcare team integral to the total care of the patient with neurological illness, including cross-covering physicians, nurse practitioners and physician assistants, referring physicians, social workers, physical and occupational therapists, speech therapists, primary care physicians, neurosurgeons, radiologists, and others [ICS, P, SBP].
  11. To acquire basic knowledge through didactic lectures and self-directed learning of neuroanatomy, neurophysiology, and neuroscience [PBL].
  12. To develop competency in Neuro-ethics and end of life care in patients with devastating neurological conditions. [PBL, P, MK]
  13. To develop a scholarly approach to the study of neurology through the research mentorship program [MK, PBL].

PGY-3

The PGY-3 training builds upon a foundation of clinical skills and knowledge established during the PGY-2 rotations. The goals of the PGY-3 experience include an expansion of clinical responsibility for the care of patients and increased independence in the assessment of neurological emergencies. The PGY-3 resident increasingly explores the subspecialties of neurology, becomes a mentor and role model for junior residents and medical students, and begins to develop research, educational, and leadership initiatives.

  1. To perform comprehensive and problem-oriented neurological histories and examinations [CS].
  2. To demonstrate a sophisticated localization and differential diagnosis of neurological lesions [CS].
  3. To gain additional clinical exposure to subspecialty neurology, including neuromuscular disease, multiple sclerosis and neuroimmunology, neuro-ophthalmology, and neuro-oncology [MK].
  4. To improve history-taking and neurological examination skills in child neurology [CS].
  5. To develop through didactic lectures and self-directed learning an improved knowledge of neuroanatomy, neurophysiology, and neuroscience [PBL].
  6. To gain experience in the supervision of junior residents and medical students on the neurology in-patient and consultation services [ICS, P, SBP].
  7. To participate in discussion forums that emphasize evidence-based medicine and practice-based learning, including Journal Club, Evidence-Based Medicine noon conferences, and Morbidity and Mortality rounds [PBL].
  8. To develop broader skills of systems-based practice by serving as team leader, and through participation in interdisciplinary rounds with other members of the healthcare team [SBP].
  9. To develop an improved understanding of principles of ethical care, including end-of-life issues [P, MK].
  10. To develop a scholarly approach to the study of neurology through the research mentorship program [MK, PBL].

PGY-4

The PGY-4 experience allows residents to consolidate a large body of neurological knowledge and subspecialty depth in preparation for the board certifying examination and the independent practice of neurology. The PGY-4 resident is expected to participate in research, education, and leadership initiatives, developing a professional identity and career plan for fellowship training or clinical practice.

  1. To become independent in the evaluation and management of patients with a wide variety of neurological problems in many clinical settings (ambulatory, emergency room, in-patient), but recognizing the need to seek subspecialty and interdisciplinary consultation when appropriate [MK, CS, ICS, SBP, P].
  2. To improve knowledge of the basic sciences and subspecialty neurology in preparation for the board examination [MK].
  3. To gain further leadership experience in the supervision and education of junior residents in neurology and other subspecialties, as well as medical students [ICS, SBP, MK].
  4. To further an academic approach to neurology through continuing participation in conferences, examination of the neurological literature and mentored scholarship, with the explicit goal of attending a regional or national meeting [MK, PBM].
  5. To develop a career plan for the next step of professional development, whether training, practice or research [P].

 

Updated 7/21/25