Western University, Canada - London Ontario

| Tuesday October 21, 2014
2:59 AM

Overview

The Department of Neurology at London Health Sciences Centre strives to give state-of-the-art training in neurology by providing exposure to a broad range of patients, utilizing the latest diagnostic techniques and advanced treatment.

Trainees gain their experience in general internal medicine and the subspecialties, surgery, psychiatry, emergency medicine, intensive care medicine, and general and special neurology inpatients, consultations, outpatients, emergency neurology, neuropathology, neuroradiology and research.

The Neurology program provides five years of training in adult neurology in accordance with the requirements of the Royal College of Physicians and Surgeons of Canada. By providing consistently excellent clinical and scientific learning opportunities, the Clinical Neurological Department has an internationally recognized tradition of training academic leaders and practitioners of neurology.

Program Contacts

CNS Department Contact
Contact:
Lisa Baker-Spiller
Position:
Education Co-ordinator
Email:
Phone:
519 - 663 - 3696
Fax:
519 - 663 - 3982
Address:

Room B7-005
339 Windermere Rd.
London, Ontario
N6A 5A5

Program Director, Division of Neurology
Phone:
519 - 663 - 3404
Address:

London Health Sciences Centre
University Hospital
339 Windermere Road
London Ontario Canada
N6A 5A5

Strengths

 

  • Dedicated and effective Program Director and Residency Training Committee responsive to residents concerns
  • Excellent clinical teaching covering all of the major subspecialty areas of neurology
  • Well-organized didactic teaching schedule
  • Library resources

Facilities

 

  • Children's Hospital of Western Ontario (CHWO) Clinical Teaching Unit
  • London Health Sciences Centre- University Campus (LHSC-UC), Clinical Teaching Unit
  • London Health Sciences Centre -University Campus (LHSC-US), Clinical Teaching Unit
  • St. Joseph's Hospital (SJH) Elective Experience

Curriculum

PGY-1 

The basic clinical year or PGY-1 is designed to allow trainees to prepare for and gain appropriate exposure to those disciplines which constitute Part II of the Medical Council of Canada Qualifying Examinations, and include medicine, surgery, radiology, pediatrics, psychiatry and public health and community medicine.

An introduction to clinical neurology allows them to become familiar with the structure and function of the program, with the institutions involved and with faculty and fellow trainees. This is the first major opportunity they will have to become part of the "Neurosciences Family" at Western and it will allow them to develop their identity within the group. Experiences in this year may be taken at the Children's Hospital of Western Ontario, the Victoria Campus, the University Campus or St. Joseph's Hospital. Trainees also are given a rotation on neuroradiology, which serves to give them a base of this important diagnostic modality.

PGY-2 

The second year internal medicine may be taken at the LHSC-VC, LHSC-UC or St. Joseph's Hospital in conjunction with the Department of Medicine. Experiences in general internal medicine and the subspecialties such as cardiology, intensive care medicine, rheumatology, immunology, respiratory and nephrology are gained over an eight month period. A rotation in neurology reaffirms the trainee's relationship with the department and allows them the opportunity to begin the selection for outpatient clinics and other experiences that are part of the third and fourth year of training. A variety of optional experiences are available in this year, as listed, which allows the trainee to broaden interests and compliment pervious training.

PGY-3 

This year is an inpatient ward, emergency room and outpatient experience. Assignment in three or six month total blocks is made to the Victoria and University clinical teaching units. Outpatient experiences may be taken at the Victoria, University and St. Joseph's Hospitals. It is during this year that the trainees develop, under the close supervision, the primary skills necessary to function as consultant neurologists. These skills include the ability to obtain a complete neurological history and to perform an appropriate general and neurological physical examination, to determine whether the patient's symptoms and signs are the result of an organic or psychological disorder, and to determine the basic anatomical localization of the process in question. During this year the trainees learn the management of neurological emergencies and how to develop investigative and treatment plans for patients with neurological disease. They are encouraged and instructed in the development of communication and counseling skills with patients, families, and colleagues and other health care workers. They learn how to keep complete neurological records and to work as part of the health care team. They engage in some teaching of medical students and other health professionals while interacting with them on the wards and in the emergency room.

Technical skills including the performance of a lumbar puncture and edrophonium test are learned in this year. Two mandated and time protected outpatient clinics are attended weekly in this year, one of which must be a general neurology clinic. Their formal educational experiences are focused during protected time on Tuesday mornings from 0800 hrs to 1300 hrs when department Grand Rounds are held which are followed by sequenced clinical and basic science seminars, lectures and tutorials. It is during this latter period that the observed clinical and oral examinations and written examinations are also held on a quarterly basis. During this year, residents have a half-day for research.

PGY-4 

This year is structured to allow the trainee to gain knowledge and skills in several of the disciplines, which support the neurological consultant. It includes the required three months in pediatric neurology, and three months in neuropathology.

During this year, trainees may select from a wide variety of general and subspecialty outpatient experiences and other activities including electroencephalography and electromyography. Trainees may also develop or enhance interests in basic and clinical research. This is a year where the call schedule is considerably reduced so that trainees have the time to consolidate much of what they have learned during the previous years and to read about topics in depth.

During the pediatric neurology experience trainees are exposed to a broad range of neurological disease as seen in the outpatient clinics and pediatric neurological consultative service while supervised by the consultant neurologists. There is a busy pediatric emergency room, with over 30,000 visits annually where the residents gain experience in this aspect of pediatric neurological practice.

Neuropathology training is taken at the University Campuses where a broad range of neurological disease is seen. Brain, muscle and nerve biopsies, are frequent as are postmortem examinations on patients dying of neurological and other diseases, as are postmortem examinations. Weekly review and teaching rounds are scheduled and there is a large library of collected cases for the trainees to review at each institution. During this year, residents have a half-day for research and a half-day for longitudinal patient follow-up.

PGY-5 

The fifth year is taken equally at the LHSC-UC and LHSC-VC where the trainee assumes the role of Senior Resident. Administrative and teaching skills are developed or improved through management of the inpatient unit. No direct ward inpatient responsibilities are required other than those that might be occasioned during call periods, rather the trainee in effect, assumes the role of a Junior Faculty and deals with the consultative service, and urgent referrals either from family physicians, other specialists, or the emergency room. Outpatient experiences are scheduled to meet general or special interests. In this way the trainee is given greater responsibility in several areas including administration, teaching, and service in an effort to encourage and develop the transition from trainee to consultant. Communication skills and counseling techniques are enhanced during this time. While the PGY-5 trainees participate in the call schedule, they have no direct ward inpatient responsibilities unless they elect to do so. Their formal educational time from 0800 to 1300 hours on Tuesdays is also protected, as are their mandated twice-weekly outpatient clinics. During this year, residents have a half-day for longitudinal patient follow-up.

During the course of the final three years of training, residents spend approximately 60% of their time pursuing outpatient experiences.

Research

 

Research can be done as an elective in PGY-4 for up to six months. Residents in PGY-2 are encouraged and helped to identify a research project in which they can participate during their PGY-3 and PGY-4 years with the goal of presenting an abstract at a meeting and/or writing a paper.

NOTE: Most postgraduate students, through the course of their training, participate in case reports, clinical or bench research such that in the preceding six years our postgraduate students have produced numerous papers and abstracts.

Seminars

 

Basic and clinical science seminars, tutorials and lectures cover a broad range of topics in annual, two or three-year cycles which encompass the knowledge base required for the discipline and include a course in evidence based medicine and ethics. Postgraduate trainees are given protected time to attend mandated weekly educational sessions. Quarterly observed clinical and oral examinations and regular written examinations form part of the evaluation process.

Selection Criteria

 

An elective experience in the program is not required but would help the candidate to learn more about the program and to meet faculty and other trainees.

We select candidates to interview on the basis of the personal letter, personal and written references and recommendations. All candidates who do an elective experience in neurology at Western are given interviews.

Application Process

Currently, the neurology program only accepts applicants through the Canadian Resident Matching Service (CaRMS).

Michael W. Nicolle
Wai P. Ng