Neurology

[panipuri]

Do we require Neurology rotation for graduation?

I was reading abim website (http://www.abim.org/certification/policies/imss/im.aspx ) and it says:

Content of Training

The 36 calendar months of full-time internal medicine residency education:

1. Must include at least 30 months of training in general internal medicine, subspecialty internal medicine and emergency medicine. Up to four months of the 30 months may include training in areas related to primary care, such as neurology, dermatology, office gynecology or office orthopedics.

We do have ambulatory rotation. Does this suffice?

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[gutonc]

Do we require Neurology rotation for graduation?

If you're a neurologist, yes. Otherwise, no.

I was reading abim website (http://www.abim.org/certification/policies/imss/im.aspx) and it says:
Content of Training

The 36 calendar months of full-time internal medicine residency education:

1. Must include at least 30 months of training in general internal medicine, subspecialty internal medicine and emergency medicine. Up to four months of the 30 months may include training in areas related to primary care, such as neurology, dermatology, office gynecology or office orthopedics.

We do have ambulatory rotation. Does this suffice?

As long as it's not ambulatory surgery or ambulatory psych, then yes.

 

[NotAProgDirector]

Actually, it's a bit more complicated than that.

In order for you to be ABIM certified, you do NOT need to have a neurology rotation. As the quote you posted points out, p to 4 months out of the 30 core months can be things like neurology, etc. But you don't have to do this, and you can have all 30 months be core internal medicine months.

However, the ACGME/RRC requires that programs have a neurology experience. The text is:

IV.A.2.c).(1) Faculty with credentials appropriate to the care setting must supervise all clinical experiences. These experiences must include:
IV.A.2.c).(1).(a) required critical care rotations (e.g., medical or respiratory intensive care units, cardiac care units) which cannot be fewer than three months and more
than six months over the 36 months of training;
IV.A.2.c).(1).(b) exposure to each of the internal medicine subspecialties and neurology;
IV.A.2.c).(1).(c) an assignment in geriatric medicine;
IV.A.2.c).(1).(d) opportunities for experience in psychiatry, allergy/immunology, dermatology, medical ophthalmology, office gynecology, otorhinolaryngology, non-operative orthopedics, palliative medicine, sleep medicine, and rehabilitation medicine;

Note that an experience in geriatrics (which MUST be at least 4 weeks long) and an experience in neurology are required. The remaining list must be available as electives. Hence, all programs should have some neurology experience. It could be a block rotation, or it could be some sort of distributed rotation (i.e. neurology as part of an ambulatory block). However, you personally will not run into any trouble if you don't have a neuro experience, your program will simply be cited for it at their next site visit.

 

[gutonc]

Follow-up question: If a program has a neurology rotation (like mine did) but not all residents are able to rotate through it due to time constraints (26 blocks of rotation time/year, 30-35 residents/year) is the program "in the clear" WRT the neurology requirement? Just curious more than anything.

 

[NotAProgDirector]

Follow-up question: If a program has a neurology rotation (like mine did) but not all residents are able to rotate through it due to time constraints (26 blocks of rotation time/year, 30-35 residents/year) is the program "in the clear" WRT the neurology requirement? Just curious more than anything.

No, mostly.

From the RRC:

Do all residents need to rotate on a neurology service? [Program Requirement: IV.A.2.c).(1).(b)]
• While a neurology rotation is not mandated in the requirements, the
Review Committee will examine very carefully programs that propose to
meet the standard without a dedicated rotation.
• The program must provide residents with instruction and sufficient clinical
experience in neurology to acquire the knowledge needed to diagnose,
follow, and treat patients with common neurologic disorders and to
recognize those disorders that should be referred to a neurologist.
What does the Review Committee consider to be an adequate geriatrics experience? [Program Requirement: IV.A.2.c).(1).(c)]
• Each resident must have a rotation in geriatrics. Although the Review
Committee does not specify the length of the rotation, experiences of less
than one month will be examined very carefully. At a minimum, each
program must have at least one ABIM-certified (or ABFM) geriatrician
directing the rotation and responsible for the curriculum. Each attending
need not have a Geriatrics CAQ.

So, all residents must have a neuro experience. If not all residents can do the neuro rotation you describe, they must have some other neuro experience. I would say that, similar to the IRS, you'd never want the RRC to "very carefully examine" anything.