question about inpatient neurology during residency

[thepretender67]

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During inpatient months, are neurology residents primarily doing consults? Or do many residencies have their own floors where they admit patients with other medical comorbidities? Do you as a neurology resident have to worry about running codes for cardiopulmonary arrest and managing other non-neurological medical problems ? I understand if your hospital has a NICU then this would be expected, but what about inpatient ward services?

 

[RenegadeSynapse]

Every adult neurology residency I interviewed / looked at had a dedicated inpatient service. I can really only describe my program in depth, but the gist is similar at most programs based on conversations with friends elsewhere. I'm sure there is a range, but at my program we deal with what I would consider a lot of medical problems. We consult medicine specialty services (e.g. cardiology, nephrology) when needed, but we manage simple AKI, Afib with RVR, post-stroke aspiration pneumonia without medicine involvement a majority of the time. Some programs probably handle less medicine and have an easier time transferring to a medicine service, and some may handle more.

MICU responds to all code blues, but obviously won't be at bedside right away, so you're managing very sick patients on the floor / step down until you can get them to the NSICU (which is semi-closed at our institution, so once they are there, a separate NSICU team handles direct patient care).

 

[kchan99]

There are usually neuro floors, but in some programs, they're may less medical management. For instance, I've heard of a program in which post-strokes are frequently transferred to medicine services after several days. In my program, we did not transfer to medicine unless the patient had complicated medical comorbidities, such as GI bleed requiring transfusions and multiple EGDs/C-scopes. When considering prelim programs, I suggest selecting prelim medicine programs in large hospitals with very sick patients rather than cush transitional year programs.