The first year of neurology (PGY-2) at Stony Brook is divided into a variety of different rotations, and a typical day for each is listed below. All of your time is spent at Stony Brook University Medical Center or the Northport VA Medical Center.
General Neurology (~8 weeks):
All neurology admissions other than strokes or TIA’s (for example seizures, Myasthenia Gravis, Multiple Sclerosis, ETC) are admitted to the general team, which consists of a PGY-4 neuro resident, a PGY-2 neuro resident, the attending, and medical students. Your day begins at 7:30AM. Interdisciplinary discharge planning rounds with the senior resident, the social worker, case manager, therapists, and nursing occurs around 9:00AM. Attending rounds usually ends before 12PM. We typically have 4-10 patients on the general service at any given time. When rounds are finished, you have the rest of the day to complete your work. All notes, discharges, and dictations will be completed. Lumbar punctures will be performed if needed. Neuroradiologists are available to review studies. There will be time to read up on the neurological diseases you encounter. Occasionally there are Epilepsy Monitoring Unit (EMU) patients who are seen with the Epilepsy attending on call and the PGY4 resident or the resident on Epilepsy rotation. Sign-out to night float occurs at 5PM.
Stroke Neurology (~7 weeks):
All strokes, hemorrhages, and TIA’s are admitted to the stroke team, which consists of a PGY-2 neuro resident, a stroke nurse practitioner or physician assistant, the attending, and medical students. Your day begins at 7:30AM. Rounds with the attending usually begin around 10AM. We typically have 10-20 patients on the stroke service at any given time. We have a Step-down Unit where our most critical patients will be admitted. Patients may go there after the administration of TNK, if they require pressors or continuous drips, or if they just need close monitoring. You will have the afternoon to complete all of your work, and sign-out to night float occurs at 6PM. Sign-out on Fridays is at 5PM.
Veterans Affairs (VA) Hospital (~7 weeks):
The VA hospital is in Northport, about 30 minutes west of Stony Brook University Hospital. The VA rotation consists of outpatient office-based care in the Veterans Affairs Hospital. PGY2s work in outpatient clinic. The day begins at 8:00AM and usually ends around 5:00PM.
Consults (~7 weeks):
The consult team consists of a first year neurology resident (PGY-2), second year neurology resident (PGY-3), two attendings (a general attending and a stroke attending), and several medical students. Your day begins at 7:30AM. The senior consult resident (PGY-3) manages the consult team. All emergency room consults, Code BATs (acute stroke codes), potential admissions, as well as new consults from other inpatient teams and ICUs are seen by the consult team. All neurology follow-ups on other floors are also seen by the consult team. The PGY-3 resident will assign consults to the PGY-2 resident as well as medical students and occasional rotators from other departments. During the course of the day, you will see the consults from the night before with one of the attendings, follow up on established patients, and see new consults and present them to the attending. Your shift ends at 6PM with sign-out to night float. Sign-out on Fridays is at 5PM. The residents usually rate this rotation as one of the busiest rotations, but also best learning experiences.
Ambulatory Rotation (~9 weeks):
Stony Brook Neurology has the 5+1 System. In this system, for 5 weeks, residents will be on inpatient rotations (or VA) and on the 6th week, they will be on one whole week of Stony Brook outpatient service where you are going to see your own patients in Continuity Clinic. The example of the schedule for that week is below.
Our patient population is diverse and includes individuals with multiple neurologic ailments. In our newly renovated outpatient offices, the examination rooms are fully equipped with all that you will need for your exam, plus a computer with EMR access. All cases are presented to an attending who will then examine the patient with you, and supervise medical decision making. The most important aspect of continuity clinic is that these patients truly become your own, and you will continue to follow them throughout your years at Stony Brook.
PGY2 Schedule on 5+1 system
| MON | TUES | WED | THURS | FRI | |
| AM | Continuity Clinic |
PGY 2 July-Dec: Wellness Jan-Jun: Research
|
Continuity Clinic |
PGY 2 LP Clinic July-Dec Wellness Jan-June
LP PGY 2 July-Dec
|
Continuity Clinic |
| PM |
PGY 2 NM/HD
|
PGY 2 ALS
|
Continuity Clinic | Continuity Clinic | Didactics |
Night Float (~8 weeks):
Night float is Sunday through Thursday, and your shift starts at 6PM. You are responsible for all in-house consults (both pediatric and adult) and neurology admissions while on-call overnight. We have Senior Night Float Rotation in place. This means that a PGY-3 or PGY-4 resident will be in-house with you at all times. Your Night Float shift ends at 7:30AM. Night float occurs in a one week block with Fridays and Saturdays off.
Elective (2 weeks):
A variety of elective opportunities exist for residents throughout the training program.
Weekend Call:
Weekend call is broken up into three different shifts. The Friday night person covers from 5PM Friday to 7AM Saturday. Saturday call starts at 7AM and goes until 7AM on Sunday. You and a senior resident round with the attendings and write notes on our own neurology inpatients, and then the junior resident covers consults for the rest of the shift. There is a third resident in-house on Saturday who is a PGY-2 resident taking Short Call that makes the day run smoother for the rounding PGY-2 resident. The next team comes in at 7AM on Sunday, receives sign-out from the Saturday resident, and then the new team rounds with the attendings and writes notes on our inpatients. Both the junior resident and the senior resident cover consults until the night float resident comes in at 6PM on Sunday.