Pediatric Neurology Residency Overview and Rotations
The Pediatric Neurology residency at Johns Hopkins is designed to train physicians in academic and clinical pediatric neurology. The program stresses the development of competence in several areas including clinical neurology (with inpatient, outpatient, and consultative experiences), neurosurgical problems and the scientific basis of neurology.
Residency at a Glance
- Number of residents per year: 4
- Application: Apply though ERAS
- Program start: July of each year
- Program duration: 3 years starting as PGY3
- Key experiences: approximately one year of clinical pediatric neurology, one year in clinical adult neurology (6 months inpatient/ 6 months outpatient) and one year in clinical subspecialties and electives).
- Research: Residents participate in at least one research project under the mentorship of a full-time faculty member, to be completed by and presented in June of the graduating year.
Time spent in each clinical area of practice is distributed over the duration of the training program to provide ongoing exposure to clinical neurological problems. Adult neurology training is divided equally between consultative and ward services as per ACGME requirements, with very strong outpatient adult neurology clinic rotations. Elective time can be spent learning clinical subspecialties or developing a more in-depth knowledge of a clinical or research area. Away electives are allowed with residency director approval.
The inpatient service team is responsible for providing primary and consultative care for children with neurological and neurosurgical problems through the Johns Hopkins Children's Center, which is divided into age-appropriate wards. Since 2021, we have had two inpatient services (floor and consult). The inpatient team is composed of:
- Pediatric neurology attending physician
- Pediatric neurology senior resident
- At least 1-2 junior residents from pediatric neurology, adult neurology, pediatrics, and the Kennedy Krieger Institute (NDD fellows).
- Often there are 1-2 Johns Hopkins or visiting medical students as well.
There are approximately 600 clinical neuroscience admissions to the Johns Hopkins inpatient service per year. An additional 5 to 10 pediatric patients are followed in consultation each day. Children admitted for epilepsy surgery are also closely followed. Inpatient admissions are managed by the Pediatric Neurology team during the day. Overnight inpatient coverage is provided by the Pediatrics team. There is no overnight in-house call on the Pediatric Neurology service. The senior/chief resident takes home call when on service.
We provide a strong outpatient experience in child neurology, as the national trend in training programs is to increase this experience to match the growing outpatient treatments. The pediatric neurology outpatient clinics at Johns Hopkins include:
- General child neurology problems
- Specialty clinics, including:
- Movement disorders
- Neuromuscular diseases
Our residents also have ample time to rotate through clinics at Kennedy Krieger Institute including those with focus on autism, developmental disabilities, rehabilitation, and neurogenetics among others. In each clinic, the resident is assigned to an attending for whom a panel of patients has been scheduled. A mixture of new and follow-up patients are interviewed, examined, and discussed with the attending.
All pediatric neurology residents have a weekly continuity clinic, staffed by a faculty member, which they attend year-round for all three years of the residency. Each resident has appropriate and escalating independence with his/her continuity patients. Since 2021, two of the 3 PGY2 residents will spend their continuity clinic in neurology instead of pediatrics to gain early experience.
An important part of the program is exposure to and participation in clinical or basic neuroscience research efforts. All residents become involved in a project during their three years of training. In the third year, results of the resident's efforts are presented at a special Neurology Grand Rounds. Our residents have consistently presented outstanding projects and have frequently won the Slotkin Award (department-wide prize for best research presentation).
Research seminars are held on a regular basis under the auspices of the Departments of Neurology, Neurosurgery, Neuroscience, and Pediatrics. To improve the resident's neuroscience background, trainees are urged to participate as teaching assistants in the School of Medicine's neuropathology and neuroscience courses.
All residents are encouraged to attend conferences designed to keep them informed of major developments in both the basic and clinical neurosciences. A wide variety of conferences, lectures, courses, and seminars are available through the Department of Neurology, Neurosurgery, Neuroscience, Pediatrics and Psychiatry:
- Ward attending rounds are held daily with didactic sessions at least three times weekly on both the adult and pediatric neurology services.
- Noontime conferences on clinical and research topics are held daily throughout the year.
- Child Neurology Grand Rounds are held every Wednesday at 8am.
For the first two months of the residency (July and August of each academic year), major topics of clinical interest to the first-year neurology resident are discussed, including a series on “neurologic emergencies” residents may encounter. During the remainder of the year, these conferences include regular discussion of movement disorders, cerebrovascular disease, seizures, neuromuscular disorders, cognitive neurology, neuropathology (clinical-pathological conference), and neuroradiology.
Other regular weekly conferences are devoted to pediatric neurology, pediatric neuro-oncology, adult neurology, neuroradiology, neuro-ophthalmology, neurovirology, epilepsy, nerve and muscle, vascular disease, and neuro-vestibular issues.
Topics of conferences at Bayview include sleep disorders, clinical neurophysiology, neuroradiology, neurotoxicology and aging. Conferences in many other areas are held under the auspices of psychiatry, neurosurgery, pediatrics, and other clinical and basic science departments.
Rotations By Year
The First Year (PGY-3)
During the first year, the resident develops clinical skills in adult and pediatric neurology. Rotations include:
- 4 months as a junior resident on the adult neurology wards at the Johns Hopkins Hospital (JHH) (stroke, general and NCCU (Neurology Critical Care Unit)) and The Johns Hopkins Bayview Medical Center (JHBMC)
- 3 months on the pediatric neurology service at JHH as the junior resident
- 1.5 months of adult outpatient neurology clinic
- 1 month of pediatric neurology outpatient clinic
- 2 weeks of EEG and 2 weeks of neuroradiology.
On adult neurology months, overnight coverage is a combination of night float and call averaging every 5th evening. Pediatric neurology months are call-free.
The Second Year (PGY-4)
The second year of the program involves subspecialty electives and rotations in both pediatric and adult neurology. During this year, the resident transitions into more supervisory responsibilities. Rotations include:
- 1.5 months as the adult neurology senior resident (at JHH)
- 2 months as the senior resident on pediatric neurology
- 1.5 months of adult neurology outpatient clinic
- 1 month on pediatric epilepsy/EEG
- 1 month on neuromuscular
- 2 weeks in the neurology intensive care nursery (NICN)
- 2 weeks of neuropathology
- 2 weeks 1 month at the Kennedy Krieger Institute
- 2.5 months in other electives
Months with in-house call are those as the adult neurology senior as the pediatric neurology senior call is from home during evenings.
The Third Year (PGY-5)
The third-year rotations include:
- 2.5 month supervising the pediatric neurology inpatient service as the primary senior resident
- 1 month on child psychiatry
- 1 month on clinical neurophysiology
- 1 month on outpatient pediatric neurology clinics
- 2 months at the Kennedy Krieger Institute
- 3.5 months on elective rotations