Adult Neurology Professional Education
Residency Program Director
Dear prospective resident,
Thank you for letting me tell you about the University of Missouri Department of Neurology Residency Program.
First, let me say this: Neurology is great. It offers you fascinating phenomenology, a diverse patient population, an intellectually challenging knowledge base, a unique skill set for clinical evaluation, and an exploding armamentarium of treatment options. Even as our health care delivery system faces unprecedented changes, a good clinical neurologist has never been more needed.
And, there has never been a better time to come here for your neurology education. Our chairman, Dr. Pradeep Sahota, has transformed our Department in recent years, marshaling an explosion of growth and productivity that has seen our faculty and our resident core surge in numbers and breadth. Since 2002, neurology admissions have risen 500%, intensive epilepsy monitoring cases have risen 800%, EMG / NCV studies have increased 500%, an acute stroke interventional program has been added and achieved level 1 status. Most recently, a neuro-intensive care unit has opened with multiple fellowship trained neurointensivists. Our residency size has increased steadily and our faculty has quadrupled.
We have a clinically active and scholarly productive faculty spanning virtually every neurologic subspecialty. For our residency, we have built an organized curriculum of rotations, didactic sessions, conferences, and research opportunities. Perhaps more important, we emphasize a supportive, collegial, and family-feeling atmosphere.
We currently accept five residents to our program each year. We have a categorical residency program. This means that you automatically get your first postgraduate year (PGY1) in internal medicine here. For you, this means continuity across your residency training and less time, money, and stress interviewing and matching for two programs.
The second postgraduate year (PGY2) is an intense year dominated by rotations on the University of Missouri inpatient services including primary inpatient neurology, acute stroke, and in the last half of the year, neurointensive care. The teams on these rotations consist of you and other junior residents, senior neurology residents, and an attending neurologist. An EEG rotation is also completed during this year. We employ a night float system so that all night time clinical work is merely “shift work” without daytime responsibilities (one PGY2 junior is always on with one PGY3 or 4 senior). That leaves only a single 24 hour on-call duty each weekend, split equally amongst the PGY2 juniors (average once a month) and PGY3-4 seniors (average once every other month). Your weekly continuity neurology outpatient clinic starts as a PGY2, and continue for three years. These experiences give you a variety of both common and rare/complex diseases, and build your foundation for basic neurologic diagnosis and management. In the PGY3 year, in the first 6 months of the year in particular, you will also rotate onto the neurointensive care service as the primary neurology resident there. Also, you will rotate as the senior resident who runs the inpatient stroke service. This is a highly active and interventional service that manages acute and subacute strokes of all kinds. Also in the PGY3 year, you will serve as the senior neurology resident managing the Harry S. Truman Veteran’s Administration Medical Center inpatient and outpatient neurology services. In addition, all PGY3 and PGY4 residents will rotate as the night float senior resident (average 6-7 weeks a year). The rest of the year includes separate blocks of time in electromyography, electroencephalography, neuropathology, rehabilitation, research, and child neurology. This year gives you greater responsibility for patient management, still with close supervision.
Your PGY4 year allows you to emerge as an independent neurologist ready to take on a post-residency career. You get to serve as the senior resident who runs the University of Missouri primary inpatient neurology service. You will complete a mentored research requirement and submit a paper for peer review. You may choose to attend a national neurology meeting with a stipend that we provide to each resident. For most of this year, you rotate through subspecialty clinic rotations to round out training with more detail in neurologic subspecialties. These activities allow you to work one-on-one with a specialist in fields such as cognitive-behavioral neurology, epilepsy, movement disorders, stroke, sleep neurology, neuromuscular, multiple sclerosis, and headache. Throughout the residency there are regular weekly conferences to include a variety of topics: neurology-neurosurgery grand rounds, a case presentation conference, neuroanatomy, Program Director’s conference, Chief Resident’s conference, research methods, neuromuscular and epilepsy, behavioral neurology, general neurology, and neurology board review. An evening journal club meets at my house several times a year. Each resident has his or her own workstation and storage area in a dedicated residents’ office in the department offices, where we also have a conference room, a library, and full departmental staff and resources. Residents have on-line access to an extensive array of products including UpToDate, our electronic medical record system, a clinical imaging system, and the University’s extensive library system. We provide our residents with an annual book fund, membership in the American Academy of Neurology, and a subscription to the Continuum journal series. All residents are guaranteed 4 weeks of vacation each year.
Our graduates go on to attend competitive fellowships at numerous institutions of their choosing, including our own expanded sleep medicine fellowship program. Our graduates have had a 100% pass rate when they sit for their neurology board exam. Our graduates have chosen careers in clinical practice as well as academics.
A huge selling point of our program is living in Columbia. I love it here. Life in a college town offers many excellent options not usually present in a smaller town, but in an affordable, friendly, and welcoming community. The University of Missouri is a major institution that offers diversions such as plays, dance, music, participatory and spectator athletics. The University draws faculty and students from all over the world, and so the city (population about 110,000) is a culturally diverse place, with several museums, many denominations of religious worship, a variety of excellent restaurants, independent and public schools, high quality stores and shops, and musical venues of all types. Columbia's Cosmo Park is home to soccer and baseball fields, a professionally designed mountain bike course, and a skateboard park. If you want more urban offerings, St. Louis and Kansas City are an easy drive away, without having to live in a more crowded city 24/7. In and around Columbia are many nice trails for running, biking and hiking that crisscross streams and pass through forests. There are also lakes and ponds for boating, swimming and fishing, many caves for exploration, and national forests for camping and backpacking. America’s largest river system, the Missouri River, flows a few miles away, flanked along its entire course from Kansas City to St. Louis by the Katy Trail. The Katy Trail is neat; once a railroad, it was renovated into a snaking well-serviced state-wide park with gravel-topped biking and running trails that transect Missouri, with access points throughout Columbia.
When you join us for your neurology residency training, please know that it is personal to me that you do well, and that you are happy. My priority is to help you become a solid clinical neurologist, and feel good about it. I intend to see to it that you leave here well prepared to take on the career you seek as a neurologist. You will not find a better place, or a better way, to get started.
Joel Shenker, MD , PhD
Residency Program Director