The School of Medicine at the University of Kansas Medical Center (KUMC) was founded in 1904. MS 1 and 2 year students attend KUMC’s Kansas City, Kansas campus. MS 3 and 4 year students attend either KUMC’s Kansas City or Wichita, Kansas campus.
Our residency program was started in 1959 and has been continually and fully accredited since then. Our most recent Residency Review Committee (RRC) visit was in 2006, and we received no major citations. Our next RRC visit is scheduled for 2010. As of May, 2008, we expanded from a three-year to a four-year complete program.
We currently train 12 residents, four in each level, PGY1 through PGY4. We have three clinical neurophysiology fellows, one critical care fellow, and one neuromuscular fellow.
PGY-1:
As a four-year program, the first post-graduate year is included in the residency match program. This year is a traditional categorical medicine training that is split equally between the University of Kansas Hospital under the supervision of the Internal Medicine Residency Program and on the Internal Medicine service at the Topeka, KS, Veterans Administration Medical Center.
The major objective for the first year of training are:
- To develop proficiency in the evaluation and management of hospitalized patients with acute and sub-acute illnesses.
- To become proficient in basic medical procedures.
- To pass USMLE part 3
PGY-2:
The first year of neurology is weighted toward teaching the resident patient care responsibilities. The resident learns how to perfect his or herneurological exam, evaluate patients with neurological problems, develop a plan of evaluation, and to initiate treatment. As the year progresses, residents achieve greater levels of autonomy and take more responsibility in teaching of medical students and residents rotating on the neurology service.
The major objectives for this year of training are:
- To develop proficiency in the neurological interview and examination.
- To use these findings to generate a broad differential diagnosis starting with the most likely diagnosis.
- To understand the appropriate use of clinical and laboratory testing; and their indications, cost, specificity, and sensitivity. They also learn how to prioritize the tests based upon the ordering of their differential diagnosis, the prevalence of disease states and the likelihood ratio of the tests.
- To triage, stabilize and manage patients presenting to the ER with acute neurological disease.
- To learn how to coordinate and supervise a clinical team as well as partner with allied health team members to optimize patient care.
- To conduct appropriate literature searches and understand electronic patient information systems.
- To explain to the patient and family in a clear and respectful manner, information about the patient’s disease and prognosis.
The year is spent:
- Ward service, KUMC and KC VAMC -
5-6 months
- Leavenworth VAMC, combined consult and clinic service -
1-2 months
- Clinic rotation KUMC and KCVAMC, general neurology and subspecialty clinics -
1 month
- Neuropathology / Neuroradiology -
1 month
- Consults, TMC, KU or VA -
2-3 months
PGY-3:
The second year of neurology training continues to refine the resident’s abilities in patient care and also educates the resident about the specialized skills required of a neurologist.
The main objectives are:
- To further refine the neurological interview and examination and to demonstrate a problem focused approach.
- To demonstrate a broadening fund of knowledge in neurological disease.
- To develop skill in reading electroencephalograms and evoked potentials.
- To acquire proficiency in reading CT, MRI, and plain film studies.
- To understand gross and microscopic pathology and correlate it with clinical and neuroimaging information.
- To teach and manage a clinical team with medical students and residents from other programs rotating on service.
- To demonstrate knowledge of the principles of evidence-based medicine.
- To learn the basic principles of research under the guidance of a faculty mentor.
- To make informed decisions about diagnostic and therapeutic interventions based on patient preferences, current scientific evidence and clinical judgment.
- To competently perform lumbar punctures and basic electrodiagnostic studies.
- To work effectively as a neurological consultant and be responsive to the patient’s referring physician(s).
- To develop and to sustain a therapeutic and ethically sound relationship with patients.
The year is spent:
- Leavenworth 2 months, combined clinic and consult service with introduction to clinical neurophysiology
- Consult service -
KUMC, KCVAMC, TMC -
2 months each
- Stroke Service / NICU - 1-2 months
- Neuropathology / Neuroradiology - 1 month
- Elective 2-3 months
PGY-4:
The final year of training is weighted towards rounding out the resident’s education with continued exposure to the disciplines of pediatric neurology, psychiatry, physical medicine/rehabilitation, and elective time, though two to three months are also spent on various consult services. Elective time is individualized based on the resident’s career plans.
The learning objectives are:
- To demonstrate an increasing ability to function independently as a neurologist.
- To demonstrate an extensive fund of knowledge of common neurological disorders, some familiarity with rare disorders, and the ability to research the differential of a rare disorder based upon his or her own clinical evaluation.
- To provide advanced teaching of neurological disorders and exam techniques and to mentor junior neurology residents.
- To demonstrate sensitivity to pediatric patients and their families, and understand the different needs of the pediatric patient and their parents.
- To demonstrate proficiency in reading EEGs, neuroimaging studies, and performing EMG/NCV studies.
- To complete a research project with faculty guidance and present it in a scholarly fashion.
- To apply the methods of evidence-based medicine to the analysis of medical literature.
- To learn and make best use of different services provided by ancillary members of the pediatric health care team, including developmental specialists, geneticists, and behavioral psychologists.
- To develop their career path through seeking and evaluating job opportunities in fellowships and in practice.
The year is spent:
- Child neurology, at Children’s Mercy Hospital -3 continuous months
- Consults KU, KCVAMC or TMC - 2 months
- Psychiatry -1 month
- PM&R - 2 weeks
- EEG,EMG - one month each
- Electives - 3 1/2 months
Electives:
- Specialty clinic / service
- MS, movement disorders
- Neuro-ophthalmology
- Sleep disorders
- Private practice neurology
- Research
- Faculty mentor
- Research plan and product
KU Training Summary:
- Clinical adult neurology - 22 months
- Child neurology - 3 months
- Neuropathology/neuroradiology - 2 months
- Psychiatry - 1 month
- NICU - 1 month
- PM&R - 2 weeks
- Elective - 4 and 1/2 months
- EEG - 1 month, EMG - 1 month
Call:
- KUMC Frequency:
- PG2 4-5 times per month, in house call required during PGY2
- PG3 4 times per month
- PG4 3 times per month
- KCVAMC call-every other week
- TMC call-every third weekend from 0800-1700
- CMH call 3 nights a month
Longitudinal Clinics:
- ½ Day each week for all three years
- Faculty supervision changes for each level
- Typical work load
- PGY2: (first six months) 1 new, 2 returns
- PGY3 and 4: 2 new, 3 follow ups
- KU Hospital patients assigned to clinics
- Referrals from KUMC and outside clinicians
How our Residents Perform:
- ABPN first time part 1 pass rate of over 90% over the last five years
- Post graduate positions (five years):
- Fellowships: 12 (Clin NP 6, Stroke 1, Pain / HA 2, Neuro Onc 1, Epilepsy 1, Mov Dis 1)
- Academia: 4 (three after fellowship)
- Private Practice: 3
Didactics Schedule:
Journal Club:
- Monthly Evidence Based Journal club
- Critical appraisal of methodology, inherent limitations and bias of each study
- Gary Gronseth, MD
- Former Co-Chair Quality Standards Subcommittee AAN and now special consultant in Evidence Based Medicine to the AAN
- Richard Dubinsky, MD, MPH
- Member TTA, Practice Improvement, AAN
Research Day:
- Third Friday of June
- All residents and fellow present a 15 minute platform presentation
- PGY 2 usually case reports
- PGY 3,4 & 5: hypothesis driven
- Yearly didactics on clinical research by Drs. Gronseth and Dubinsky
- Award for best research for each level
Benefits:
- In addition to the standard benefits (link to GME page) we also provide:
- AAN membership and dues
- $250 yearly for books / media
- PGY 3 and 4: $1000 each year for meetings
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The University of Kansas Medical Center