PROGRAM COORDINATOR: Meshia Addison
CONTACT US: kaddison@northwell.edu

Day in the life of a resident

Welcome to the Day in the life of being a resident at North Shore-LIJ Neurology at Northwell!

We hope that this page can provide insight into how our residents thrive together as a community. We are happy to walk you through the day-to-day of being a neurology resident at our program. As you may already know, our residency program encompasses two hospitals: North Shore University Hospital and Long Island Jewish Hospital.  The split between the two hospitals is roughly ~70% NSUH and ~30% LIJ.

  • At North Shore University Hospital, our residents rotate primarily through three different services: Consult, floors/EMU and Stroke.
  • At LIJ Medical Center, residents rotate on the stroke team as well as the consult team.

General Neurology Consult Services: On the consult service for both NSUH and LIJ, which runs from 7:00 am to 4:00 pm, three residents staff all general neurology consults, as well as morning code strokes. Residents usually table round with the attending in the morning, followed by seeing patients together. Attendings prioritize integrating education into rounds, including reviewing imaging, formulating a differential diagnosis, and strategizing how to optimize the neurological examination for each individual case.

Junior residents lead the stroke codes and see consults on their own before staffing with their senior residents and attending. This experience allows residents to learn to triage new patients as well as optimize their neurological exam skills. Senior residents are responsible for leading their teams and organizing work-flow. Overall, the junior residents have independence in managing new patients, while at the same time receive mentoring from attendings and seniors.

NSUH Primary Stroke Service: This service runs from 7:00 am to 4:00 pm, and includes three residents and two NPs/PAs. Residents receive signout at 7:00 am from the overnight resident and ACP. Residents are responsible for all patients on the primary stroke service and stroke consult service. Residents see stroke consults and attend to stroke codes in the afternoon. The team is composed of two ACPs, a stroke fellow, and the stroke attending. There are neurovascular conferences on Thursdays at 7:30 am, presented by the residents and medical students on service.

General Neurology/Epilepsy Monitoring Unit Primary Service:  The general neurology primary service runs from 7:00 am to 4:00 pm, and is composed of two residents and an ACP. Residents receive signout at 7:00 am from the overnight resident and ACP. Residents are responsible for all patients on the primary general neurology service and epilepsy monitoring unit. There are two sets of rounds, first with the general neurology attending at 8:00am, and then at 10:00 am with the epilepsy team and fellow.

General Neurology Primary Service: A service offering excellent exposure to bread-and-butter neurological illnesses, such as Guillain Barre, Myasthenia Gravis, and Multiple Sclerosis, as well to much more rare conditions and diagnostic challenges. Procedures include lumbar punctures.

Epilepsy Monitoring Unit: A service offering excellent exposure to complex epilepsy cases, developing the skills to manage intricate anti-epileptic drug regimens. Additionally, some patients are admitted to the unit through the Autoimmune Brain Disorders Center for work up of autoimmune encephalitis. Consists of real-time EEG interpretation, epilepsy conference discussing all the cases and plans. Fridays consist of epilepsy teaching which is led by the epilepsy attending. Procedures include lumbar punctures.

Night Float: We employ a full “night-float” system, and there are no 24-hour calls. We believe that 24-hour calls contribute to fatigue and burnout and have therefore done away with them. PGY2s generally begin to take “night-float” duties by the 3rd month of the year, mostly at NSUH. There is also an ACP present during the night at NSUH. LIJ night-float is staffed mainly by PGY3s and PGY4s. Senior night-float residents at LIJ provide extra support and guidance for the PGY2s doing night-float at NSUH at the same time.

Formal Didactics: Morning didactics occur every day. These take the form of either morning report in which the night-float resident presents a case to the group, a resident-directed case conference geared towards practical aspects of inpatient epilepsy, neuro-vascular conference, or grand rounds.

Noontime didactics occur every day. These take the form of traditional lectures led by faculty members, board-review sessions led by senior residents, Chairman Rounds, or Continuum article reviews.

didactics

Medical Education Opportunities: Throughout residency, there are a myriad of opportunities to teach the next generation. Even as a PGY2 resident, you will teach MS3 and MS4 medical students and other rotators who are part of each of the inpatient teams. As a PGY3, you begin to oversee the team as a “senior resident” and help guide PGY2 residents while on night-float rotations. PGY4s help oversee medical education for the residency as a whole and each take turns as “Education Chief”, ensuring that a broad range of board-style content is covered. For PGY3s and PGY4s who are interested in medical education, an “Education Track” is available.

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