Neurology

Program Director
Dr. Michael Yeung/Dr. Jeptha Davenport
12^th Floor, Foothills Medical Centre
1403 – 29 Street NW
Calgary  AB  T2N 2T9
Phone: 403-944-1148
Fax: 403-283-2270
e-mail: michael.yeung@albertahealthservices.ca
e-mail: jeptha.davenport@albertahealthservices.ca 

Program Administrator
Elizabeth Martens
e-mail: Elizabeth.martens@albertahealthservices.ca

For further information see also:
http://www.carms.ca

http://www.ucalgary.ca/dcns/divisions

 

Goals and Philosophy
The major goal of the Neurology Residency Education Program is to give residents the opportunity to gain the knowledge, attitudes, and skills to enable them to provide exemplary health care to people with neurological disease. The program will facilitate learning through an atmosphere of collegiality and mutual respect that fosters active communication between residents and faculty. We will stress the pursuit of excellence in clinical neurology and encourage the development of a deeper interest in the academic aspects of the discipline. We will endeavor to create a level of excitement that will stimulate our residents to seek further education and pursue careers in academic neurology. Our program aims to serve both the present and future requirements of our patients and our discipline.

Participating Departments and Institutions

Department of Clinical Neurosciences
The Department of Clinical Neurosciences comprises the Divisions of Neurology, Neurosurgery and Physical Medicine & Rehabilitation and includes 45 neurologists and 80+ full or part-time faculty members. The alliance of neurology and neurosurgery at the University of Calgary allows collaboration in several departmental activities, including weekly rounds, research day, outpatient services, etc. (for further information see the Departmental Annual Report). Other departments, including Internal Medicine, Psychiatry, Histopathology, and Diagnostic Imaging also participate actively in the neurology training program.

Foothills Medical Centre
Foothills Medical Centre is a large, tertiary care medical facility (825 acute care beds) that serves as the major referral centre in Southern Alberta for patients requiring inpatient neurology care. There are two neurology ward/consultation services, a dedicated stroke service, and several general neurology and subspecialty neurology outpatient clinics (see below). There are two neurology/neurosurgery inpatient wards comprising 60 beds plus an 18-bed stroke unit. Another FMC ward is devoted to inpatient neuro-rehabilitation. There is a neurology/neurosurgery intensive care unit, an EMG/EEG Lab, and a neurosciences library and resident office with computers and internet access on the same floor as the inpatient neurology wards. A neurology/neurosurgery outpatient wing is located adjacent to the neurology wards. The Foothills/NRC Magnetic Resonance Centre houses an intraoperative MRI-scanner and a 3-Telsa research and clinical scanner. The University of Calgary medical school is located adjacent to the Foothills Medical Centre and includes three large buildings that house research facilities and outpatient clinics. 

Peter Lougheed / Rockyview Hospitals
The Peter Lougheed and Rockyview Hospitals are 500-bed, modern, fully equipped hospitals with active medical, surgical, and intensive care units. Both sites support neurology consultation services, neurology clinics, EEG and EMG laboratories, and CT and MR scanners. Residents also rotate on a new neurology inpatient unit at the Rockyview Hospital.

Alberta Children’s Hospital
Alberta Children's Hospital, opened in September 2006,  is a tertiary care pediatric medical facility with active inpatient and outpatient neurology services and subspecialty clinics.

Electronic Resources
The Resident Office, located adjacent to the neurology ward, is equipped with computers, printers, and a scanner. Electronic Resources include Up-to-Date, Alberta Health Knowledge Network (HKN) plus a large selection of Electronic Journals available via the web through the University of Calgary Health Sciences Library.

Educational Program

The residency program covers a period of five years and has been designed to meet the objectives of The Royal College of Physicians and Surgeons of Canada for Neurology Residency Programs.

Clinical Program
The University of Calgary program consists of:

• 18 months of internal medicine and other clinical rotations, including psychiatry, neurosurgery, and neuroradiology (see PGY-1 and PGY-2);
• 24 months of clinical neurology, including at least 3 months of pediatric neurology and
  6 to 12 months of senior resident training, and;
• 18 months of clinical and research rotations related to neurology, including neuropathology, neuromuscular/EMG, Epilepsy/EEG, research, and several elective blocks.

Rotation-specific objectives have been developed for all rotations.

University of Calgary Residency Programs follow a lunar calendar of 13 four-week blocks per year.

PGY-1 and PGY-2
A four-block rotation of ward- and clinic-based neurology is undertaken early in the first year to allow the resident to bond to the neurology program and his or her new career. The learning objectives for these four blocks are to perform a complete neurological history and physical examination, interpret neurological findings, and formulate the differential diagnosis of common neurological conditions,  including anatomical localization.

PGY-1 and -2 comprise nineteen blocks of non-neurology rotations, including internal medicine, psychiatry, surgery (neurosurgery), radiology (neuroradiology), and emergency medicine. Twelve months of internal medicine are required by the Royal College and include general medicine ward service and ICU/CCU and six blocks of elective rotations, such as general medicine consult service, endocrinology, infectious disease, etc. Internal medicine rotations are tailored to provide the resident with a strong background in medicine useful in subsequent neurology training. Three blocks of PGY-2 are devoted to clinical neurology. In addition to fulfilling the neurology objectives noted above, training in the PGY-1 and PGY-2 years is meant to fulfill the objectives of basic clinical training as outlined by the Royal College: to give the resident a degree of independent responsibility for clinical decisions; an opportunity for further development of the skills required in making effective relationships with patients; the consolidation of competence in primary clinical and technical skills across a broad range of medical practice; and an understanding of the nature of the relationship between a referring physician and a consulting specialist.

PGY-3
PGY-3 generally includes five blocks of clinical neurology. Neurology inpatient experience is obtained at the Foothills Hospital. During the inpatient general neurology rotations, the resident is responsible for the primary care of inpatients on the neurology ward, the assessment of patients in the emergency department, and inpatient neurological consultations. During the stroke rotations in PGY-3 to -5, the resident manages acute stroke and participates in the stroke fellow call rota. The resident also rotates through the neurology services at the Peter Lougheed and Rockyview hospitals. Outpatient experience is emphasized. One quarter of neurology rotations comprise clinics which are scheduled in periods of one or more weeks at a time. Clinics are available in general neurology and several subspecialty areas which are listed below. For most residents, the balance of the PGY-3 rotations comprise rotations in neuropathology and neuromuscular/EMG.

PGY-4
In PGY-4 most residents undertake a six-block period of clinical or basic neuroscience research (see below). PGY-4 also includes three blocks of adult neurology and three blocks of pediatric neurology. Residents embark on their weekly longitudinal neurology clinics at the start of this year (see below). 

PGY-5
PGY5 residents spend a minimum of seven blocks as senior neurology residents/junior consultants in inpatient and outpatient settings. During this period, the resident is expected to assume greater independence in the management of patients and more responsibility for teaching and supervising junior residents and clinical clerks. The resident may also have the opportunity to participate in the teaching of second year medical students during the neurosciences portion of the curriculum.

For the other six blocks, the resident may select elective rotations from a number of different areas including EEG, neuro-oncology, neuro-ophthalmology, pain, neuro-rehabilitation or community neurology, or choose to spend further time in electromyography, neuromuscular disease, neuroradiology, neurosurgery, or psychiatry. Special requests for other options will be considered on an individual basis.

Throughout the PGY4 and PGY5 years, there will be a weekly outpatient clinic where patients are evaluated and followed by the senior resident, at arm's length from the attending neurologist preceptor. 

Residents in all years have certain duties and responsibilities in common. These include:

1. Participating in all departmental educational activities as a first priority.
2. Participating in the education of more junior residents (from all disciplines) and clinical clerks who are rotating through the Neurology Service.
3. Periodically making case presentations and short focused presentations at Neurology/Neurosurgery Rounds.

Academic Program
Educational sessions for residents are held every weekday throughout the academic year:
Monday am: Formal bedside teaching rounds, led by various preceptors.
Tuesday am: "Les Lecons du Mardi" - Neurology Case Rounds.
Wednesday am: Neuroradiology or Neuropathology rounds (each bi-weekly).
Wednesday noon-hour (with lunch): "Spot the Brain Cell" - neurology residents teaching rotating residents and clerks.
Thursday academic half-day (12:15-18:00): Neurology subspecialty/CanMEDS lunch rounds (including ethics and EBM) and a two-hour seminar. Communications Skills sessions (with actors). All sessions are led by neurology preceptors.
Friday Departmental Grand Rounds (08:00-10:15): During the first hour, neurology and neurosurgery residents each present a patient, followed by a short didactic and interactive session. In the second hour, a topical didactic presentation is given, often by an invited guest speaker, or there is a clinical-pathological conference.

Annual departmental events include a sponsored neurology/neurosurgery resident week-end basic science and ski symposium in early spring and the departmental Research Day.

Research
Resident research is a mandatory part of the University of Calgary Neurology Training Program. The goal is to promote the development of knowledge, skills, and interest in the field of clinical or basic neuroscience research. The completion of a well-designed research project, whether clinical or basic, also facilitates future career development. Every effort is made to tailor the type and scope of the research project to the resident's interests and needs. Most residents will spend three to six months in research during the PGY-4 year.

Toward the middle of the PGY-3 year, the resident is encouraged to develop a special interest in a particular problem or area and to develop a clinical or basic research project in that area. It is expected that the results of the research will be presented at the departmental Research Day and at a national or international meeting, and will be published.

In addition, neurology residents may request a leave from the Neurology program to enter an MSc or PhD program funded by the Hotchkiss Brain Institute (HBI) Resident Scientist Program or the Clinician Investigator Residency Program. The salary is pegged at the PGY level of the resident. Details can be found at http://www.hbi.ucalgary.ca/research and http://www.medicine.ucalgary.ca/postgrad/listprograms/programinfo/CIP.

Evaluations
There are regular, web-based in-training evaluations (ITERs) of resident performance. The Neurology Program Director receives the evaluations and closely follows the progress of each resident. Preceptors are encourgaed to give frequent informal feedback and review each ITER with the resident.

Additional formal evaluations occur in PGY-3 through PGY-5. Twice yearly, residents write a seminar exam and perform a multi-station OSCE exam, using formats similar to those used in the Royal College fellowship examinations. PGY-3 through PGY-5 residents also write the annual American Academy of Neurology In-training Examination.

The program director meets formally with each resident three times a year and reviews the results of ITERs and examinations. In addition, informal feedback is an ongoing activity within the program and takes place frequently when patients are being reviewed and during conferences and teaching rounds.

Administration of the Program
The Program Director and Program Committee (NRPC) supervise the neurology residency program. The NRPC concerns itself with recruitment, resident evaluations, rotation evaluations, the content of the program, discipline, and promotion. Membership includes the chief resident, two elected residents, the Division Chair (or delegate), 3-6 staff neurologists and the pediatric neurology program director. The committee meets monthly except for July and August.

Residents also have the opportunity to participate in various faculty level committees related to the overall education programs at the university.

Subspecialty Clinics
Participation in the Subspecialty Clinics provides the opportunity to gain in-depth experience dealing with particular groups of diseases. Subspecialty Clinics are available in each of the following areas:

Cancer Pain
		Dr. N. Hagen
Dementia
		Dr. D. Hogan Dr. D. Patry
Epilepsy
	Adult
		Dr. N. Pillay Dr. P. Federico Dr. W. Murphy Dr. A. Hanson Dr. B. Klassen Dr. S. Wiebe Dr. N. Jetté
	Pediatric
		Dr. A. Kirton Dr. J. Mah Dr. K. Barlow Dr. H. Sarnat
Headache
		Dr. W. Becker Dr. L. Cooke Dr. A. Eloff Dr. J. Kohli Dr. F. Amoozegar
Movement Disorders
		Dr. O. Suchowersky Dr. R. Ranawaya Dr. S. Furtado Dr. S. Kraft Dr. T. Pringsheim
Multiple Sclerosis
		Dr. L. Metz Dr. R. Bell Dr. D. Patry Dr. W. Murphy Dr. F. Costello Dr. K. Busche Dr. J. Burton
Neuro-epidemiology
		Dr. M. Hill Dr. M. Eliasziw Dr. J. Mah (Pediatric)
Neurogenetics
		Dr. O. Suchowersky
Neuro-HIV
		Dr. C. Power
Neuromuscular Diseases
	Adult
		Dr. K. Brownell Dr. D. Zochodne Dr. C. White Dr. C. Toth Dr. L. Komgut
	Pediatric
		Dr. J. Mah
Neuro-oncology
		Dr. P. Forsyth Dr. G. Cairncross Dr. P. De Robles Dr. A. Hanson
Neuro-ophthalmology
		Dr. W. Fletcher Dr. F. Costello
Neuro-otology
		Dr. E. Lange Dr. W. Fletcher
Pain/Palliative Care
		Dr. N. Hagen
Sleep Disorders
		Dr. W. Murphy
Stroke
		Dr. A. Demchuk Dr. M. Hill Dr. P. Barber Dr. T. Watson Dr. S. Coutts Dr. E. Smity Dr. P. Stys Dr. G. Klein Dr. D. Pearson Dr. A. Kirton (Pediatric)
Urgent Neurology
		Dr. K. Busche Dr. M. Yeung Dr. K. Hoyte Dr. W. Murphy Dr. A. Hanson Dr. K. Brownell Dr. D. Pearson

Research Interests
The following list outlines the research interest of department members who will have clinical contact with the residents: 

Dr. F. Amoozegar	- Headache
Dr. W. Becker	- Headache
Dr. R. Bell	- Multiple sclerosis, molecular genetics
Dr. A. K. Brownell	- Muscle diseases, medical education
Dr. J. Burton	- Multiple sclerosis
Dr. G. Cairncross	- Neuro-oncology
Dr. L. Cooke	- Headache, medical education
Dr. F. Costello	- Neuro-ophthalmology, multiple sclerosis
Dr. S. Coutts	- Stroke
Dr. A. Demschuk	- Stroke
Dr. M. Eliasziw	- Neuro-epidemiology
Dr. P. Federico	- Epilepsy
Dr. W. Fletcher	- Neuro-ophthalmology, neuron-otology
Dr. P. Forsyth	- Neuro-oncology
Dr. S. Furtado	- Movement disorders
Dr. N. Hagen	- Neuro-oncology, cancer pain management
Dr. A. Hanson	- Epilepsy
Dr. M. Hill	- Stroke, epidemiology
Dr. D. Hogan	- Dementia
Dr. N. Jetté	- Epilepsy
Dr. A. Kirton	- Pediatric stroke
Dr. B. Klassen	- Epilepsy
Dr. G. Klein	- Stroke
Dr. L. Komgut	- Neuromuscular disorders
Dr. S. Kraft	- Movement disorders
Dr. J. Mah	- Pediatric neuromuscular disorders, epidemiology
Dr. L. Metz	- Multiple sclerosis, neuro-immunology
Dr. W. Murphy	- Sleep disorders
Dr. D. Patry	- Dementia
Dr. N. Pillay	- Epilepsy
Dr. T. Pringsheim	- Movement disorders and headache
Dr. O. Suchowersky	- Movement disorders, neurogenetics
Dr. E. Smith	- Stroke and cognitive dysfunction
Dr. P. Stys	- Anoxia and stroke
Dr. C. Toth	- Neuromuscular disorders
Dr. S. Wiebe	- Epilepsy and medical education
Dr. T. Watson	- Stroke
Dr. C. White	- Neuromuscular disorders
Dr. V.W. Young	- Disorders of CNS glia, multiple sclerosis, gliomas
Dr. D. Zochodne	- Neuromuscular disorders

There are many other members of the Department and Faculty who are interested in interacting with neurology residents, including neurosurgeons, physiatrists, neuroradiologists, neuropathologists, and basic neuroscientists. Further information about specific areas of research activity in the neurosciences may be found in the HBI directory.

Participation in Meetings
Residents are allowed 10 working days each year to attend meetings. The Department of Clinical Neurosciences contributes $2,500 toward resident travel to a meeting each year. In addition, the University of Calgary Faculty of Medicine (through the office of the Associate Dean of Postgraduate Medical Education) provides financial assistance to residents for travel costs to a meeting when the resident is the first author of a presentation.

Recruitment Procedures

Selection Criteria
All applicants must be eligible for placement on the Educational Register of the College of Physicians and Surgeons of Alberta. The applicant must apply for entry to a five-year neurology program.

Preference is given to applicants with:

• A strong academic record;
• A high level of motivation;
• An interest in an academic training environment and research (basic or clinical);
  however, prior experience in research is not necessary;
• Excellent interpersonal skills.

Interviews
We review the application files and then invite selected candidates for in-person interviews. Our program utilizes a structured in-person interview process.