Child Neurology Residency Curriculum Overview

The Child Neurology Residency program offers a balanced curriculum training residents to become leaders within their field of study.

Residents learn through a variety of adult and child rotations, collaborative research and didactics.

Clinical Rotations

Rotations in the Child Neurology Residency Program at Wake Forest University School of Medicine are designed to allow our residents to experience all aspects of adult and child neurology while caring for diverse populations of patients. Residents work closely, often one-on-one, with attending physicians while being given the opportunity to pursue research. Electives, chosen in the second and third year of training, allow residents to delve deeply into their subspecialties of interest. During all rotations, residents continue to see patients in our weekly outpatient clinics.

Adult Neurology Rotations

To satisfy board certification requirements, each child neurology resident at the School of Medicine spends at least 12 months on adult neurology rotations at Wake Forest Baptist.

Year 1

Residents spend approximately five months training in the adult inpatient wards during their blocks in general neurology service, stroke service, NeuroICU, and consult service. They also spend approximately three months training in the adult outpatient rotations. One month in Adult Epilepsy focuses on epilepsy monitoring unit (EMU), EEG and adult epilepsy clinic. There is time spent in other outpatient electives such as sleep medicine and headache. As well as subspecialty clinics including multiple sclerosis, movement disorders, stroke, headache and cognitive. Our residents receive an early foundation in neuroradiology with a one-month block during this year.

Year 2

Adult neurology training concludes with approximately one inpatient block on the Adult Consult Service and outpatient blocks in an neurophysiology and neuromuscular medicine.

Child Neurology Rotations

Years 1, 2 and 3

Child neurology clinical training is at Brenner Children’s Hospital and Wake Forest Baptist Health, which are located on the same medical center campus. Our residents are introduced early in their training to child neurology during their first year with blocks in child neurology consult service and child neurology clinic rotation.

Additional Rotations include:

Inpatient Child Neurology Rotation (Years 1, 2, 3)
Outpatient Child Neurology Rotations (Year 1, 2, 3)
Child Epilepsy Rotation (Year 1)
Neurophysiology (Year 2)
Inpatient Child Psychiatry (Year 3)
Child Neurosurgery (Year 3)
Neuroscience (Year 3)
Neuropathology (Year 3)
Elective Rotations (Year 2, 3)

Pediatric Neurology Residency Curriculum Guide

Inpatient Pediatric Neurology Rotation (Years 1, 2, 3)

Across the three years of training, our child neurology resident will act as the chief resident of our active inpatient consult service, working with adult neurology residents, pediatric residents and medical students. The consult service interfaces with almost all other services in the hospital, caring for patients on pediatric hospitalist service, NICU, PICU, hematology-oncology service, inpatient psychiatry, trauma and surgery services, nephrology service, neurosurgery service, cardiology service and gastroenterology service. Our resident performs new consults on patients on the wards or in the emergency room and rounds on active consults with the attending child neurologist. Our resident is involved in reading preliminary readings and spot

readings on consulted patients on LTM.

Outpatient Pediatric Neurology Rotations (Year 1, 2, 3)

Our residents spend approximately six months evaluating and following a wide range of cases in a variety of ambulatory settings and subspecialty clinics. Our residents will gain experience in the assessment of general neurology patients, including learning disabilities and developmental delay, neurofibromatosis, mitochondrial and metabolic diseases, sleep disorders, and movement disorders. Our residents will participate in subspecialty clinics focused on pediatric epilepsy, epilepsy surgical planning, ketogenic diet clinic, tuberous sclerosis clinic, pediatric headache clinic, pediatric multiple sclerosis and demyelinating clinic, pediatric brain injury clinic, Neurogenetics clinic, Pediatric movement disorders clinic and an active pediatric MDA clinic, which our residents spend time in during these blocks as well as other outpatient months.

Pediatric Epilepsy Rotation (Year 1)

Residents spend one month on the Pediatric EMU Service, gaining exposure to EEG monitoring, Routine EEG reading, epilepsy surgical planning and surgeries and sophisticated neuroimaging techniques such as SPECT and MEG scans.

Neurophysiology (Year 2)

Our residents will spend a mixture of time reading EEG, ambulatory EEG, pediatric EMG, EMU, sleep and LTM studies.

Inpatient Child Psychiatry (Year 3)

Our resident will spend time on the inpatient pediatric psychiatry service located at Brenner Children’s Hospital, which includes inpatient consultation and management of acute and chronic psychiatric illnesses. Our resident will round with the inpatient team and will be able to participate in ongoing group therapy sessions for patients. They also have the opportunity to have a more outpatient focused rotation depending on their career interests.

Pediatric Neurosurgery (Year 3)

Our resident will spend time paired one-on-one with one of our pediatric neurosurgeons as he or she performs urgent and non-urgent surgical cases in the operating room. Our resident will spend time in clinics dedicated to the evaluation and management of chiari malformation, vascular malformations, epilepsy surgical patients, pediatric brain tumors and spinal processes.

Our resident will also join the neurosurgery resident in performing consultations in the pediatric ED.

Neuroscience (Year 3)

This month is a devoted block for neurology board preparation with reading and board review questions. Many of our residents will also use this time to complete research projects,

complete abstracts/posters, prepare and submit manuscripts, prepare lectures, attend specialty clinics within their future career interest, meet with mentors and attend additional educational

lectures across the medical center.

Neuropathology (Year 3)

This month is focused on building knowledge in science and clinical practice of neuropathology. Our residents will review pathology slides on common intracranial tumors and neuromuscular conditions. Our residents will attend neuropathy clinical case conference along with

neurosurgical residents.

Elective Rotations (Year 2, 3)

Our residents can choose additional elective months among a wide variety of options depending on their clinical interests (see list below). Our residents can elect to do research months to develop and complete a research project with this time as well.

Our current elective list includes:

Research
Neurogenetics
Pediatric Neuromuscular/MDA
Spasticity/Botox
Pain Medicine/Headache
Sports Neurology/TBI
Pediatric/Adult Neuro-immunology
Child Protective Service
Movement Disorders
Neonatal Neurology
Neuro-oncology
Neuro Ophthalmology
Epilepsy/EMU
Neuro-rehab
Medical Education
Neurophysiology (Pediatric EEG, EMG, other procedures as applicable)
Neuro-palliative care
Neuro Ultrasound (including time for the Free course)
Stroke and Telestroke

On-call Duties

Adult Neurology Call

Our residents do not have any adult in-house call throughout their three years of training. They participate in back-up home-call for code strokes to support adult neurology residents on weekends.

Child Neurology Call

Our residents have a night call system which is shared with our Adult Neurology colleagues. Night call is taken in two-week blocks from home. There are no daytime responsibilities during the time you are on home call. The percentage of calls is highest in Year 1, decreasing each year. Child Neurology Fellows also take outside calls and transfer calls. There is always an attending on Call and available for questions during night call.

Teaching

There are numerous teaching and educational opportunities during Pediatric Neurology Residency. Residents partner with attending physicians to ensure that inpatient rounds address topics relevant to medical students. The team make up varies throughout the years with medical students, PA students, adult neurology residents, and child psychiatry fellows sometimes a part of the team. Our residents teach their pediatric, Adult Neurology, and Child Neurology Fellow colleagues on a regular basis by leading conferences. Our residents annually prepare an educational problem-based learning workshop for the child residents. Our Residents in their fourth and fifth year are intrinsic to designing and implementing our educational curriculum. They lead key department wide conferences such as Neuro-radiology Rounds. Those who have additional interests have taken on educational projects and taken on other teaching roles with our Pediatrics colleagues and the medical school. Senior residents in Year 3 will prepare and present Neurology Grand Rounds featuring their research or a clinical topic of interests to an audience of both adult and child residents and faculty prior to graduation.

Conferences and Didactics

Child Neurology

There are twice weekly child neurology conferences. “Wednesday Case Conference” is attended by our child neurology faculty, nurse practitioners, medical students and the inpatient team and learning is typically case based though formal lectures by faculty also sometimes occur during this time. There is also weekly Program Director Rounds which covers a variety of topics and formats throughout the year and includes Boot Camp, Board Review, Mini-Journal Club, Root Cause Analysis, Journal Club, and other topics depending on the season. Formal Lectures by Child Neurology faculty which are relevant to both Adult and Child Neurology trainees occur during shared time with our Adult Neurology colleagues.

Shared with Adult Neurology

Residents attend a rich variety of weekly conferences that are a shared curriculum between adult and child neurology residency programs. In a monthly neuroradiology case conference co-led by neurology and radiology, rare and interesting clinical scenarios of both child and adult patients are discussed while the approach to reading imaging is reviewed. There are simulation labs hosted for the review of status epilepticus and code stroke.

Research Opportunities

The Child Neurology Residency Program offers limitless opportunities to engage in basic and translational neuroscience, participate in neurology clinical trials and collaborate with emerging biotech industry or neuroradiology imaging researchers. Resident investigators are encouraged to present their research at regional and national meetings.

Our residents are required to participate in quality improvement initiatives and develop a research project. They’re encouraged to take a research elective where they are given protected time to fully develop manuscripts and submit them for publication. They are expected to have an abstract presentation at either a regional or national meeting, which is supported by departmental travel funds, and to attend at least one national meeting during their training (though most of our residents attend more like one annually).

Research in the Department of Neurology

Currently, our neurology department has both federally-funded research and industry funded research (including clinical trials). We are part of major research networks such as NEURO Next and StrokeNET. Our neurology department has become one of the top-producing research grant funded departments across the medical center.

Our residents can learn and participate in ongoing clinical research. Specific research studies targeted toward child neurology patients include studies on the treatment of:

Duchenne muscular dystrophy
Spinal Muscular Atrophy
Concussion and TBI (Biomarkers of PPCS)
Translational Research in Rare Leukodystrophies
Tourette’s syndrome and Stigma
Clinical Trials in Epilepsy, including Lennox-Gastaut and infantile spasms
Pediatric Stroke- FOCAS Trial and Stroke Database
Pediatric Headache – Impact of Intimate Partner Violence

Technology Transfer and Commercialization

Research Focus Areas

Translation to Care

More Resources