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Welcome to. Weekly Duties Monday Clinics AM Continuity ClinicAM Continuity Clinic Lord & Taylor BuildingLord & Taylor Building 1 st Floor1 st Floor 8:00.

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Presentation on theme: "Welcome to. Weekly Duties Monday Clinics AM Continuity ClinicAM Continuity Clinic Lord & Taylor BuildingLord & Taylor Building 1 st Floor1 st Floor 8:00."— Presentation transcript:

1 Welcome to

2 Weekly Duties

3 Monday Clinics AM Continuity ClinicAM Continuity Clinic Lord & Taylor BuildingLord & Taylor Building 1 st Floor1 st Floor 8:00 AM to noon (ideally)8:00 AM to noon (ideally) Staff: Drs. Sumner, Gutierrez, Mader, BranchStaff: Drs. Sumner, Gutierrez, Mader, Branch You will have 6 patients scheduled every clinicYou will have 6 patients scheduled every clinic Occasional snacks or lunch by drug repsOccasional snacks or lunch by drug reps

4 Epilepsy Monday afternoons after Continuity ClinicsMonday afternoons after Continuity Clinics Assigned residentsAssigned residents Electives (Psych, Research, other elective months)Electives (Psych, Research, other elective months) ClinicClinic Epilepsy:Epilepsy: Lord & TaylorLord & Taylor 1 st Floor1 st Floor Staff: Dr. MaderStaff: Dr. Mader

5 Multiple Sclerosis Clinic 1 st Monday afternoon of the month1 st Monday afternoon of the month Assigned residents (same as Epilepsy clinic)Assigned residents (same as Epilepsy clinic) MSMS Lord and TaylorLord and Taylor 1 st floor1 st floor Staff: Dr. LoveraStaff: Dr. Lovera

6 Stroke Clinic Every Tuesday 8:00 AM – noonEvery Tuesday 8:00 AM – noon Assigned residentsAssigned residents Elective resident(s)Elective resident(s) StrokeStroke Lord and TaylorLord and Taylor 1st floor1st floor Staff: Dr. BranchStaff: Dr. Branch

7 Didactic Thursdays Every Thursday starting at 1pmEvery Thursday starting at 1pm 1542 Tulane Ave. 7 th floor conference room1542 Tulane Ave. 7 th floor conference room Line-up:Line-up: 12:00 – Lunch12:00 – Lunch 1:00 – Professor’s Rounds (case or guest lecturer)1:00 – Professor’s Rounds (case or guest lecturer) 2:00 Neuroradiology/Neuropathology2:00 Neuroradiology/Neuropathology 2:30 – Core Curriculum (Merrit’s Quizzes or Continuums)2:30 – Core Curriculum (Merrit’s Quizzes or Continuums) 3:00 – Fellow Conference3:00 – Fellow Conference

8 Didactic Thursdays: Professor Rounds Case PresentationCase Presentation Faculty and residents presentFaculty and residents present You should present a complete case with HPI, Neuroexam, Labs, Imaging or anything else that is available.You should present a complete case with HPI, Neuroexam, Labs, Imaging or anything else that is available. When possible you can bring the patient.When possible you can bring the patient. After your case presentation you should have a brief presentation about the diagnosis.After your case presentation you should have a brief presentation about the diagnosis.

9 Didactic Thursdays Stroke Conference 2 nd Thursday of every month at 11:30AM2 nd Thursday of every month at 11:30AM UH Basement conference roomUH Basement conference room Will replace professors roundsWill replace professors rounds Alternate presentations with TulaneAlternate presentations with Tulane We will do July and every other month there afterWe will do July and every other month there after Resident to present will be the resident assigned to UH the prior monthResident to present will be the resident assigned to UH the prior month

10 Didactic Thursdays: Neuroradiology/Neuropath We alternate Thursdays between radiology and neuropath.We alternate Thursdays between radiology and neuropath. Should be about a 15 minute presentation.Should be about a 15 minute presentation. Present a neuropathology slide or neuroradiology image.Present a neuropathology slide or neuroradiology image. Follow by discussion of the diagnosisFollow by discussion of the diagnosis

11 Core Curriculum This year we will alternate weeksThis year we will alternate weeks Merritt’s Chapter QuizzesMerritt’s Chapter Quizzes Every two weeksEvery two weeks Each resident will have a chapter assignedEach resident will have a chapter assigned Residents will be responsible for creating a quiz of their assigned chaptersResidents will be responsible for creating a quiz of their assigned chapters ContinuumsContinuums Every two weeksEvery two weeks Resident will have continuum assignedResident will have continuum assigned Discussion of Continuum questionsDiscussion of Continuum questions

12 Friday Morning Neuropathology at Children’sNeuropathology at Children’s Pain Rounds at UHPain Rounds at UH

13 Call

14 Call 4 to 6 call nights a month4 to 6 call nights a month Home callHome call Even days:Even days: University HospitalUniversity Hospital TouroTouro KennerKenner Odd days:Odd days: TouroTouro KennerKenner UH Floor CallUH Floor Call

15 Call University (Even days)University (Even days) Stroke callStroke call Stroke pagerStroke pager Ideally respond within minutes to make tPA decisionIdeally respond within minutes to make tPA decision ER consultsER consults Floor call for admitted primary patientsFloor call for admitted primary patients University(Odd days)University(Odd days) Floor call onlyFloor call only

16 Call Touro/Kenner (Monday – Thursday)Touro/Kenner (Monday – Thursday) Routine consults can be seen by the resident on service the next dayRoutine consults can be seen by the resident on service the next day Get patient’s name and room numberGet patient’s name and room number Give information to resident in AMGive information to resident in AM Urgent or STAT consults need to be seen and discussed with staff the same dayUrgent or STAT consults need to be seen and discussed with staff the same day

17 Call Kenner (Friday-Sunday)Kenner (Friday-Sunday) All consults need to be seen within 24 hours and staffedAll consults need to be seen within 24 hours and staffed Call or text the resident covering for the weekend so the patient can have appropriate follow-upCall or text the resident covering for the weekend so the patient can have appropriate follow-up

18 Call You will always have a PGY 4 resident as back up.You will always have a PGY 4 resident as back up. During the first 3 months you will be required to call your back up for every consult at UH.During the first 3 months you will be required to call your back up for every consult at UH. Call staff on call directly for any consult at Touro or Kenner.Call staff on call directly for any consult at Touro or Kenner.

19 Hospital Rotations

20 Ochsner-Kenner Inpatient Consults/Outpatient ClinicsInpatient Consults/Outpatient Clinics ClinicsClinics Wednesday: VA Clinic 8 or 9-12Wednesday: VA Clinic 8 or 9-12 Friday: Dr. GutierrezFriday: Dr. Gutierrez Inpatient Consults from LSU Medicine, LSU Family Practice and Private MDsInpatient Consults from LSU Medicine, LSU Family Practice and Private MDs

21 Ochsner-Kenner Consult Service Staffed by either Dr. Barton (M-W) or Dr. Mader (R-F)Consult Service Staffed by either Dr. Barton (M-W) or Dr. Mader (R-F) On your first day go to the GME office to get registeredOn your first day go to the GME office to get registered Parking: FreeParking: Free Free Breakfast and LunchFree Breakfast and Lunch

22 Touro Infirmary Inpatient ConsultsInpatient Consults Consults mainly from private doctors, LSU medicine, LSU OB/GYN, and rehab servicesConsults mainly from private doctors, LSU medicine, LSU OB/GYN, and rehab services

23 Touro Infirmary Inpatient Consults Staffed by Dr. Gutierrez, Dr. Branch, and Dr. Fiore.Inpatient Consults Staffed by Dr. Gutierrez, Dr. Branch, and Dr. Fiore. Go to GME office and register on first day of your rotation to get ID and access to computer systemGo to GME office and register on first day of your rotation to get ID and access to computer system Free LunchFree Lunch Free Parking at Delachaise garage with ID accessFree Parking at Delachaise garage with ID access

24 WEEKENDS : WEEKENDS : During weekends you should round on patients that you have been following during the week.During weekends you should round on patients that you have been following during the week. Coverage for the weekends will be split among the residents working at Touro and Kenner.Coverage for the weekends will be split among the residents working at Touro and Kenner. Please inform the chief of who will be covering what weekends.Please inform the chief of who will be covering what weekends. We will not be taking new consults at Touro but the patients should have a note daily until we sign off.We will not be taking new consults at Touro but the patients should have a note daily until we sign off. Some patient may not need to be rounded on daily but this is at the discretion of the attending on service, but when in doubt write the note.Some patient may not need to be rounded on daily but this is at the discretion of the attending on service, but when in doubt write the note.

25 St. Charles Clinic Clinics – St. Charles ClinicClinics – St. Charles Clinic 3700 St.Charles Ave., 4 th Floor3700 St.Charles Ave., 4 th Floor Tuesday: MDA Clinic with Dr. Gutierrez and Dr. EnglandTuesday: MDA Clinic with Dr. Gutierrez and Dr. England Wednesday: VA Clinic (divide equally if two residents on clinic)Wednesday: VA Clinic (divide equally if two residents on clinic) Friday: Dr. England (or Kenner depending on the schedule)Friday: Dr. England (or Kenner depending on the schedule) Validated daily parking in Prytania garageValidated daily parking in Prytania garage

26 Touro/Clinic hybrid New rotationNew rotation Due to high volume of consults at Touro I have made a rotation to allow “backup” at TouroDue to high volume of consults at Touro I have made a rotation to allow “backup” at Touro Help Touro resident with rounds on Monday and Friday afternoons also Thursday morning.Help Touro resident with rounds on Monday and Friday afternoons also Thursday morning. The other days will function as the Clinic schedule outlined aboveThe other days will function as the Clinic schedule outlined above

27 VA Clinic Every WednesdayEvery Wednesday 8AM - Noon (Kenner resident)8AM - Noon (Kenner resident) 8am - 4PM (Clinic resident)8am - 4PM (Clinic resident) Noon – 4PM (Ochsner clinic resident)Noon – 4PM (Ochsner clinic resident) Both residents work with Dr. Danon for clinicBoth residents work with Dr. Danon for clinic clinic with Dr. El-Abassi1 - 4 clinic with Dr. El-Abassi Please be sure your VA access codes are working at least the Tuesday before you start!Please be sure your VA access codes are working at least the Tuesday before you start!

28 VA Clinic Please be sure your VA access codes are working at least the Tuesday before you start!Please be sure your VA access codes are working at least the Tuesday before you start! Credentials expire about every 90 daysCredentials expire about every 90 days Working to see if remotely logging in will be sufficientWorking to see if remotely logging in will be sufficient May need to go to VA monthly to login to keep credentials activeMay need to go to VA monthly to login to keep credentials active

29 University Hospital Inpatient Primary and ConsultsInpatient Primary and Consults Team will consists of Neurology resident(s), Medicine, Psychiatry Resident, and medical studentsTeam will consists of Neurology resident(s), Medicine, Psychiatry Resident, and medical students Staffs: Dr. Sumner, Dr. Branch, Dr. Mader, and othersStaffs: Dr. Sumner, Dr. Branch, Dr. Mader, and others Stroke pager system for tPAStroke pager system for tPA LSU takes new patients on even days and Tulane on odd daysLSU takes new patients on even days and Tulane on odd days

30 University Hospital We will admit strictly neurological cases and medically uncomplicated stroke and TIA patientsWe will admit strictly neurological cases and medically uncomplicated stroke and TIA patients Since resident on call will take care of floor calls it is IMPORTANT to check out patients everyday to whoever is on callSince resident on call will take care of floor calls it is IMPORTANT to check out patients everyday to whoever is on call Divide weekend follow up coverage among residents on the teamDivide weekend follow up coverage among residents on the team

31 University Hospital We are responsible for all stroke activations M-F 7AM - 5PMWe are responsible for all stroke activations M-F 7AM - 5PM Weekend stroke call is done by on call resident 7a-7aWeekend stroke call is done by on call resident 7a-7a Tulane will cover 7a-7a on the odd weekend dayTulane will cover 7a-7a on the odd weekend day Even days – ER/floor consultsEven days – ER/floor consults Odd days – Tulane will handle all new consultsOdd days – Tulane will handle all new consults

32 Ochsner Inpatient Two weeks NeuroICUTwo weeks NeuroICU 7AM – 5PM7AM – 5PM Checkout from on-call resident and/or moonlighter at 8AM in conference room across from room 3075.Checkout from on-call resident and/or moonlighter at 8AM in conference room across from room Two staff physicians and two midlevel- providers divide patients for morning roundsTwo staff physicians and two midlevel- providers divide patients for morning rounds Ask staff who you should round with but in general round on the same patientsAsk staff who you should round with but in general round on the same patients

33 Ochsner Inpatient Two weeks Stroke/Vascular NeurologyTwo weeks Stroke/Vascular Neurology 7AM – 5PM7AM – 5PM Work with Stroke service with Vascular Neurology staff and medicine residentsWork with Stroke service with Vascular Neurology staff and medicine residents Call schedule continues as with ICUCall schedule continues as with ICU You only work the weekends that you are on callYou only work the weekends that you are on call Be there at 7AM to see the ICU patientsBe there at 7AM to see the ICU patients Weekends not on call are off daysWeekends not on call are off days

34 Ochsner Inpatient CallCall In-House CallIn-House Call You will be on call the 1 st of the month and every 5 th night (Q5) thereafter (i.e. 1 st, 6 th, 11 th, 16 th, 21 st, 26 th )You will be on call the 1 st of the month and every 5 th night (Q5) thereafter (i.e. 1 st, 6 th, 11 th, 16 th, 21 st, 26 th ) You are expected to care for 8 patientsYou are expected to care for 8 patients You can do only two (2) new admitsYou can do only two (2) new admits The rest of the patients are cared for by a moonlighterThe rest of the patients are cared for by a moonlighter Call ends at 7AMCall ends at 7AM Turn over spectralink and pager no later than 7AM to moonlighter, midlevel, or incoming residentTurn over spectralink and pager no later than 7AM to moonlighter, midlevel, or incoming resident You should leave after checkoutYou should leave after checkout

35 Ochsner Outpatient Outpatient ClinicsOutpatient Clinics Rotate through different clinics:Rotate through different clinics: Movement Disorders (M&T) – Dr. Lea and Dr. HaughtonMovement Disorders (M&T) – Dr. Lea and Dr. Haughton VA – Wednesday afternoon (leave by noon to arrive on time)VA – Wednesday afternoon (leave by noon to arrive on time) Sleep (Baptist R&F)Sleep (Baptist R&F)

36 Ochsner Outpatient Clinic resident takes call on the 2 nd of the month and Q5 thereafter (i.e. 2 nd, 7 th, 12 th, 17 th, 22 nd, 27 th )Clinic resident takes call on the 2 nd of the month and Q5 thereafter (i.e. 2 nd, 7 th, 12 th, 17 th, 22 nd, 27 th ) Only work weekends you are on call as in the ICUOnly work weekends you are on call as in the ICU

37 Pediatric Neurology Round with Neurology teamRound with Neurology team Attending (changes weekly)Attending (changes weekly) +/- Peds Neurology Fellow (Dr. Rashmi Rajendra)+/- Peds Neurology Fellow (Dr. Rashmi Rajendra) +/- Tulane Neurology Resident+/- Tulane Neurology Resident Medical Student(s)Medical Student(s) See floor and ICU consults and new consults/admissions from the EDSee floor and ICU consults and new consults/admissions from the ED

38 Pediatric Neurology Round times daily depend on staffRound times daily depend on staff Generally table round with Pediatrics team then bedside rounds with Neurology teamGenerally table round with Pediatrics team then bedside rounds with Neurology team Rotation is changing and details will be provided as availableRotation is changing and details will be provided as available

39 Pediatric Neurology Wednesday conferenceWednesday conference Case presentationCase presentation You are expected to present or help present a casein conjunction with the other residents or the fellowYou are expected to present or help present a casein conjunction with the other residents or the fellow Journal Club after lunchJournal Club after lunch Articles will be provided by Staff or fellowArticles will be provided by Staff or fellow Presentation by fellow or staffPresentation by fellow or staff

40 Other Rotations Psych – 1 month in the MHEREPsych – 1 month in the MHERE Hours vary depending on staffHours vary depending on staff Team of PGY 1 Psych and medical studentsTeam of PGY 1 Psych and medical students Research – Find a mentor to work on a long term research project or publicationResearch – Find a mentor to work on a long term research project or publication

41 Students You are the resident in charge of your serviceYou are the resident in charge of your service PatientsPatients StudentsStudents Students depending on capability and timing are to be assigned 1-2 patients to followStudents depending on capability and timing are to be assigned 1-2 patients to follow Our primary goal with students in to TEACHOur primary goal with students in to TEACH

42 Students We are responsible for all notes, orders, labs, and follow-up for every patientWe are responsible for all notes, orders, labs, and follow-up for every patient Full notes (as appropriate) should be written after student notesFull notes (as appropriate) should be written after student notes Take every opportunity to teach about the Neuro exam and localization as well as pathophysiologyTake every opportunity to teach about the Neuro exam and localization as well as pathophysiology

43 Students Students are there to learn and are expected to be hard workersStudents are there to learn and are expected to be hard workers In general they get much more in a short period by following one patientIn general they get much more in a short period by following one patient Very difficult to know everything about multiple patientsVery difficult to know everything about multiple patients Any complaints should be directed to the PGY4s then the attending as appropriateAny complaints should be directed to the PGY4s then the attending as appropriate

44 Other Topics Book fundBook fund $500 annually$500 annually Can be used for any work related expensesCan be used for any work related expenses VacationVacation 4 weeks4 weeks Christmas schedule will be discussed later in yearChristmas schedule will be discussed later in year

45 Other Topics Step 3Step 3 LicensingLicensing RITERITE MoonlightingMoonlighting New InnovationsNew Innovations Journal ClubJournal Club

46 Books that you may want to have this year Neuroanatomy Through Clinical Cases by Hal Blumenfeld Merritt's Neurology by Lewis P. Rowland Pocket Neurology By David M. Greer

47 Books that you may want to have this year The Massachusetts General Hospital Handbook of Neurology by Alice W Flaherty On Call Neurology: On Call Series by Randolph S. Marshall MD Aids to the Examination of the Peripheral Nervous System

48 Any Questions? Feel free to approach, call or us at any time with questions or concerns

49 Expectations Work hardWork hard Maintain a “family” environmentMaintain a “family” environment Help each other as much as possibleHelp each other as much as possible

50 Expectations HAVE FUN!!!HAVE FUN!!!

51 LSU Neurology Staff And a little bit about them

52 John D. England, MD Chairman

53 Amparo Gutierrez, MD Program Director

54 Austin J. Sumner, MD Former Chairman

55 Epilepsy/EEG Peter Olejniczak, MD Edward Mader, MD

56 Multiple Sclerosis Jesus Lovera, MD

57 Lionel A. Branch, MD Stroke

58 Headache Amy Voigt, M.D.

59 Harry Gould, MD, PhD Pain Specialist

60 Jayaraman Rao, MD Movement Disorders

61 Caroline Barton, MD Assistant Professor

62 Child Neurology

63 Let’s have a great year!


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