SUBSPECIALTY CLINICs

The subspecialty clinic rotation is designed to ensure residents gain a broad exposure to all neurology subspecialties during their training. The rotation is timed to allow for exposure early in training prior to fellowship decisions, with one week of movement disorders and neuroimmunology each and two weeks of general subspecialty clinic during PGY-2 year.

Subspecialty clinic rotations include

  • Epilepsy: 4 weeks

  • Neuromuscular: 4 weeks

  • General Subspecialty (mix of all subspecialties): 2 weeks

  • Movement Disorders: 1 week

  • Neuroimmunology: 1 week General helpful clinic information can be found on the Continuity Clinic page - please review before your rotation.

For those interested in getting exposure to neuro-ophthalmology: Dr. Singman has offered to have residents shadow him in clinic on 1st and 3rd Tuesdays. If you are interested, please email him directly so that he knows when to expect you: ESingman@som.umaryland.edu. Clinic is held at the Redwood office.

LOCATION

All clinics are held at the Neurology Care Center at 16 S. Eutaw St, 3rd floor except for Neuro-Oncology clinics with Drs. Ahmad and Pham at the Stoler Cancer Pavilion (room varies depending on the day).

SCHEDULE

You will receive a weekly schedule from Andrea Reddick.  If you do not, please email her.

08:00-11:30 Morning Session

11:30-12:30 Midday Didactics (12:30-1:30 on Wed)*

  • Residents are excused from midday didactics in leu of subspecialty specific lunchtime meetings when on Neuroimmunology and Movement Rotations

12:30-5:00 Afternoon Session

Each week, the resident will be assigned:

~6 Sessions: Subspecialty clinic

1 session Faculty Teaching Practice clinic

1 session Scholarly time (meet with research mentor, work on IRB, analyze data, write, etc.)

1 session Personal time (schedule your own doctor, dentist, car repair, etc.). 

Wed Afternoons: Grand Rounds & Case Conference

EVALUATIONS

Ask Penelope Birckhead to send the evaluation for this rotation through MedHub to whichever attending you worked with the most.

This rotation is an opportune time to complete Clinical Skills Exam requirements for ABPN board eligibility completed. Find more information on the CSE requirements here.

COMPETENCY-BASED GOALS AND OBJECTIVES


SUBSPECIALTY - SPECIFIC INFO

NEURO-IMMUNOLOGY

Learning Objectives

  • Discuss approaches to MS diagnosis, including the application of the McDonald Criteria, as well as ancillary studies including CSF studies and MRI

  • Discuss differential diagnosis of demyelinating and other inflammatory CNS disorders

  • Discuss the clinical features of MS phenotypes

  • Identification and evaluation of a MS relapse

  • Discuss evaluation of MS-related disability

  • Identify and discuss the MS platform disease-modifying therapies

  • Identify MS treatment failure

  • Gain experience in decision-making regarding disease-modifying therapy transitions

  • Gain experience with MS symptom management

Schedule

Unless otherwise specified in the assignment email, the rotation schedule for Neuroimmunology is as below:

Lunchtime Meetings (11:30-12:30pm):

  • 1st and 3rd Thursdays: Case Conference

    • Bressler Research Building 12th floor conference room

  • 4th Thursdays: Research Meeting

    • Shock Trauma Conference Room

  • 5th Thursdays: Journal Club

    • Shock Trauma Conference Room

* = Residents may request >1 week in advance to trade one half day of Dr. Fredrich clinic for OCT Reading with Dr. Harrison, Neuroanatomy and CSF with Dr. Benavides, or Iatrogenic Demyelinating Diseases with Dr. Fredrich.

readings

AAN Practice Parameters

Others:

MOVEMENT DISORDERS

Learning Objectives

  • Perform a thorough and accurate neurologic history and examination on an adult patient with a Movement Disorder.

  • Initiate the appropriate diagnostic evaluation of most patients who present with both common and uncommon Movement Disorders in both the inpatient and outpatient setting.

  • Initiate treatment of common Movement Disorders that present in the inpatient and outpatient setting, including Movement Disorder emergencies.

  • Initiate treatment of common non-motor components of movement disorders

  • Discuss appropriate patients for surgical treatments of movement disorders

  • Recognize and distinguish functional movement disorders

  • Clinically classify abnormal movements by phenomenology: parkinsonism, chorea, tremor, dystonia, tics, ataxia, myoclonus and others

  • Construct a differential diagnosis for patients with each of the broad categories of movement disorders

  • Formulate a diagnostic strategy for patients with movement disorders

  • Describe non-motor components of movement disorders including behavioral, cognitive, autonomic and other features

  • Describe basic principles of neuroanatomy, neuropathology and neuropharmacology as they pertain to Movement Disorders

  • List side effects of common Movement Disorder therapies

  • Describe the indications for botulinum toxin injection therapy

  • Perform basic interpretation of common neurologic imaging studies of the brain and spine (MRI and CT) in patients with Movement Disorders

Schedule

The weekly assignment email will include the rotation schedule.

Movement Disorders Division meetings:

  • Every week Wednesdays 4-5pm: Didactics with Dr. Reich

    • Grand rounds auditorium

  • 2nd Mondays 5-6pm: DBS meeting

    • Neurosurgical conference room, 12th floor main hospital

  • 2nd Thursdays 4-5pm: Journal Club

    • Paca Pratt Conference room or ZOOM

  • 4th Thursdays 4-5pm: Video Meeting

    • Paca Pratt Conference room or ZOOM

REadings

Treatment of Restless Leg Syndrome

Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache

Evidence-based guideline: Treatment of tardive syndromes

Evidence-based guideline: Treatment of essential tremor

Continuum – Movement Disorders August 2019 (or most recent version if/when updated)

Last Updated: August 30, 2024