The Mount Sinai residency program in Neurology is designed to provide residents with a broad knowledge-base in neuroscience, and the clinical abilities to recognize and treat the full spectrum of neurologic diseases. The program provides an extensive clinical and didactic grounding to enable the trainee to handle and understand the growing body of neuro-therapeutics throughout their careers. The residency program also establishes a degree of maturity, responsibility, and empathic understanding that is inherent in the modern practice of clinical neurology. By graduation, the Mount Sinai-trained neurologist will be well-grounded in basic neuroscience, have had a broad clinical experience, and have developed as a seasoned clinician-scientist, skilled at utilizing the evolving understanding of neurologic disease, to become a professional neurologist of the highest caliber.
The first year of the program (PGY-2) is designed to provide maximal clinical exposure under the guidance of senior residents and attending, divided into three services: general neurology inpatient care, stroke/neuro-critical care, and consultative service. Each rotation is staffed by a senior resident and attending neurologist. There is a daily morning report of the prior day’s new clinical consultations and admissions, staffed by a teaching attending neurologist. Clinical conferences also include weekly Grand Rounds, Chief of Service rounds, a year-long noon conference series in neuroscience, a semester-long evening course in graduate-level neuroanatomy, as well as supplementary didactic conferences across the range of neurologic subspecialties.
The PGY-2 year is spent mostly on the two Neurology inpatient services at Mount Sinai Hospital: the Stroke/ICU service, and the General Neurology service. These rotations always have a senior resident and/or stroke fellow to teach and assist the PGY-2 residents. In addition, there are two-week block rotations of night float to cover the hospital between 8pm-8am. The PGY-2 year also includes a two-week outpatient rotation in neurology subspecialties. The remainder of the year is spent at the Bronx VA Hospital consult service and outpatient rotations and elective.
In the second year of the program (PGY-3 year), residents have the opportunity to run a team as senior residents at Elmhurst Hospital on the inpatient service and the consult service, as well as rotations through the outpatient clinic program. A significant increase in autonomy is required for the PGY-3 resident to be able to lead a team at Elmhurst Hospital, although there is close clinical supervision by the experienced neurology faculty members at this site. The rotations through the inpatient and consultation services at Elmhurst Hospital Center during the PGY-3 year, expose the resident to an extraordinary array of both cultures and neurological disorders. Elmhurst, Queens, comprises one of the most culturally diverse populations in the United States, and the patients at Elmhurst Hospital Center come from across the globe, speaking a multitude of languages and dialects, and bringing with them their particular beliefs and customs. The neurology faculty members at Elmhurst Hospital have made a lifetime study of communicating effectively with these patients and are vested in helping the neurology residents develop their own cultural competence through modeling as well as informal and case-based teaching. The Elmhurst residents will work in a team with medicine interns and students, where the role includes supervision of patient care and teaching.
PGY-3's also have a supervisory role during their rotations on the consult service at the Bronx VA where they guide and help educate the PGY-2 on the service. In addition, there is a 6-8 week rotation at the Bronx VA, a month of Neurophysiology, and two months of Pediatrics. The remainder of the year is made up of outpatient clinics and elective time that can be spent in subspecialty rotations or research.
In the third (PGY-4) year of the program, the resident develops and expands their teaching and supervisory skills. The PGY-4 residents return full time to Mount Sinai Hospital as senior residents on the Stroke/ICU and General Neurology services, serving as teachers and mentors for the PGY-2 residents and medical students. In addition there are two months on the Mount Sinai consult service. The remainder of the year consists of one month of Pediatrics, Psychiatry, and electives. Two weeks in the early part of the year will be spent as night float in order to teach and mentor PGY-2 residents during the first two months of their neurology training. An attending neurologist is present on all in-patient and outpatient rotations.
Ample opportunity and incentive are provided for clinical and basic neuroscience research with a welcoming faculty. For those interested in research-based careers, the Research Residency Track is available for residents who wish to devote a 6-month block of time to research and grant preparation (see separate section on the website for Research Track overview). With this expanding knowledge base and close supervision, residents develop an enhanced level of neuroscience knowledge, professionalism, and patient care skills.
The overall residency program is designed to stimulate maximal interest in clinical neuroscience, and to provide a sound clinical, ethical, and professional base on which trainees will continue to grow as mature, dedicated neurologists and scientists. Residents completing the Mount Sinai Neurology Residency Program in the past 5 years have an outstanding boards-pass rate, and have been highly successful in launching careers by securing competitive fellowships and clinical and academic faculty positions.
Yearly Schedule (Sample; this will continue to evolve as the residency grows in size and flexibility)
|Stroke Service and ICU||4 months|
|General Neurology Floor||2 months|
|Night Float||6-8 weeks|
|Bronx VA Consults||6-8 weeks|
|Ambulatory Care||2 weeks|
|Elmhurst Neurology Service||6 weeks|
|Elmhurst Consult Service||6 weeks|
|Elmhurst Outpatient Clinic||6 weeks|
|Night Float||6 weeks|
|Bronx VA Consults||6 weeks|
|Pediatric Neurology||2 months|
|Ambulatory Care||4 weeks|
|General Neurology Floor||2 months|
|Consult Service||2 months|
|Stroke Service and ICU||6 weeks|
|Night Float||2 weeks|
|Pediatric Neurology||4 weeks|
Special Summer Schedule
The first two months of training is a time for PGY-2 residents to gain confidence in their abilities as new neurologists. As part of our summer schedule to ease the transition from medicine intern to neurology resident, the program ensures that there will be a senior resident in the hospital at all times during July and August. There is also a summer lecture series with daily noon conference topics prepared especially for the PGY-2 class.
Every day at Mount Sinai begins with Morning Report, where the nightfloat resident presents the cases seen overnight. There is a different attending leading Morning Report each day including the chairman, program director, and specialists from across the Department. Friday morning reports are often dedicated to a review of a topic from the Continuum publication or a journal article. Attending teaching rounds take place each morning followed by a review of imaging studies with the Neuroradiologists. At noon there is a conference given by a wide variety of staff including specialists from the departments of Neurology, Neurosurgery, Radiology, and Psychiatry. The afternoon is spent on work rounds. Once a week there is continuity clinic in the afternoon at Mount Sinai’s Center for Advanced Medicine. There is a weekly Grand Rounds that brings in lecturers from across the country. The residents also take part in a Neuroanatomy course that is offered in conjunction with the graduate school. Educational opportunities are also an integral part of the rotations at the Bronx VA and Elmhurst Hospitals. The Bronx VA has daily Morning Report with the chairman, weekly outpatient clinic, Grand Rounds, Neuroradiology, and EEG rounds, and monthly participation in the National VA Parkinson’s Disease Consortium. At Elmhurst, Neuroradiology rounds occur weekly. In addition, the residents are responsible for presenting cases at departmental Grand Rounds.
|10AM||Attending Teaching Rounds|
|1PM||Work Rounds, Clinic|
The call schedule is approximately short call every 3 days until 8pm, while rotating on the inpatient services at Mount Sinai and Elmhurst Hospitals. At 8pm a night float takes over. The Bronx VA has home pager call after 5pm on weekdays and on weekends. PGY-4 residents also take home pager call after the first two months. There is no call while on Neuroradiology, Ambulatory Care, Psychiatry, or during elective rotations. We are compliant with the updated ACGME work-hours limitations and New York State Bell Commission rules limiting resident work hours.
Elective time is tailored towards the interests of the individual resident. Some popular clinical electives include movement disorders, multiple sclerosis, and neuromuscular diseases. Electives at outside institutions can also be arranged. It is expected that residents choose to use elective time to get involved with a research project. The faculty is very approachable and enthusiastic about assisting residents with these projects. The program also encourages residents to attend academic conferences related to each individual’s interests.
Each resident receives a faculty mentor who is available throughout all three years as a source of career guidance, advice, and mentoring. Mentors meet with residents periodically to discuss how resident life is going and to help with the process of exploring different career paths. An individual mentor’s primary responsibility will be to guide you through residency. This includes helping you to acclimate to Mount Sinai and making you aware of the resources available to you, helping you to develop organizational and life management skills, ensuring that you are developing an appropriate knowledge base and clinical skill set and acting as your advocate. There are also designated go-to faculty members from a broad range of neurological and neuroscience subspecialties to help guide career interests, fellowship applications, and research projects in areas of mutual interest. In addition to the mentor program, residents meet with the program director semi-annually to discuss setting short- and long-term goals and to review personal accomplishments.
The Mount Sinai Neurology residency-training program takes place at three diverse hospitals.
Mount Sinai Hospital is a tertiary care center with 1171 beds located in Manhattan at the intersection of the Upper East Side and East Harlem communities. Mount Sinai is equipped with a shared Neurosurgery and Neurology Intensive Care Unit staffed by Neurocritical Care attendings, as well as an outstanding 6-bed Stroke Unit. The Neurology service at Mount Sinai works with a dedicated team of Neurointerventionalists for patients who would benefit from emergent catheterization procedures.
The James J. Peters Veterans Affairs Medical Center is a 311-bed hospital situated in the Bronx on a historic site from the Revolutionary War. The Bronx VA has a fully computerized medical record system and an accomplished medical research program. The Medical Center is a regional referral center for spinal cord injuries with a dedicated spinal cord unit.
Elmhurst Hospital Center in Queens is located in the most ethnically diverse community not only in New York City, but in the world. It is a Level 1 Trauma Center and a designated Stroke Center. The experience at Elmhurst is an opportunity to care for patients from an extraordinary range of cultures and backgrounds. The extensive bedside teaching by the neurology faculty at Elmhurst makes it often cited by residents as the most valuable part of the residency training.
Salary and Benefits
The current PGY2 salary is $57,155 (effective for July 2012 academic year). Mount Sinai provides yearly salary increases based on level of training. Obtaining the salary increase for the PGY3 level is dependent upon obtaining a New York State Medical License. Housestaff benefits include subsidized health, dental, vision, and disability insurance. All neurology residents receive a PDA and a standard neurology textbook at orientation. Neurology residents are provided membership to the American Academy of Neurology, which includes a subscription to Neurology and the educational review Continuum.
Department of Neurology