Board eligibility in neurology requires that the year preceding formal neurology training (PG-I year) include at least 6 months of internal medicine. Applicants who match with the Iowa Neurology Program can choose to do their PG-1 year at Iowa, which is coordinated through the NRMP. It includes 7 months of Internal Medicine, 1 month of Intensive Care Unit, 1 month of Rehabilitation Medicine, and 2 months of Neurology. A year containing no less than six months of internal medicine at an approved Internal Medicine or flexible program in another institution is also acceptable prior to entering the three-year neurology program at Iowa.

Residency Rotations
In addition to instruction in basic neuroscience, the program emphasizes a broad experience in clinical neurology with appropriate time spent in direct patient care. The program is based on rotations in several services within the department and in other departments whose specialties are required for board eligibility. A typical experience in the 36-month program is as follows:

PG-2 Year: (All rotations at University Hospital except *)

PG-3 Year:

PG-4 Year:

For residents with previous training in any of these disciplines, the program can be altered to accommodate special experience.

The neurology inpatient service at UI Hospitals and Clinics is managed by two teams, each monitored in daily staff rounds by faculty physicians and led by a neurology resident. One of the two inpatient services is headed by a senior neurology resident, assisted by junior neurology residents, and generally accepts the most critically ill patients. The other inpatient service, headed by a junior resident and assisted by a second neurology resident or a resident rotating from another service. This service accepts patients not requiring intensive monitoring or intensive neurology residents. The residents rotate through the outpatient clinic in one month blocks where they are staffed by four to six faculty physicians representing different specific neurological subspecialties each day.

Each resident takes three months of EMG/EEG during the PG-4 year. The residents undertake an intensive three-month experience in clinical electrophysiology, dividing time between EEG, evoked potentials, sleep disorders and EMG. Nearly 3,000 patients are evaluated with electroneurodiagnostic procedures annually in our department. The resident is exposed to a full range of techniques, including EMG, nerve conduction studies, elicitation of evoked potentials, EEG determination of cerebral death, monitoring of convulsive disorders, and polysomnography.

Neuropathology training is encompassed in two months in the Department of Pathology. Current material, including muscle biopsies, is studied, and a teaching file consisting of a broad range of neurologic entities is mastered. Ultrastructure is also considered. Investigative collaboration is encouraged.

The pediatric neurology rotation provides experience under the direction of six faculty members with primary appointments in Child Neurology. In addition to participating in a busy university child neurology program, the resident can elect to participate in field clinics, focusing on neurogenetics and childhood neuromuscular disorders.

The psychiatry rotation takes place in the Department of Psychiatry of University Hospital. One month is spent attending patients in an inpatient setting. Appropriate conferences are included, with emphasis on the organic basis of psychiatric disease, with particular attention to neurochemical underpinnings, and the epidemiology of mental disorders. This experience provides a basic understanding of psychiatric illnesses and the areas of overlap with neurologic conditions.

Teaching of the basic neurosciences including neuroanatomy is conducted in lecture format. Residents may elect to serve as instructors for the medical student neuroanatomy course.

During the neuroradiology rotation, the resident interprets images with a senior neuroradiologist with special attention to clinical/anatomic correlations. A teaching file is also reviewed. The entire range of modern neuroimaging techniques is available, including computerized tomography, magnetic resonance imaging, three-dimensional MR reconstructions, functional MR, and positron emission tomography.

In the PG-3 and 4 years, residents prepare a research manuscript on a topic of their interest, either focusing on a scholarly presentation of a clinically pertinent topic or an analysis of research performed during their residency. These scholarly papers are presented at a specially designated conference.

Residents have a designated, tastefully furnished study office with fully equipped, modern computer facilities. Each resident has a personal carrel within this office, where they can maintain their own study materials. The department's library is also available, as is the nearby Hardin Library for the Health Sciences.

Rounds, Conferences, and Seminars
Teaching ward rounds are conducted by staff members on a daily basis. Two weekly department-wide conferences are scheduled. In the Friday Neuroscience seminar, a disease entity or a basic neuroscience topic is discussed in depth, often with contributions from faculty of other disciplines. Guest speakers from other institutions are also featured. Grand Rounds on Tuesday focuses on discussions that are of clinical interest.

Subspecialty conferences are typically held over or near the noon hour, with no overlap so that residents have the opportunity to attend or as many as possible. Subspecialty conferences include epilepsy, neuromuscular diseases, movement disorders, behavioral neurology, pediatric neurology, sleep disorders, and neuropathology. The gross and microscopic features of autopsy and surgical specimens, referable to current cases and problems, are presented in a neuropathology conference which is held on Wednesday.

"Stroke rounds" is a daily conference held at 8:00 am at which an interesting inpatient or consultation case from the last several days is presented as an unknown to the residents, students, and presiding faculty members. Anatomic localization, imaging correlates and differential diagnosis is emphasized.

"Mock Boards" are held once each week. This conference is open to residents and faculty only. Each week neurology residents analyze and discuss, both individually and as a group, a brief clinical vignette and respond to questions from an "examiner" who is a faculty member from adult neurology or child neurology.

Courses in Basic Science and Clinical Topics
Lecture courses for residents are presented in an alternating schedule, and both clinical and research issues are discussed. A year-long neurophysiology review course is presented annually. A graduate course in cognitive neuroscience is offered which emphasizes the neuro-anatomical basis of cognition. Additional course topics include neuroanatomy, neurochemistry and neuropharmacology.

Teaching Opportunities
Both junior and senior medical students serve as clinical clerks on the Neurology inpatient units, in the outpatient clinics, on the consultation service, and on the Veterans Administration Medical Center service throughout the year. Each student in the College of Medicine spends four weeks on clinical neurology. Teaching of students is a high priority in our department and both residents and faculty take pride in their teaching accomplishments. In addition to regular bedside and rounds teaching, both faculty and residents provide formal lectures to medical students. From among the 600 full-time faculty and 650 medical specialty residents at University Hospitals, several Neurology residents and faculty have recently been the recipient of "teacher of the year" awards by the junior or senior medical school class.

Residents have a key role in patient care. Dr. Edward Aul interviews a patient in the clinic.
 

The neurology program incorporates training in pediatric neurology. Pictured with their young patient are division director Dr. William Bell (center) and Dr. Adel Afifi.
 

Digital format EEG recordings are reviewed by Dr. Thoru Yamada (right), director of the Clinical Electrophysiology division, and Dr. Todd Rave. The division conducts an active fellowship training program.
 

Neurology books, journals, and reference materials are quickly accessible in the department’s library.
 

Weekly department converences provide continuing education and discussion opportunities. Dr. Robert Rodnitzky leads a movement disorders conference each Thursday.