Institutional Partners
Residents learn by providing care for patients at 5 principal sites: St. Luke's Hospital (the primary clinical affiliate of Baylor College of Medicine), The Methodist Hospital, Ben Taub General Hospital, The Michael E. DeBakey Veterans Affairs Hospital, and the Texas Children's Hospital. In aggregate, these institutions provide unparalleled educational resources in terms of patient populations, clinical resources, and associated clinical and basic research.
The Neuroscience Institute at St. Luke's Episcopal Hospital (SLEH)
St. Luke's is the principal clinical affiliate of the Baylor College of Medicine. Two of our major clinical programs are focused here: vascular neurology/neurocritical care and epilepsy.
The Neurosensory Center at The Methodist Hospital
and Baylor College of Medicine
The Neurosensory Center of The Methodist Hospital and Baylor College of Medicine, which includes the three buildings in the foreground, is devoted to neurological, ophthalmological, and ENT patients.
The Methodist Hospital is the largest not-for-profit hospital in America. The Neurosensory Center, which is the first three buildings in the photo, is a special wing devoted to patients with diseases of the nervous system including neurological, ophthalmological, ENT, and sometimes neurosurgical disorders.
The principal inpatient residency rotations at the Methodist Hospital are the general neurology consultation service and the Stroke service.
The Methodist Hospital is also the site of several large neurology outpatient services, including the movement disorders clinical program and the dementia clinical program, in the Scurlock Tower. The EMG laboratories and the multiple sclerosis clinic are in the Neurosensory portion of the Hospital.
The patients seen by residents at the Neurosensory Center are very diverse. There are the general neurology patients that would be seen at any large, urban hospital. There are also sub-specialty patients that are often referred by outside physicians and neurologists. Those sub-specialty areas include movement disorders, multiple sclerosis, neuromuscular disease, epilepsy, headache, behavioral neurology and dementia, neurolaryngology, and stroke. There are approximately 2,000 admissions per year to neurological physicians plus another 3,500 consults. Another 1,880 outpatients are seen each month, equivalent to about 22,500 per year.
The Methodist Hospital is shown in the
foreground (reddish), and its two outpatient
buildings can be seen in the background (white).
In addition to the many conferences, residents also round daily with the individual attendings that admit patients to their team.
This Neurology Service at The Methodist Hospital was recently ranked 10th in the nation by US News and World Report in 2003, which is a move up from 12th in 2001 and 15th in 1999.
Ben Taub General Hospital
The Ben Taub General Hospital is a major teaching site for the clinical Departments of Baylor College of Medicine. Ben Taub is operated by Harris County, which has a population of 4.5 million, and provides care for patients across the entire socioeconomic spectrum. In addition to patients with neurological problems common in urban settings, Ben Taub also serves patients recently arrived from latin American who have disorders that are not often seen in the United States urban centers, such as neurocysticercosis and tuberculous meningitis.
Ben Taub also serves a population with many acute neurological problems such as head trauma, drug overdoses, gunshot wounds, intracerebral hemorrhages, status epilepticus, and spinal cord compression. There are approximately 520 admissions per year to the Neurology Service, 850 consults, and 2,040 outpatient clinic visits per year.
The Baylor Neurology Service provides consultative services and inpatient care. The inpatient service census averages about 15-20 total patients each day with a similar number of consult patients. Each resident has an average daily census of only 4-6 patients, but these patients are often very ill. The residents function with a degree of autonomy and responsibility that is unusual in modern teaching hospitals.
The Ben Taub hospital provides care to Harris County's 4.5 million inhabitants.
There are also five outpatient neurology clinics at Ben Taub Hospital each week: New Patient Clinic, Follow-up Clinic, Epilepsy Clinic, Procedure Clinic, and the Specialty Clinic. For the Specialty Clinic, a different patient group is seen each week, including multiple sclerosis, movement disorders, neuromuscular disease, and stroke. Senior residents also attend a monthly high-risk ob/gyn clinic to care for neurologic disorders such as epilepsy in those patients. They also attend the Thomas Street Clinic where they care for the neurologic complications of HIV.
Residents at Ben Taub also attend the daily conferences that all Program residents attend (see Conferences), and they attend Ben Taub-specific conferences, such as neuropathology and a recently added Neurology-Psychiatry Combined Conference.
Michael E. DeBakey Veteran's Affairs Hospital
Our VA, the second largest in the country and the largest residency program in the country, is a modern facility that was completed in 1991. It is a specially designated flagship facility equipped with ultramodern resources not found in other VA hospitals. The Neurology Service has recently undergone substantial growth with the addition of a new Chief of Service, Thomas A. Kent, M.D., two new full time stroke physicians, and specialty clinics in Stroke prevention, Cognitive disorders, Epilepsy, Neuromuscular Disease and Movement disorders. The hospital is equipped with a 3T MRI, two 64 slice CT scans and an upcoming PET/CT facility. The faculty is active in both clinical and basic science research. A dedicated 3T research MRI is anticipated in calendar year 2008.
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The Michael E. DeBakey VA Hospital.
Neurology has its own 18-bed ward including 2 Long Term Monitoring beds for epilepsy patients. A new joint Neurology/Medicine Stepdown Unit includes 4 dedicated Neurology beds primarily used for acute stroke admissions. There are two first-year neurology residents (PGY-2) on the inpatient ward along with two psychiatry interns and Internal Medicine residents, and five to six medical students, all of whom are supervised by an upper-level neurology resident. A Neurology Department faculty member rounds at the bedside every day to see every new admission. These faculty members are full members of the faculty at the Baylor College of Medicine and many attend at other affiliated hospitals. All VA specialty faculty are available for back up consultations should the need arise. There are close affiliations with a newly enlarged Neurosurgery service, excellent Neuroradiology support, critical care medicine and Rehabilitation medicine.
Residents have considerable control of the inpatient and consultation service, which admits approximately 900 patients per year. There are additional inpatient consults (600 per year) and clinic patients (160/week) also seen each year. Call is every fourth night. Patients often have typical neurological disorders such as stroke, headache, dementia, neuropathy, epilepsy and cervical spondylosis. Because of its size and substantial drawing population, there are always a number of less common disorders. Of recent interest is the neurological sequelae of traumatic brain injury.
The team also covers all the inpatient neurological consultations. Our residents are very fond of this service as provides considerable autonomy. At the same time, the resident rounds with an attending every day so that he or she has intensive, personal teaching. Clinic experience is extensive and includes new and follow up general neurology patients, longitudinal clinic experiences, and specialty clinics in a variety of conditions.
State-of-the-art EMG, muscle and nerve biopsy suites and EEG services are located next to the inpatient ward to facilitate teaching. Additional facilities include 24 hour Epilepsy Monitor Unit, Neuropsychology services and portable Trans Cranial Doppler. Record keeping at the VA is facilitated by access to all medical records online. In addition, all original x-rays, CTs, and MRIs are accessible online.