Department of Pediatrics

Child Neurology and Neurodevelopmental Disabilities Rotations

Master
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First-Year of Training

Content

First-Year of Child Neurology Training

During the first year of Child Neurology Training, residents spend six blocks rotating in various adult neurology inpatient rotations and seven blocks rotating at Texas Children’s Hospital in inpatient and outpatient rotations. The schedule for each resident is designed to intermix these adult and pediatric block months over the course of the year, alternating between adult and pediatric experiences. This year is designed to teach the fundamentals of caring for neurology patients.

On the six blocks of inpatient rotations at adult neurology sites, first-year residents evaluate patients in consultation with other services as well as those patients directly admitted to Neurology. During the seven blocks at Texas Children’s Hospital, the first-year resident spends two blocks on the inpatient Primary Child Neurology Service. Additionally, Texas Children’s Hospital rotations include Neuropathology (four weeks), Neuroimaging (four weeks), EEG (eight weeks), and Neurogenetics (four weeks).

Example: First-year Child Neurology Resident Schedule

Block

Site

Rotation

1

TCH

Electroencephalography (EEG)

2

ST. LUKE’S

St. Luke’s Medical Center Consult Service

3

TCH

Neuroradiology

4

VAMC

VA Medical Center

5

TCH

Neuropathology

6

BEN TAUB

Ben Taub Hospital

7

TCH

Inpatient Neurology Primary Service

8

TCH

Electroencephalography (EEG) – TCH

9

ST. LUKE’S

St. Luke’s Medical Center Neurocritical Care Unit

10

TCH

Neurogenetics

11

BEN TAUB

Ben Taub Hospital

12

TCH

Inpatient Neurology Primary Service

13

VAMC

VA Medical Center

First-Year of Neurodevelopmental Disabilities Training

During the first year of Neurodevelopmental Disabilities Training, residents spend 6 blocks rotating in inpatient adult neurology, 2 blocks in the inpatient Primary Child Neurology Service, and 1 block in outpatient neuroradiology. The first year of Neurodevelopmental Disabilities Training starts with “NDD Boot Camp” which includes didactics, clinics, and critical readings in Neurodevelopmental Disabilities. This rotation provides residents with essential neurodevelopmental knowledge, emphasizing the interconnectedness of brain-based symptoms, thereby establishing the NDD framework for the remainder of training. Neurodevelopmental Disabilities residents rotate through three additional developmental blocks during their first year of training, primarily located at Texas Children’s Hospital Meyer Developmental and Autism Centers, though residents will also go into the community during the Advocacy and Resources block.

Example: First-Year Neurodevelopmental Disabilities Resident Schedule

Block

Site

Rotation

1

TCH

Neurodevelopmental Disabilities Boot Camp

2

ST. LUKE’S MC

Inpatient Adult Neurology Consult Service

3

TCH

Inpatient Neurology Primary Service

4

VA Medical Ctr

Inpatient Adult Neurology

5

TCH

Early Childhood Development/Autism Center

6

BEN TAUB

Inpatient Adult Neurology

7

TCH

Inpatient Neurology Primary Service

8

TCH

Neurodevelopmental Disabilities Advocacy and Resource

9

ST. LUKE’S

St. Luke’s Medical Center Neurocritical Care Unit

10

TCH

School Age Development

11

BEN TAUB

Inpatient Adult Neurology

12

TCH

Neuroradiology

13

VA Medical Ctr

Inpatient Adult Neurology

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Second-Year Training

Content

Second-Year of Child Neurology Training

The curriculum for second-year residents include seven blocks of inpatient services at Texas Children’s Hospital, three blocks of child neurology outpatient clinics and electives, and three blocks of outpatient adult neurology subspecialty clinics. The adult neurology subspecialty clinics include a weekly ½ day clinic in the pediatric correlate specialty.

Example: Second-Year Child Neurology Resident Schedule with examples of resident-selected elective

Block

Site

Rotation

1

TCH

Inpatient Neurology Primary Service

2

TCH

Outpatient Clinics- General and subspecialty clinics

3

BCM

Outpatient Multiple Sclerosis (MS)- Adult with weekly pediatric MS clinic

4

TCH

Inpatient Neurology Consult Service

5

TCH

Neurocritical Care Consult Service

6

BCM

Outpatient Neuromuscular Disease (NMD)- Adult with weekly pediatric NMD clinic

7

TCH

ICU Consult Service

8

TCH

Elective – Pediatric Headache

9

TCH

Inpatient Neurology Consult Service

10

BCM

Outpatient Movement Disorders (MD)- Adult with weekly pediatric MD clinic

11

TCH

ICU Consult Service

12

TCH

Outpatient Clinics- General and subspecialty clinics

13

TCH

Inpatient Neurology Primary Service

Second-Year of Neurodevelopmental Disabilities Training

During the second year of training, neurodevelopmental disabilities residents spend six blocks rotating in the inpatient child neurology services at Texas Children’s Hospital.  The second-year neurodevelopmental disabilities curriculum also includes five essential or required outpatient clinical blocks (physical medicine and rehabilitation, child and adolescent psychiatry, neurogenetics, fetal and neonatal neurology, and EEG) as well as two blocks of child and adult inpatient/outpatient electives.

Example: Second-Year Neurodevelopmental Disabilities Schedule

Block

Site

Rotation

1

TCH

Inpatient Neurology Primary Service

2

TCH

Neurogenetics

3

TCH

Physical Medicine and Rehabilitation – Outpatient Clinics

4

TCH

Inpatient Neurology Consult Service

5

TCH

Electroencephalography (EEG)

6

TCH

Child and Adolescent Psychiatry

7

TCH

ICU Consult Service

8

TCH

Elective - Palliative Care

9

TCH

Inpatient Neurology Consult Service

10

TCH

Fetal and Neonatal Neurology

11

TCH

ICU Consult Service

12

BCM

Outpatient Adult Elective - Dementia

13

TCH

Inpatient Neurology Primary Service

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Third-Year of Training

Content

Third-Year of Child Neurology Training

The curriculum for third-year residents include block rotations in Child Psychiatry, Physical Medicine and Rehabilitation, and Neuro-Oncology. On each of these blocks, the residents work with related subspecialists to see pediatric patients in the outpatient setting as well as inpatient consultations. The hospital has an inpatient rehabilitation unit under the direction of physiatrists where the resident learns aspects of care in the rehabilitation and recovery of children initially hospitalized with more severe neurological conditions such as stroke, autoimmune encephalitis, and Guillain-Barre syndrome. Each resident additionally spends a block working with Dr. Lotze, which includes additional training in neuromuscular and neuro-immunological disease as well as opportunities to learn more about clinical research through participation in various research meetings. There are three blocks of outpatient adult neurology electives, which the resident can design based on their interests and training needs. Residents often use these electives for additional training in neuropathology, neuro-ophthalmology, and neurophysiology, but many other electives are available. The remaining six months are electives designed by the resident. View descriptions here of subspecialty clinical services that residents might include as electives during their training.

Example: Third-Year Child Neurology Resident Schedule with examples of resident-selected electives

Block

Site

Rotation

1

TCH

Elective – Sleep Medicine

2

TCH

Physical Medicine and Rehabilitation

3

BCM

Adult Elective - EMG

4

TCH

Neuro-Oncology

5

TCH

Child Psychiatry

6

BCM

Adult Elective - Neuropathology

7

TCH

Dr. Lotze Block

8

TCH

Elective – Fetal Neurology

9

TCH

Elective - Neurosurgery

10

BCM

Adult Elective – Neuro-ophthalmology

11

TCH

Elective - Epilepsy

12

TCH

Elective - Neuropsychology

13

TCH

Elective – Clinical Research Project

Third-Year of Neurodevelopmental Disabilities Training

The curriculum for third-year neurodevelopmental residents begins to incorporate more time for mentored research and focused clinical education (Clinical and Basic Science blocks). The Neurometabolics block enhances neurogenetics knowledge acquired throughout the first two years in neurodevelopmental training through increased exploration into the underlying basic science in addition to clinical experiences. Blocks in specific adult subspecialties with the related weekly pediatrics clinic allow residents to understand the manifestations of neurological processes at different ages as well as to experience the life-course of these disorders. Furthermore, the inpatient Physical Medicine and Rehabilitation block compliments the block in Adult Transition and NDD Outcomes, providing an understanding of the course of recovery in children with acquired neurodevelopmental disabilities and the transition to adult neurodevelopmental medical care. Residents will also spend one block on neurosurgery, reviewing neuroanatomy, seeing children a multitude of neurological processes requiring neurosurgical intervention, and discerning both primary and secondary neurodevelopmental sequelae. Finally, third-year neurodevelopmental residents serve as a senior resident, taking a leadership role in their two developmental blocks.

Example: Third-Year Neurodevelopmental Disabilities Schedule

Block

Site

Rotation

1

TCH

Physical Medicine and Rehabilitation – Inpatient Unit

2

TCH

Clinical and Basic Science, Statistics

3

TCH

Clinical and Basic Science, Pharmacology

4

TCH

Neurosurgery

5

BCM/TCH

Adult Transition and NDD Outcomes

6

BCM/TCH

Outpatient Neuromuscular - Adult with weekly pediatric clinic + EMG

7

TCH

Neurometabolics

8

BCM/TCH

Outpatient NeuroImunology- Adult with weekly pediatric clinic

9

BCM/TCH

Outpatient Movement Disorders- Adult with weekly pediatric clinic

10

TCH

Clinical and Basic Science

11

TCH

Clinical and Basic Science

12

TCH

Early Childhood Development 2

13

TCH

School Age Development 2

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Fourth-Year of Neurodevelopmental Disabilities Training

Content

During the fourth year of training, neurodevelopmental disabilities residents focus primarily on mentored research and/or development of clinical expertise. During clinical and basic science blocks, neurodevelopmental disabilities residents continue to attend continuity clinic as well as pertinent neurodevelopmental didactics and conferences. There is flexibility in the timing of these rotations (for example, if the resident is involved in a mentored research project at the Neuroscience Research Institute that requires 15 consecutive months in the lab, then rotations can be shifted between the third and fourth year of training as needed).

Example: Fourth-Year Neurodevelopmental Disabilities Schedule

Block

Site

Rotation

1

TCH

Clinical and Basic Science

2

TCH

Clinical and Basic Science

3

TCH

Clinical and Basic Science

4

TCH

Clinical and Basic Science

5

TCH

Clinical and Basic Science

6

TCH

Clinical and Basic Science

7

TCH

Clinical and Basic Science

8

TCH

Clinical and Basic Science

9

TCH

Clinical and Basic Science

10

TCH

Clinical and Basic Science

11

TCH

Clinical and Basic Science

12

TCH

Child Neurology Subspecialties

13

BCM

Adult Elective - Neuropathology