Day in the Life of a Resident & Core Attributes: Neurology

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Neurology is a competitive and challenging residency. You will face a range of complex conditions, and have to deal with long hours. Here we’ll consider the typical day that a neurology resident might face working on an inpatient service, and then look briefly at core attributes that neurology residents require.

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Day in the Life of a Neurology Resident

0500: Wake up. You’ll need to be awake early as a neurology resident, although perhaps not quite as early as friends working in orthopaedics or general surgery, for example.

0600: You arrive at the hospital and immediately begin to review charts and start pre-rounding. Residents are responsible for all acute neurological inpatients, which can include patients suffering from conditions as diverse as exacerbations of MS, encephalopathies, or strokes and seizures. This part of the residency is therefore relatively more fast paced, and you need to prepare well for the day.

0830: Seniors arrive and round on all patients, discuss any imaging that has been ordered, and decide on management plans. The neurology team is large, with an attending, advanced nursing practitioners, a senior resident, four junior residents, and four medical students attached as well. This is just the day team – the night team is handled by two residents, one senior and one junior. The breadth of the team allows for great learning opportunities, and it’s vital that you make use of the combined expertise of the rest – especially at the start of your residency.

1130: Finish tasks before lunch. You might have to write up some remaining notes or get back to other clinicians who have made requests of you – there may also be some consults required. You grab some food and head to an education session.

1200: Noon conference. Each day a different case is presented, ensuring that you encounter a range of different conditions. Each is presented either by an attending who has selected it as being of particular interest, or by a resident who has been asked to present that day. You are not presenting today, but make use of the time by asking questions and taking notes. Some days you have slightly different sessions, including a once-weekly journal article club, in which you and other residents gather together to critically appraise an article and provide feedback on it to an attending.

1300: Rounding and admin. The afternoon will consist of a range of different tasks – there will be some direct patient contact, with a few interviews to be conducted or examinations that need to be performed. However, a significant amount of time is also devoted to writing up notes, speaking to families, and speaking to others in the team about patients’ plans. As a junior resident, you are responsible for your own small set of patients – you have eight at the moment. You will need to ensure that you have rounded on all by the end of the day, that each has a sensible management plan, and that you have reviewed all charts. Your work here is done along with seniors, who you will present cases to – you are not expected to work independently. This afternoon, you find that you need to perform two lumbar punctures, which take longer than expected, meaning that you have to work efficiently to finish your notes before the end of your shift.

1900: Night team arrives. You are able to sign out your patients, and then head home. You’ve been in the hospital for 13 hours, and are tired. However, you still need to do a little extra learning, which you do online with a group of other residents via webcam, discussing cases and honing your knowledge.

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Core Attributes of Neurology Residents

Neurology residents need to be highly resilient, and able to think logically through complex cases. The hours are long and cases are difficult, which can make for an exhausting residency – it’s therefore vital that you are able to overcome adversity, and that you have sensible ways of dealing with stress. You must have reflected on this before your residency interviews, and be able to show that you are ready for the challenge. You should also have given thought to how you can illustrate your academic potential and ability to solve problems.

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