Neurology Residency

General Considerations

The goals of the Neurology Resident Training program are to develop clinical expertise in the diagnosis and management of small and large animals with neurological disease, fulfill the requirements for certification in the American College of Veterinary Internal Medicine (ACVIM) Specialty of Neurology and prepare the veterinarian for a career in medical and surgical neurology in academia or private practice. To meet these goals the Resident will spend 75% of their time in small animal neurology service activities and 25% of their time in research, special rotations, manuscript preparation, seminars, independent study, and vacation.

A formal internship or its equivalent and a formal neurology resident training program with 75 weeks assigned to a clinical neurology service and supervised by a Diplomate in the Specialty of Neurology are required to satisfy ACVIM – Neurology requirements. The 75 weeks should include 50 weeks of direct supervision where the resident and the Diplomate are on clinic duty
at the same time. The remaining 25 weeks may be indirect supervision where the Diplomate and resident meet four times weekly. To fulfill these qualifications, we require 3 years in the Neurology Resident Training Program.

The resident will have a committee of 2-3 individuals, one as their major advisor and others related to their clinical and research interests. The committee and resident will meet a minimum of once every 6 months to review the completion of program goals and for planning of the next 6 months activities.

Research: All residents at the University of Florida are required to complete a research project in the biological sciences. A manuscript on the project must be prepared and submitted to a peer reviewed journal in order to satisfactorily complete the residency program. Residents must also present their projects at Phi Zeta day or a national meeting. Intramural funding (up to $2000) is available on a competitive basis in the fall of each year for residency research projects. Residents compete for these funds by researching literature and writing a proposal. This proposal will be undertaken primarily by the resident with the supervising diplomat acting as advisor and listed as the required primary investigator (P.I.). Financial support is available to assist with the costs associated with travel to a national meeting and miscellaneous academic expenses including literature searches, photocopying and acquisition of texts.

 

Overview of the ACVIM Neurology Requirements
  • The resident must spend 75 weeks working in the clinic with an ACVIM board certified neurologist, develop competence in clinical neurology and be endorsed by the ACVIM
    board certified neurologist at the completion of their residency.
  • The resident must have 25% of their time as a Chief Neurology Resident with primary management of cases.
  • In addition, the resident must spend 50 hours of activity in each of the following: clinical pathology, neuropathology, neuroradiology and neurosurgery.
  • The resident must maintain a weekly log of activities showing hours spent in other rotations.
Required ACVIM and UF Residency Activities
  • The resident must maintain a surgery case log with date, type of surgery, case identifying number and whether the resident was primary or assistant surgeon.

 

Neurology Service Activities (75% of time)

  • Participate in the diagnosis and management of animals in the small animal neurology service including client and referring veterinarian communications and medical records.
  • Accurately complete and interpret:
    • a neurological history
    • a neurological examination and localization of lesions
    • a differential diagnosis list based on mechanisms of disease
    • diagnostic plans and initial therapeutic plans when applicable
    • cerebrospinal fluid collection and analysis
    • electroencephalography
    • electromyography
    • brain stem auditory evoked responses
    • spinal cord and cortical evoked responses
    • myelography
    • computerized axial tomography
    • magnetic resonance imaging scans
    • final diagnosis
    • medical and surgical treatment plans
      common neurosurgical approaches to the lumbar and cervical vertebral column and cranium
    • prognosis
    • gross necropsy findings
    • histological findings
  • Review necropsy and histology on all cases managed that go to the Pathology Department by attending afternoon “Show and Tell” rounds for gross findings.
  • Organize and set a schedule for monthly neurology, neuroradiology and neuropathology rounds.
  • Participate in the clinical instruction of Phase III Neurology junior and senior veterinary students including clinic case management, informal rounds and seminars and formal
    seminar presentations.
  • Be primary consultant on neurology case calls from outside veterinarians and in-house neurological case consultations on small, exotic and large animals in other services.
  • Attend the resident’s conference weekly and give formal neurology presentations to the group once a year.
  • Organize and set the schedule for biweekly neurology journal club and present articles in Neurology when scheduled.
  • Attend weekly radiology rounds for residents (counts toward 50 hour requirement).
  • Attend internal medicine rounds and seminars whenever possible (preparation for ACVIM qualifying exam).
  • Attend ACVIM qualifying board preparation seminar topics for residents.
  • Teach in neurology didactic courses.
  • Attend one annual ACVIM Forum and present an research abstract as an oral
    presentation or poster.
  • Review of all veterinary neurology articles in journals on the reading list monthly.
  • Participate in the UFVH Emergency Service on a rotating schedule with the other residents.
  • Attend biannual meetings with the major advisor to discuss cases, research projects and miscellaneous topics.
  • Participate in a program and resident review evaluation every 6 months with committee. Submit a residency program evaluation to the College Residency Committee upon completing the residency.

Required Other Activities (25% of Time)

  • Research project proposal completed 6 months after beginning residency program.
  • Preparation and submission of a first author clinical neurology paper to a refereed journal.
  • Completion of resident research project, manuscript preparation and submission as first author to a refereed journal.
  • Clinical pathology, radiology, and neuropathology experience.
  • Rotations in internal medicine (qualifying exam preparation).
  • Rotations with other board certified neurologists in private practice or academia.
UF Neurology Residency Overview

Suggested Year 1:

9 Months Small Animal Neurology Service Activities:

  • Medical neurology plus neurosurgery

3 Months Other Activities:

  • One month on the surgery service for review of basic surgical skills. The basic skills are to be evaluated by a Board Certified surgeon and the resident will not be able to complete the residency without showing competency in the skills. The surgical skills are outlined at the end of this document.
  • Internal medicine
    Radiology, clinical pathology and neuropathology
    Research project proposal
    2 weeks vacation

Goals for Year 1:

  • Demonstrate competency in the basic surgical skills as evaluated by an ACVS Diplomate
  • Increase internal medicine experience if needed
  • 10 hours radiology and clinical pathology experience
  • Beginning clinical neurology and neurosurgical skills including electrodiagnostics and neurodiagnostic imaging
  • Research Project written and submitted for funding

Suggested Year 2:

9 Months Small Animal Neurology Service Activities:

  • Medical neurology plus neurosurgery

3 Months Other Activities:

  • Internal medicine
  • Radiology, clinical pathology and neuropathology
  • Complete research project
  • Prepare for and take ACVIM Qualifying Exam (5 weeks total)
  • 3 weeks vacation

Goals for Year 2:

  • Prepare for and take the ACVIM Qualifying Exam
  • 20 hours radiology and clinical pathology experience
  • Strengthen clinical neurology and neurosurgical skills
  • 20 hours neuropathology experience
  • Complete resident research project
  • Competently complete the minimum number of hemilaminectomies and cervical ventral slots to allow the resident to work under indirect supervision. Minimum numbers of surgeries are outlined below.

Suggested Year 3:

9 Months Small Animal Neurology Service Activities:

  • Medical neurology plus neurosurgery

3 Months Other Activities:

  • Submit first author manuscript to refereed journal
  • Large animal neurology
  • Radiology and clinical pathology experience
  • Neuropathology experience
  • Present resident research project at Phi Zeta day
  • Prepare research manuscript
  • Present abstract of research at ACVIM Forum
  • Prepare for and take ACVIM Neurology Certifying Exam (5 weeks total)
  • 3 weeks vacation

Goals for Year 3:

  • Submit first author manuscript to refereed journal
  • Large animal neurology experience
  • 20 hours Radiology and clinical pathology
  • Expertise in all types of neurological problems of all species and common Neurosurgical procedures of the vertebrae and cranium.
  • Expertise in electrodiagnostics and diagnostic neuroradiography
  • 20 hours of neuropathology
  • Complete and present Resident Research Project as an abstract or poster at the ACVIM Forum and Phi Zeta day and submit the manuscript to refereed journal
  • Receive neurology residency certificate from University of Florida
  • Prepare for and take the ACVIM Neurology Certifying Exam

The Resident Advisor and resident may alter the program as outlined above to take advantage of special learning opportunities that might arise.

Detailed List of Basic Surgical Skills

  • Able to correctly clip and prep the surgical site.
  • Able to correctly position the patient for the specific surgery.
  • Able to perform sterile skin preparation.
  • Able to perform a proper surgeon’s surgical scrub.
  • Able to demonstrate proper gowning
  • Able to glove both closed and assisted
  • Able to demonstrate the proper technique for unwrapping and opening sterile items.
  • Able to interpret tape and indicator strips for sterilization.
  • Shows correct handling of sterilized items.
  • Able to name the instruments listed:

Operating loupes

Retractors: Gelpi, Weitlander, Adson-Baby, Balfour, Hohmann, Senn and Navy

Backhaus towel clamp

Allis tissue forceps

Periosteal elevator

Shea and House curette

Ball tip probe

Dental cycle scalar

Iris scissors

Jeweler forceps

Rongeurs: Lembert, Kerison

Intraocular forceps

Hall Surgitome: bur guard, burs

Poly Methyl Methacrylate

Positive profile pins, cortical bone screws, cancellous bone screws

 

 

  • Able to demonstrate proper draping technique.
  • Knows how to attach scalpels to handles and knows a 3 from a 10 from an 11 blade.
  • Is able to control bleeding with bone wax, monopolar and bipolar electrodes, Hemoclips, Surgicel and Gelfoam.
  • Demonstrates proper handling of tissues with moistened gauze and avoids tissue trauma.
  • Shows proper use of lavage.
  • Able to assemble suction apparatus
  • Knows how to assemble the surgitome, choose and insert a bur.
  • Is familiar with specific suture materials; catgut, synthetic absorbable, organic nonabsorbable, synthetic nonabsorbable and metallic.
  • Able to show the correct technique to mix Poly Methyl Methacrylate.
  • Knows needle types and their specific uses; taper and cutting.
  • Is able to describe the suture patterns; subcutaneous and subcuticular, simple interrupted, horizontal mattress, vertical mattress, interlocking, Connell, Cushing and Bunnell and knows when they are indicated.
  • Able to use the stapling instrument and staples.
  • Knows how to tie sutures by instrument, hand and burying.
  • Can define wound contracture.
  • Knows the concept of skin tension lines.
  • Knows the principles of undermining skin to facilitate wound closure.
  • Knows what walking sutures are and what are their advantages and disadvantages in wound closure.
  • Knows the principles and clinical application of Z-plasties in wound management.
  • Knows the difference between skin flaps and skin grafts.
Minimum numbers of surgeries expected to assist in before being deemed competent to perform without direct supervision.

 

Simple

  • Hemilaminectomy 10
  • Lumbo-sacral dorsal laminectomy 6
  • Cervical ventral slot 10
  • Muscle nerve biopsy 2
  • Approach for a spinal tumor 2

Complex

  • Transfrontal craniotomy TBA
  • Lateral craniotomy TBA
  • Foramen magnum decompression 6
  • Shunt placement for hydrocephalus 4
  • Atlantoaxial stabilization 10
  • Dorsal cervical decompression 10
  • Cervical distraction/ stabilization 10
  • Vertebral fracture repair 10

TBA is noted since it is not expected to ever have the resident performing these without the senior faculty.