The Neurology Health Care Service of Fletcher Allen Health Care (FAHC) and the Department of Neurology of the College of Medicine, University of Vermont, welcome you as an applicant to the Neurology Residency Training Program of our integrated health care system and academic medical center. The Neurology residency three-year training program provides a thorough and broad-based clinical neurological experience, and offers a fourth year in clinical neurophysiology that will prepare residents for obtaining added qualification in electrophysiology. Additional fellowship training in neuromuscular disease, multiple sclerosis and movement/neurodegenerative disorders is available. The faculty is committed to clinical neuroscience education as well as clinical and basic neuroscience research. The program is designed to support the development of clinical excellence and career development in the clinical and academic neurosciences.

A broad range of clinical and investigative opportunities exists during the Neurology residency training program. The clinical and academic environment is extremely supportive and the collegiality of the program is reflected in the warm interrelationships among residents, staff and faculty. As the health care system continues to change to enhance the quality and efficiency of delivering health services, the integrated care system of Fletcher Allen Health Care provides the unique opportunity for neurologists to play a major role in the development of integrated care systems. The residency training program in Neurology is well-positioned to provide training opportunities for residents in the clinical care pathways that are evolving for neurologic care.

The University and greater Burlington community is an attractive, friendly and safe environment for residents and their families. There is easy access to university programs, community culture, the beautiful outdoor environments of Vermont, northern New England, and Upstate New York, and the international flavor of Montreal, just 90 minutes away.

We look forward to meeting you and answering any questions you might have regarding our training program. We recognize this is a critical and important time in the development of your education and career. We are committed to providing an outstanding and supportive environment for the training of neurologists, and know you will find your time here at Fletcher Allen and the University of Vermont College of Medicine challenging and rewarding.

Training Program

The hallmarks of our Neurology Residency Training Program are the broad clinical experience, the integration of clinical and basic neurosciences, resident participation in curriculum development and teaching, the close daily contact among residents and faculty, and the friendly and supportive atmosphere. The program provides a full experience in all aspects of clinical neurology. There are 18-22 months devoted to adult clinical neurology (wards, consultations, clinics and neurointensive care including four-six months as chief resident), four months in pediatric neurology, two months in neuropathology, one month in psychiatry and neuroradiology, two months in clinical neurophysiology and three elective months (i.e., neurosurgery, neuro-ophthalmology, neuro-rehabilitation, neuromuscular, and/or extra time in clinical neurophysiology, neuropathology or neuroimaging).

Each resident is allotted $600 each year to use for textbooks, journals, conferences, memberships or other neurologically related educational activities. Most residents opt for a variety of the above.

Neurology residents come from the best medical schools in the U.S. and abroad. There are six resident positions, two in each of the three years of residency. Completion of an AMA approved PGY 1 year in Internal Medicine, or a Transitional year, is required (see information for applicants from the American Board of Psychiatry and Neurology).

Each resident is entitled to three weeks of vacation annually. Vacation time is limited during inpatient months (i.e., general neurology or stroke months and neurointensive care). Two weeks consecutively is the longest period allowed. In addition, time to attend conferences and to interview (in PGY 4 year) is allowed after discussions with the Program Director and Chief of Service.

There are 21 faculty involved in the instruction of the clinical and basic neurosciences. The clinical faculty include nine adult and two pediatric neurologists who participate in direct supervision of patient care as well as didactic sessions focused on the clinical neurosciences. Two additional communicate practicing neurologists are involved in residency education.

Also, four basic scientists in the department are involved along with the department chair and director of the residency training program in developing the basic science curriculum for neurology trainees. This integrated curriculum provides a specific means by which to correlate clinical disorders of the nervous system with the fundamental neurosciences.

The clinical faculty have a broad range of expertise in the clinical neurological sciences, and have specific clinical and basic science research interests in neuromuscular disease, including motor neuron disease and peripheral neuropathy, stroke, neurodegenerative disorders, including Alzheimer's and vascular dementia, movement disorders, multiple sclerosis, epilepsy and seizure disorders, sleep disorders, headache and pediatric neurology.

Many of the clinical research programs involve the discipline of experimental therapeutics and clinical trials. The department provides specialized clinical care and multidisciplinary management approaches that are exemplified by the activities of the Vermont Sleep Disorders Center, the Memory Center, the ALS Research Center, the Muscular Dystrophy Association Clinic, the Multiple Sclerosis Center and the MIND (movement, Inherited and neurodegenerative disease) program.

Faculty in the department of surgery (neurosurgery and ophthalmology), radiology (neuroradiology), orthopaedics (rehabilitation), pathology (neuropathology), psychiatry, and clinical psychology are actively involved in the clinical neuroscience training program. An interactive and integrated clinical seminar series is developed to provide an interdisciplinary approach to disorders of the brain, spinal cord, and peripheral nerves. Also, combined clinical conferences occur providing for clinical neuroradiographic and clinical neuropathologic correlations.

Neuroscience is well represented in the preclinical (basic science) and clinical departments of the University of Vermont College of Medicine. The Departments of Neurology and Anatomy and Neurobiology are particularly strong in developmental neurobiology, cell and molecular neuroscience, animal and in vitro models of neural injury and disease, neuroplasticity and regeneration, and the electrophysiology and biophysics of neuronal membranes. The Department of Physiology and Biophysics is recognized for studies of the neurophysiology and biophysics of smooth cardiac muscle. The Department of Pharmacology is known for studies of vascular smooth muscle, including studies of the cerebral circulation. Neurosurgery research is focused on cerebrovascular disease, CSF pressure dynamics and neuro-oncology. Interventional neuroradiology is an active member of the neurovascular research team.

The Departments of Medicine and Orthopaedics conduct a number of clinical and basic studies that are directly relevant to the clinical neurosciences. The Department of Medicine directs the Clinical Research Center (CRC) of Fletcher Allen. The CRC is internationally recognized for metabolic studies of carbohydrate dysregulation in diabetes and obesity, autonomic nervous system function as it relates to metabolism and muscle protein synthesis and degradation. The Department of Orthopaedics is recognized for its studies of the biomechanics of the spine and spinal injury.

The Department of Neurology admits about 400 patients per year to Fletcher Allen Health Care. The average length of stay is approximately five days reflecting fairly rapid patient turnover. Children with neurologic diseases are admitted to the pediatric floor under the care of the pediatric neurologist and general pediatrics. Neurology residents rotating on Pediatric Neurology evaluate and follow these children through the pediatric neurology service.

The adult clinical neuroscience floor (Neurology and Neurosurgery) on McClure 6 of the MCHV campus of FAHC has a total of 46 beds. Total hospital capacity is approximately 500 beds and the Rehabilitation Center is a 40-bed facility with outpatient multidisciplinary clinics. Resident rotations provide both outpatient and inpatient experiences.

All Neurology outpatient clinics are held at the University Health Center (UHC) Campus at the offices of the Department of Neurology. Both General Neurology and Specialty Clinics, including the Muscular Dystrophy Clinic, Neuromuscular Diseases Clinic, Movement Disorders Clinic, Multiple Sclerosis Center, Seizure and Paroxysmal Disorders Clinic, Headache and Stroke Clinic are held each week. Approximately 12,000 patient visits occur per year. Residents rotate through these clinics throughout the three years of their residency, and receive a breadth of clinical experience in common and rare neurological disorders.

The Clinical Neurophysiology Laboratory is fully equipped for electroencephalography (EEG), including ambulatory studies, electromyography (EMG) and nerve conduction studies, single fiber electromyography, quantitative motor unit counting, and quantitative sensory threshold determination. The department annually performs about 1,600 EEGs (including polysomnograms), 500 evoked potentials, and 1,200 EMGs and nerve conduction studies. The neurology program sponsors a fourth year of neurology training in clinical neurophysiology. The directors of the EEG, Sleep Disorders, and EMG laboratories are specialty board certified neurologists. The department also has access to facilities for non-invasive carotid and vertebrobasilar blood flow studies, including transcranial doppler studies.

The neuro-radiological facility includes two GE MRI scanner, two rapid CT scanners, one SPECT scanner as well as standard equipment for myelography and angiography. Also, interventional neurovascular capabilities permit state-of-the-art management of stroke. A new 3D tesla MRI to establish functional neuroimaging will be in place in 2003.

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