Customized Programs in Neurology Residency

  
A unique feature of our Neurology Residency Program is the opportunity for residents to custom-design aspects of their training. In addition to cultivating a broad range of interests and Izzo and Laracompetencies for all residents, the faculty recognize that some residents gravitate to a clinical subspecialty or a basic science area relatively early in their training; others enter the program with prior training in a clinical or research discipline. For these residents, a specially oriented program may begin during the senior resident years. A wide range of possibilities exists at UMass Memorial Medical Center and its clinical partners.


Trainees have the opportunity to participate in a complete range of outpatient clinical presentations some of which are not generally seen in hospitalized patients, including the evaluation, treatment, and individual care of patients whose diseases are complex or refractory to usual treatments.

Subspeciality Opportunities:

Alzheimer’s and Related Disorders
Ambulatory and Inpatient Rehabilitation
Autonomic Disorders
Epilepsy
Headache
Multiple Sclerosis Clinic
Movement Disorders Clinic
Neuro-Intensive Care Unit
Neuromuscular Clinic
Neuro-Oncology
Sleep Disorders Center
Vascular Neurology


Alzheimer’s and Related Disorders (Aging and Dementia) (return to top)
There is an interdisciplinary approach to the diagnosis, clinical research and care of patients with dementia. Opportunities are available for participating in the intensive study of the neuropsychology, epidemiology, neuropathology and experimental treatment of Alzheimer's and related diseases. UMass Memorial Neuropsychology Center

Ambulatory and Inpatient Rehabilitation (return to top)
At the Fairlawn Rehabilitation Hospital, residents have the opportunity to become skilled in optimizing the functional outcomes of patients with neurological disorders. Emphasized are therapies for aphasia, the practical treatment of dysphagia, and the use of orthotics and other adaptive aids. Fairlawn Rehabilitation Hospital

Autonomic Disorders (return to top)
Autonomic disorders is now an official subspecialty of neurology, with its own board certifications as of 2009. Through our autonomic clinic and autonomic laboratory here at UMass, we provide evaluation and treatment of patients with dysautonomia. Autonomic dysfunction is common in individuals with Parkinson disease, multiple system atrophy, peripheral neuropathies, neurogenic syncope, hyperhidrosis and many other conditions. Residents have the opportunity to evaluate and manage these patients. Residents will be introduced to the panel of autonomic testing procedures, including skin biopsies. UMass Memorial Autonomic Testing LabParkinson's Disease Treatment

Epilepsy (return to top)
We boast a comprehensive epilepsy program. The Epilepsy clinic is responsible for the care of patients with a wide range of problems related to seizures. These include chronic seizure disorders referred for management, the use of new antiepileptic medications, evaluations for surgical treatment or vagus nerve stimulators, and questions related to the discontinuation of medications, pregnancy, or undiagnosed spells. On the inpatient side, we provide 24 hour availability of EEG monitoring for our critically ill patients. We also evaluate patients using inpatient video EEG monitoring and perform intracranial monitoring and functional mapping. We offer comprehensive neuropsychological evaluations of seizure disorders and perform WADA testing for language mapping. There are several basic science and clinical research projects in which residents might get involved. 

Headache (return to top)
Residents see patients with head pain and facial pain syndromes, specifically to provide tertiary diagnostic evaluations, and multidisciplinary headache management. There are clinical trials in migraine treatment.

Multiple Sclerosis Clinic (return to top)
The clinic evaluates new patients referred for diagnosis and/or management of multiple sclerosis or other CNS inflammatory conditions such as lupus or vasculitis. Residents become familiar with the clinical and radiologic features of neuroimmunologic disorders and their differential diagnoses. There is also ample opportunity to become familiar with management of multiple sclerosis at all phases of the illness. UMass Memorial Multiple Sclerosis Center

Movement Disorders Clinic (return to top)
The clinic provides subspecialty consultative services and clinical trials for Parkinson's disease, Huntington's disease, dystonia, Tourette's syndrome and many related problems. The program includes assessment and treatment with botulinum toxin, preoperative evaluation for surgical management of Parkinson's disease, and educational services to patients and their families about movement disorders. Parkinson's Disease Treatment, Deep Brain Stimulation

Neuro-Intensive Care Unit (return to top)
We have a designated Neurocritical Care Unit of 16 beds, which also includes 4 Stroke Step-down beds. There are three Neurocritical Care specialists directing the care in this unit. While on rotation, residents will obtain training in patient care in the neurological intensive care unit setting. This training will include the diagnosis and management of life-threatening neurological diseases, as well as of the medical conditions that frequently occur as complications. The residents will also receive supervised training in some of the technical aspects and procedures related to the practice of neurological intensive care. Residents are also invited to participate in clinical and/or basic science research related to neurological intensive care. Fairlawn Rehabilitation Hospital

Neuromuscular Clinic (return to top)
We are a Muscular Dystrophy Association (MDA) Neuromuscular center and a MDA ALS center. Residents have the opportunity to see patients with a wide variety of neuromuscular disorders, among them amyotrophic lateral sclerosis, polyneuropathies (genetically determined and acquired), disorders of the neuromuscular junction and a wide range of myopathies and muscular dystrophies. There is ample opportunity to develop and refine the skills necessary for the assessment and management of neuromuscular disorders.

Neuro-Oncology (return to top)
The treatment of the most common CNS malignancies remains a challenge. The treatment of patients with malignant glioma involves a multidisciplinary approach and experimental protocols are an important part of the standard of care. We are currently collaborating with basic science laboratories here to develop new approaches to treatment based on recent advances in our understanding of glial stem cells and the role of oncoviruses. Residents see a wide variety of tumors in clinic both here at the UMass campus and at Memorial Hospital. We encourage the residents to get involved in clinical and basic science research with the goal of presenting at national and international conferences and publishing their work. UMass Memorial Neuro-Oncology Center

Sleep Disorders Center (return to top)
The UMassMemorial Sleep Disorders Center on Prescott St in downtown Worcester and the Sleep clinic on the University and Memorial campuses provide comprehensive diagnostic and management services for the approximately 120 defined sleep disorders that include insomnia, snoring and obstructive sleep apnea, parasomnias, circadian rhythm disorders and secondary sleep disorders (those related to medical or psychiatric disorders). The center coordinates an interdisciplinary team of more than 40 specialists including pulmonologists, neurologists, otolaryngologists, psychologists, dentists, nurses and technologists. The center includes a state-of-the-art, fourteen-bed sleep lab and an ambulatory consultation area.  UMass Memorial Sleep Disorders Center

Vascular Neurology (return to top)
We are a designated Primary Stroke Center. Residents have the opportunity to care for strokes of all types and severity in many different clinical situations. We provide state of the art care of ischemic and hemorrhagic strokes. Neurosurgeons, neurointerventional radiologists and neuro-intensivists provide support around the clock. Treatment might include coiling and clipping of aneurysms, extra and intracranial stenting, intra-arterial tPA and mechanical clot extraction, multidisciplinary treatment of AVMs, and more. We have a separate inpatient stroke team attended by stroke specialists and stroke fellows. We have physiatrists and neurologists interested in the rehabilitation of stroke patients, including techniques like Botox injections. We have outpatient stroke clinics that focus on stroke prevention and management. In Stroke clinic residents will become familiar with the outpatient evaluation of a probable cause of stroke, modification of risk factors and medication adjustment. Resident’s will become familiar with the more unusual causes of stroke, as patients are often referred if they are young, have recurrent strokes or have other atypical features. Examples seen in the last year include CADASIL, MELAS, hereditary hyperhomocysteinemia and fibromuscular dysplasia. Fairlawn Rehabilitation Hospital , UMass Memorial Stroke Center , Stroke Gold Plus Award.