Sinai Consult:
The Neurology Inpatient Consult Team consists of a General Neurology consult attending, a Stroke Neurology consult attending, one PGY-4 senior neurology resident, two PGY-2 junior neurology residents, one PGY3 resident, as well as 1-2 medicine/psych resident rotators, and one or two medical students. Teaching rounds are held at least three times daily, once each with the morning General Neurology Consult attending and Stroke attending.
The neurology residents on this service are responsible for seeing and examining all patients either in the ED or admitted to the hospital for whom a consultation is requested and writing an appropriately thorough consult note. The residents present the case to the attending with a preliminary plan, and decide on recommendations together. The residents are also primarily responsible for following up diagnostic and therapeutic recommendations, communicating with the primary teams, and teaching medical students.
The PGY-4 neurology resident supervises the care of all consult patients and organization of rounds, with the exception of stroke consult follow-ups in the NSICU or in Rehab (these consults are seen solely by the stroke fellow and stroke consult attending). This supervisory role means that the initial detailed history and exam of new consults should be completed by a PGY2, PGY3, or rotator (ideally with a medical student) with critical elements verified by the PGY4 prior to rounds. The degree of patient-care involvement of the Medicine or Psychiatry rotators depends on their level of clinical neurology experience; most observe the process of an initial neurology consult and review the neurologic exam prior to seeing and examining patients with supervision.
The PGY-3 neurology resident is stationed in the ED and sees the ED neurology consults. These cases are typically staffed with the ED Consult Attending (vascular neurology trained). He/She will go to stroke codes from the ED.