Elmhurst Consult
At Elmhurst Hospital, the Consult Service includes a Neurology attending, one PGY-3 neurology resident and two to three medical students. Attending rounds occur 5-6 days a week.
The PGY3 is responsible for seeing all consults called during the day on patients that are admitted to an inpatient service at Elmhurst. The patient may still be physically located in the ED. He or she is responsible for seeing and examining all patients on whom a consultation is requested and writing a thorough consult note. The resident then presents the case to the attending and together they decide on recommendations. The resident is also primarily responsible for following up diagnostic and therapeutic recommendations, communicating with the primary teams and teaching the medical students. The Consult resident should also assist in formally teaching the medical students given the time constraints on the Clinic residents.
Elmhurst Clinic
The Elmhurst clinic rotation affords the PGY-3 exposure to the diverse pathology of Elmhurst Hospital primarily in the outpatient, clinic setting. Mornings will be spent in the clinic (adult and pediatric) with coverage as necessary for urgent Emergency Department neurology consultations. Afternoons will be spent in outpatient Neurology, including general clinic, Neurophysiology lab, and pediatric neurology clinic. Short- and long-call coverage of the inpatient neurology service will round out the ElmCl rotation and provide continuity with the inpatient service. Continuity clinic at Mount Sinai will be maintained during this rotation, and the ElmCl resident will cover the Floor or Consult resident who is at clinic on Wednesday afternoons. The clinic resident should assist with formal teaching of medical students (red card sessions) when their clinic duties allow.
Elmhurst Nightfloat
The ElmNF rotation allows for improved continuity of care, eased work hours for the inpatient service residents, and more efficient signout and close-the-loop regarding admissions and discharges. The responsibilities while on night call at EHC include covering both the inpatient service and seeing consultations in the Emergency Department and throughout the hospital. An on-call Attending is available to discuss all emergencies including cases requiring Neurosurgical evaluation.
The covering neurology resident must see all patient consultations called by the Emergency Department or elsewhere in the hospital, generate the initial differential diagnosis and treatment plan, discuss the case and plan with the covering neurology attending, communicate with the ED team to ensure that Neurology's recommendations are understood and followed, and make disposition decisions. This includes writing a consult note even on patients to be admitted to the neurology Floor service.
The night intern (from medicine or psychiatry) is expected to answer all pages regarding patients admitted to the Neurology service, follow-up on any testing results not completed during the day, and assist the Night Float with stroke codes. The night intern can also join the neurology resident to see consults, particularly for patients that may be admitted to the Neurology service. For admitted patients, the intern will enter orders and write an admission note, with help from the neurology resident. Especially if they have not yet spent time on the Neurology service, the neurology resident should teach the intern the neurologic physical exam, basic neurologic differential diagnoses, diagnostic work-up, and treatments.