Outpatient Clinics Extensive training and experience in ambulatory neurology occurs throughout the three-year neurology training program. Neurology Resident Longitudinal Clinic (Resident Firm) The Neurology Practice Groups ("firms") were established in 1987 to provide the best possible patient care and resident education in a hospital-based neurology continuity clinic. The firms were set up in such a way as to simulate as much as possible a private-practice setting. Continuity of patient care and resident education are a high priority in the design of the firms. Hence, residents are assigned to a specific firm, each headed by two attending neurologists, for their entire four years of their residency. Also, the patients are maintained as much as possible in the same firm, even though residents change every four years. In this way, the firm attendings become familiar with the more complex firm patients and smooth the transition of resident turnover. We view the firms as the most important outpatient activity for the neurology residents, since they provide a continuity experience for learning how to care for a cohort of patients. In addition, a unique mentoring relationship develops between the resident and the firm attendings over four years. Each resident is assigned to one of six neurology resident firms. All neurology residents spend one half-day per week throughout their entire four-year residency in the neurology firms. Faculty Practice Experience Fourth-year residents may spend one afternoon per week seeing outpatients in a subspecialty clinic of their choice or the neurology faculty group practice, University of Rochester Neurology, which is located in a private medical office building two miles from Strong Memorial Hospital. Each resident works closely with one attending neurologist for a three-month period and typically evaluates three new patients per afternoon session. This experience exposes the neurology chief residents to a patient cohort similar to that seen in a typical general neurology office practice. Subspecialty Clinics Several neurological specialty clinics function at the University of Rochester Medical Center. Second- and fourth-year residents spend about one month each in the ambulatory subspeciality clinics. The subspecialty clinics include the following: Dementia Clinic This clinic specializes in the evaluation and care of patients with dementia. Many patients participate in therapeutic drug trials for dementia and other behavioral disorders. Epilepsy Clinic Comprehensive evaluation and treatment is provided to pediatric and adult patients with difficult seizure disorders. Selected patients with intractable epilepsy are assessed for surgical treatment of their disorder. Headache Clinic This clinic specializes in the evaluation and care of patients with difficult-to-treat headache disorders including migraine, trigeminal autonomic cephalgias and medication overuse headache. Movement Disorders Clinic Patients with Parkinson's disease, Huntington's disease, myoclonus, tremors, Tourette's syndrome, and a host of other neurological movement disorders are seen. Many patients participate in clinical research protocols designed to evaluate experimental medications. Neuroimmunology Clinic Patients with multiple sclerosis, allied demyelinating, and other neuroimmune disorders receive clinical care and often participate in experimental therapeutic and diagnostic studies. Neuromuscular Disease Clinic Adults and children with a wide range of muscle, anterior horn cell, nerve, and neuromuscular junction disorders are seen in this busy clinic sponsored by the Muscular Dystrophy Association (MDA). Many patients in this clinic also participate in clinical research studies designed to evaluate and better treat a range of neuromuscular disorders. Neuro-Oncology Clinic Patients with primary brain tumors, metastatic brain tumors and neurological complications of cancer and cancer treatments are seen in this busy clinic. Pediatric Neurology Clinic Children with a wide range of neurological disorders undergo evaluation and treatment in this busy clinic. Sensory-Motor Neurology Clinic This clinic provides diagnosis and care to patients suffering from disorders of vision, eye movement, balance, and equilibrium. Electronystagmography and rotatory and balance studies are performed routinely in this clinic. Stroke Clinic Patients with ischemic and hemorrhagic strokes, TIAs, CNS vasculitis, vascular malformations, and aneurysms are seen in follow-up by the stroke faculty and residents. Many of these patients participate in clinical trials coordinated by the faculty.