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Curriculum

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Longitudinal Experiences

Type of experience

Time commitment per week

Memory Care Program Clinic

4 half days per week

Geriatric Psychiatry

1 half day per week

Movement disorders

1 half day per week

Neuropalliative care

1 half day per week

Academic

3 half day per week

Experience description:

Memory Care Program Clinic: The majority of the fellow’s time spent in an outpatient interdisciplinary memory disorders clinic evaluating patients with memory and cognitive complaints and interacting with patients and caregivers.

Geriatric Psychiatry:  A fellow’s time will be split between clinic overseen by a geriatric psychiatrist managing difficult behaviors in patients with cognitive disorders and a Project ECHO program, a telemedicine program providing geriatric psychiatry services to nursing homes in NY state. 

Movement Disorders Clinic:  The majority of the fellow’s time spent in an outpatient movement disorders clinic evaluating patients with disorders affecting movement and cognition. 

Neuropalliative Care: The majority of the fellow’s time spent in an outpatient neuropalliative care clinic evaluating patients with neurologic disorders with unmet needs to provide support for them and their care teams. 

Academic: The fellow’s time will be split between educational experiences, shared time with their mentor and independent quality improvement/research project work. 

Didactic Programs:

Didactic program and description

Required for fellows?

Attendees

Offered Weekly

Case Conference at Memory Care Program

Includes teaching on interdisciplinary team approaches in BNNP, neuropsychologic testing, neuroimaging, somatic therapies and psychosocial interventions.

Yes

Fellows, residents, memory clinic providers and staff

Didactic lecture series

Includes lectures on structural and functional neuroanatomy, neuropsychiatric assessment, treatments, focal neurobehavioral syndromes, neuropsychiatric syndromes, BNNP manifestations of neurologic disorders.

This didactic lecture series also allows participation in the combined lecture series for the URMC Geriatric Psychiatry and Geriatric Medicine fellowships which share a combined lecture seizures and will provide additional lectures on the following topics:

Psychosis, anxiety, psychologic transitions through the lifespan, depression, issues regarding ageism, interprofessional communication, community resources, spirituality, and communicating bad news.

Yes

Fellows

Offered Monthly

Journal Club/Evidence based medicine lectures 

this will include lectures for fellows regarding evidence-based medicine techniques along with the formal journal club

Yes

Fellows and faculty

Neurology Grand Rounds (topics vary, not used for curriculum requirements)

Yes

Entire neurology department

Offered Annually

New Fellow Orientation

Yes

Fellows and program director

Annual American Neuropsychiatric Association meeting

No

Fellows


URMC Behavioral Neurology and Neuropsychiatry Fellowship Program Policy on Supervisioon

Supervisory Requirements for Patient Care by Fellows:

The behavioral neurology and neuropsychiatry fellowship (BNNP) at URMC provides an opportunity for trainees to develop their clinical skills and judgment. This responsibility and independence should be fostered by faculty and staff but tempered by appropriate supervision with modification of fellow decisions and plans as needed, accompanied by review of the reasoning and evidence behind the change in plan so the fellow may learn from the experience. Ultimately the final decision for assessment and treatment rests with the supervising attending.   

ACGME Classification of Supervision Levels:

  • Direct: the supervising physician is physically present with the fellow and patient
  • Indirect:
    • With direct supervision immediately available:  the supervising physician is physically within the hospital or other site of patient care, and is immediately available to provide direct supervision
    • With direct supervision available: the supervising physician is not physically present within the hospital or other site of patient care, but is immediately available by means of telephonic and/or electronic modalities, and is available to provide Direct Supervision.
    • Oversight: the supervising physician is available to provide review of procedures/encounters with feedback provided after care is delivered.

In this program the following levels of supervision are provided:

  • Outpatient Clinic:  The BNNP fellows will spend the majority of their time in the memory care program, neuropalliative care, movement disorders and geriatric psychiatry clinics.  In each of these clinics, attendings will provide direct supervision
  • Inpatient service:  BNNP fellows are not expected to provide inpatient coverage. If a fellow is asked to provide an inpatient consult or if a fellow provides advice about clinical care to the primary Neurology service taking care of inpatients, the BNNP attendings will provide indirect supervision with direct supervision immediately available.
  • Electives: If a fellow chooses to set up an elective, it will be in an outpatient clinic and attendings in those clinics will provide direct supervision.
  • Procedures: There are no procedures that the BNNP fellow will be expected to provide.
  • Overnight/Weekend Clinic Calls: The BNNP fellow will not be expected to provide on call or after hours coverage.

Supervising physicians will attest to supervision provided according to institutional and departmental policies.