The UNC Hospitals and Health Care System includes a 768-bed academic medical facility that is the main teaching hospital for the University of North Carolina School of Medicine. It serves as a referral center for the people of North Carolina, and as a primary care facility for the local community. Located in the Division of Health Affairs complex on the main campus of the University, the UNC Hospitals complex includes North Carolina Memorial Hospital, the North Carolina Neurosciences Hospital, the North Carolina Women’s and Children’s Hospital, and the North Carolina Cancer Hospital. Resident training in neurology is carried out in these facilities. The Schools of Dentistry, Nursing, Pharmacy, and Public Health are located in the same complex. UNC Hospitals admits each year over 38,000 inpatients, accommodates over 650,000 outpatient visits, delivers 2500 babies, and provides 37,000 ER visits, 18,000 operations, 1.9 million lab procedures, and 290 organ and bone marrow transplants. Patients come from all 100 North Carolina counties, most states, and about 40 foreign countries. The UNC Hospitals and Health Care System is staffed by 1086 attending physicians and 745 resident physicians.
The North Carolina Neurosciences Hospital serves as the inpatient and outpatient facility for Neurology, Neurosurgery, Otolaryngology, and Psychiatry. This facility is one of the few modern dedicated neuroscience hospitals in the country. The Department of Neurology adult neurology ward is located on the 6th floor of the Neurosciences Hospital (6NSH). This is a 34-bed unit comprised of private and semi-private rooms, all with in-room computer terminals for order entry and electronic medical records. The majority of beds are designated for use by Neurology, and the others are shared with ENT and Neurosurgery. 6NSH serves as the home of the UNC Health Care Comprehensive Stroke Center, a Joint Commission-certified Comprehensive Stroke Center. The UNC Epilepsy Monitoring Unit, with rooms hardwired for video EEG monitoring and a EEG telemetry monitoring core, is also located on 6NSH. A physical therapy treatment room, thre physician work areas, and a conference room are located on the unit. One of the physician rooms (the "fishbowl") is outfitted with six workstations and a large image viewing monitor, and daily neurology teaching rounds and Chairman's Rounds are held in this room.
The Neurosciences Intensive Care Unit (NSICU) provides care for critically ill patients with injury or disease of the central and peripheral nervous system. This care is provided by a multidisciplinary team including physicians with specialized training in neurocritical care, nurse practitioners, critical care nurses with neuroscience training, pharmacists with specialized ICU training, in collaboration with an extensive team of specialists from various disciplines. Patients cared for in the NSICU have a diverse range of neurological diseases including brain tumors, brain aneurysms, strokes, hemorrhages in the brain, head and spinal cord injury, severe nervous system infections as well as many other life-threatening neurological conditions requiring management in an intensive care unit. The NSICU holds 16 beds and functions as a closed unit with all aspects of care provided by the neurosciences critical care team in collaboration with other disciplines such as respiratory therapy, physical therapy, occupational therapy, speech/language pathology, nutrition, and social work.
The Department of Neurology maintains separate adult and pediatric inpatient services, inpatient and ER consultation services, an acute stroke service, pediatric and adult general neurology clinics, and specialty clinics in adult and pediatric epilepsy, neuromuscular disorders, myasthenia gravis, therapeutic chemodenervation (botulinum toxin), pain, movement disorders, dementia, stroke, multiple sclerosis, and sleep disorders. The large patient volume in electrophysiology, epilepsy, sleep disorders and pain management promotes a high degree of hands-on experience in these areas. The ancillary facilities of UNC Hospitals are truly outstanding. Extensive neuroimaging, clinical neurophysiology, and neuro-ophthalmology resources are available and easily accessible.
The UNC Neurology Clinic is a freestanding outpatient unit within the Neuroscience Hospital, comprised of 18 exam rooms, 2 consultation rooms, and a treatment room. The treatment room is used for outpatient procedures including lumbar puncture, administration of intravenous infusions, and muscle and nerve biopsies. The outpatient facility also includes 2 physician work rooms, a conference/teaching room, a remote EEG reading area, and an outpatient teaching room.
Neurology residents have primary responsibility for the care of patients on the adult or pediatric inpatient services and outpatient clinics, under the direct supervision of attending neurologists. PM&R, neurosurgery and psychiatry interns are assigned to the adult inpatient service on a monthly basis. Pediatric residents rotate on the pediatric neurology service. The total number of patients seen in the neurology clinics exceeds 15,000 per year. Approximately 1000 patients are admitted to the inpatient neurology service per year, and approximately 1,200 patients on other inpatient services are seen in consultation by the Neurology residents annually.
The single-site organization of the residency program within a large university-based medical center allows for an exceptionally enriched training environment with an optimal ratio of outpatient to inpatient care. This single-site arrangement also allows a low on-call requirement. Since UNC Hospitals is a major academic secondary- and tertiary-referral center, a great number of subspecialty opportunities are available for our residents. A large number of senior clinicians and a well-organized mentorship program also ensure outstanding clinical training. Ready access to faculty conducting basic and clinical research within the department, along with exceptional degree of integration with basic science and other clinical departments, provide outstanding research opportunities for the early stages of an academic career.
Clinical Laboratory Facilities
The University of North Carolina Hospitals is a large and active university hospital, with a full complement of general and specialty laboratories. Results are available online, and hard copies of test results are sent to the ordering physician. Of particular importance to Neurology is a very active Peripheral Vascular Laboratory performing state-of-the-art evaluations. The Department of Neurology has medical directorship of the Clinical Neurophysiology Laboratory, which includes: Autonomic Function; Electroencephalography; ambulatory EEG monitoring; evoked potential studies; intraoperative monitoring; and complete electromyography and nerve conduction facilities and quantitative sensory testing. The laboratory performs 2,000 EEGs, 1,200 EMGs and nerve conduction studies, and 250 sensory evoked potential studies per year. As part of the UNC Epilepsy Center, a centralized area on the 6th floor of the Neurosciences Hospital houses video EEG telemetry equipment for inpatient monitoring. This includes equipment for monitoring up to 6 patients, as well as review stations. Approximately 300 Video/EEG telemetry diagnostic and pre-surgical evaluations, ranging from 1-21 days in length are performed annually. The 16-bed Sleep Disorders Laboratory, also under the direction of the Department of Neurology faculty, provides for the comprehensive evaluation of sleep related problems. Muscle and nerve biopsies are performed weekly, amounting to approximately 100 per year, with comprehensive histological, histochemical, and electron microscopical analysis of these specimens.
UNC offers a rich environment for neurology residents interested in basic or clinical research. The Department of Neurology laboratories occupy the sixth floor of the UNC Neuroscience Center, a multi-departmental facility that provides an exceptional environment for neuroscience research. Collaborations between the participating departments are encouraged and common. One example is the formation of the Neurogenetics Unit by the Departments of Genetics and Neurology. The Department’s laboratories include facilities for molecular biology, cell culture, transgenic mice, image analysis, neurophysiology, neuroendocrinology, neurochemistry, neurotoxicology, neurobehavior, neuropathology and electron microscopy. Advanced core facilities are located within the Neuroscience Center and throughout the UNC campus. An NIH-funded Clinical Research Center is available for faculty and resident clinical studies. Advanced 3T-fMRI and PET imaging facilities are also available. The UNC School of Public Heath, one of the major public health schools in the United States, provides outstanding collaborative possibilities for residents interested in disease prevention and health care policy. The UNC School of Medicine also maintains a highly successful program in mentorship and assistance for senior residents and junior faculty applying for NIH Career Development Awards and other mentored funding. The relatively high number of elective months in the UNC Neurology Residency Programs, along with a highly supportive and interactive research environment, provides a very high success rate for residents pursuing fellowship and other post-residency academic paths.
Residents have full access to all library facilities at the University. In addition, they have full on-line access to computerized databases in these libraries and have access to a number of on-line medical data search programs.
The Health Science Library is the primary library for the UNC Schools of Dentistry, Medicine, Nursing, Pharmacy, Public Health, and UNC Hospitals. The library serves the State’s health professionals through the Area Health Education Centers (AHEC) Library and Information Services Network. The library collections contain over 290,000 volumes, including recent and historical materials, 4,000 current serial titles, and over 8,900 audiovisual and microcomputer software programs. The library maintains subscriptions to all major electronic journals, and access to these e-journals is available on all computers on the campus network and remotely via user login.
The Department of Neurology maintains a reference library contiguous with the departmental office space. Copy machines are available for use by the residents. There are also satellite reference collections of texts on the ward, in the Neurology clinic, and in the Clinical Neurophysiology Laboratory.
UNC Neuroscience Center
The UNC Neuroscience Center is a multidisciplinary effort involving members of the Department of Neurology and other departments at the Medical School. It supports a number of training programs in various aspects of basic neuroscience, including the UNC Neurobiology Curriculum, a graduate program that emphasizes basic research and a well-balanced representation of all the disciplines of neurobiology. Neurology residents are encouraged to participate in all Neuroscience Center activities, which include graduate courses, a weekly neurobiology seminar series, an annual research day, an annual day-long symposium, an endowed distinguished lectureship, and frequent faculty and student research presentations.
E-mail and other network services are supported by the Neurology Department in the UNC-CH Neurosciences Hospital and Physicians Office Building. A departmental computer network makes electronic mail communications readily available within our neurological group and with colleagues around the world and networks all of the offices in the Neurology Department. Neurology faculty, staff, and residents not only have access from their offices, but also from their homes via a virtual private network (VPN) connection provided by the UNC School of Medicine Office of Information Systems. This VPN enables access to email, departmental shared storage, WebCIS (UNC patient data system), the School of Medicine intranet, UNC Health Care Systems intranet, online journals, and other user-restricted sites from home.
About Chapel Hill, North Carolina
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