Overview by year

PGY-1 (internal medicine)

Our neurology residency is a four-year categorical program. Our first-year internal medicine training at Barnes-Jewish Hospital is exceptional and provides residents with a solid foundation in clinical practice. Interns rotate through the Medical Intensive Care Unit (MICU) and inpatient floors, including the cardiology specialty service and other specialty services. We are unique in that the psychiatry requirement is fulfilled as an intern, opening up more elective time during your neurology training. As an intern on the psychiatry service you will lead an inpatient service with the guidance of an attending physician. For six weeks, interns also get first-hand experience on the inpatient neurology service and outpatient neurology clinic. The internal medicine department prides itself on being “resident run,” and with the complexity of the patients seen at Barnes-Jewish, you will become proficient in the management of the most common illnesses that prompt admission to the medicine service.


This is the first year of formal neurology training and is the most demanding year but will provide immense exposure to every type of neurological illness. Residents spend the majority of the year rotating on the inpatient general neurology and stroke services, taking call every fourth night on a traditional 28-hour call cycle. Unique to our program, the PGY-2 on the consult and acute stroke services sees all acute strokes, does the NIH Stroke Scale and makes the decision to give t-PA after discussing the case with an attending and/or the PGY-4 resident. There is one month dedicated to the Neurology/Neurosurgery Intensive Care Unit. By the end of this year, residents are confident and function independently on the inpatient services, while making t-PA decisions.


The goal of this year is to transition into the role of a senior resident. For eight to 10 weeks, you run the neurology consult service, which sees patients on other services and in the Emergency Department. You also serve as the mentor for the PGY-2 on the team; primarily helping them transition into the role of making t-PA decisions. The remainder of the year includes two weeks of night float, two weeks of the acute stroke service, eight to 10 weeks on the inpatient neurology service, four weeks in the NNICU and around 15 weeks of elective. Residents can use their elective time to rotate in subspecialty clinics or perform clinical/basic science research. Lastly, six weeks of inpatient pediatrics at St. Louis Children’s Hospital is incorporated into the PGY-3 year.


This year includes 10 weeks serving as either the inpatient stroke or general neurology service chief. The chief is responsible for accepting admission, guiding the PGY-2 residents with management decisions, assisting with t-PA decisions via phone and most importantly, overseeing a busy inpatient service. The stroke/general neurology chiefs alternate home-call q2. The remainder of the year is divided into elective and rotations through adult and pediatric subspecialty clinics, allowing for ample time to master your clinical knowledge or delve into academic research.


“If you can think of it, there’s a WashU resident who’s done it.”

Omar Butt, MD, PhD ’20

The program takes pride in providing the most elective time of any adult neurology residency program in the country — 35 weeks for exploring clinical or research interests.