Residency
Combined Residency in Neurology and Psychiatry
Introduction
The fields of neurology and psychiatry have been brought closer together by advances in basic neuroscience, genetics, pharmacology, and imaging. Each field offers unique perspectives for understanding diseases of the brain and central nervous system. The Combined residency training in neurology and psychiatry is designed for physicians who plan on a clinical or research career in the clinical neurosciences and who have determined that completing clinical training in each specialty will provide them with the best background to meet their career goals.
Mission
The mission of the Brown University Combined Residency Program in Neurology and Psychiatry is to provide solid clinical training in both neurology and psychiatry for future leaders in clinical neuroscience. At the completion of training combined residents are eligible for board certification in both neurology and psychiatry.
The Brown University Combined Training Program began in 1995. The combined residency was certified by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Psychiatry and Neurology (ABPN) in 1996. The first combined resident graduated in 2001. We are currently one of a small group of combined programs who are certified by the ABPN and ACGME.
Alpert Medical School
offers an excellent environment for combined training in neurology and
psychiatry. The residency programs in neurology and
psychiatry are both well developed, and the departments enjoy a close
working relationship. There is also a close working relationship with
the Department of Neurosurgery and a growing collaboration with the
campus department of neuroscience, which is quite strong in
brain/behavior research. The program is small enough that residents are
able to develop close mentoring relationships with an outstanding group
of faculty in the Medical School. Neuropsychiatric research is a major
theme for a large number of faculty in the School of Medicine. The
Neuropsychology
program at Brown has a strong
national reputation. There are mature neuropsychiatric research
programs in movement disorders, dementia, geriatric psychiatry, mood
and anxiety disorders, stroke, epilepsy and pediatric neurology.
The Training Program: Curriculum
The Brown University Combined Residency Program in Neurology and Psychiatry provides a year of internal medicine, two years of neurology training, two years of psychiatry training and an integrated final year of neurology and psychiatry training. The combined program is designed to provide solid training in the diagnosis and treatment of neurological and psychiatric disorders. In addition, combined residents develop expertise in the treatment of neuropsychiatric disorders by working closely with a large group of faculty studying brain disorders.
Applicants are strongly encouraged to do their PGY I internship in internal medicine at Rhode Island Hospital. For residents completing their internship at Rhode Island Hospital, their internship in Internal Medicine includes 9 months of Internal Medicine, 2 months of Inpatient Psychiatry, and 1 month of Behavioral Neurology Consults.
The first year of the Combined Residency Program involves 6 months Neurology Ward, 2 months of Neurology Consultations, 1 month EEG and 1 month of Pediatric Neurology. Residents have a weekly half-day Neurology Continuity clinic throughout the year and a monthly half-day Neuropsychiatry clinic.
Second year residents complete a 3 month rotation in EEG, EMG, and Neuromuscular disease, 2 months of Pediatric Neurology, 2 months of Neuropathology, 2 months of Neurology Consultations, and 3 months of Inpatient Psychiatry and Dual Diagnosis. Residents continue their Neurology Continuity and Neuropsychiatry clinics and in addition rotate through specialty clinics in Neuromuscular Disease, Movement Disorders, Stroke, Epilepsy, and Child Neurology.
The third year of the program includes 3 months as the Chief Resident on the Neurology Consultation Service, 3 months of Psychiatry Inpatient and Dual Diagnosis, 2 months of Consultation-Liaison Psychiatry, 1 month of ER Psychiatry, and 2 months of Community Psychiatry. Residents continue their Neurology Continuity and Neuropsychiatry Clinics and begin a Psychiatry Continuity Clinic.
Fourth year residents complete a 9 month rotation on the Psychiatry Outpatient Service and 3 months of Child and Adolescent Psychiatry. The inpatient and outpatient psychiatry rotations involve extensive exposure to geriatric psychiatry and forensic psychiatry. Clinics involve a weekly Psychiatry Continuity Clinic and monthly Neuropsychiatry and Neurology Continuity Clinics.
The curriculum for the fifth and final year is determined in consultation between the combined resident and the directors of the Neurology, Psychiatry, and Combined Programs. Residents serve as Chief Resident of the Combined Program and will help supervise and teach residents and medical students. The resident complete 3 months in the Neurology Specialty Clinics. There is considerable elective time in the final year. Residents must complete a data-oriented research project of their own design. Throughout the residency, Additional work on clinical research projects is strongly encouraged.
Rotations
PGY I Internal Medicine-internal medicine rotations are completed primarily at Rhode Island Hospital. The neurology and psychiatry rotations in year 1 are done at Rhode Island and Butler Hospitals. Click here for more information.
PGY II-IV Neurology rotations are done primarily at Rhode Island Hospital, with some rotations carried out at Butler, Memorial and Miriam Hospital. Click here for more information.
PGY III-V Psychiatry and PGY VI Psychiatry and
Neurology are completed at all of the hospitals affiliated with Brown
Medical School (Bradley, Butler, Eleanor Slater, Memorial, Miriam,
Rhode Island, VA). Click here for more information.
Elective months may be completed
with faculty at any of the Brown affiliated hospitals plus rotations
away from Providence by special arrangement with the Program Directors.
Evaluation of Trainees
Trainees receive monthly evaluations for
each rotation, Practice board evaluations are administered twice
annually by full-time faculty. The dual board resident will take the
Residency In-Service Training Examination for Neurology twice and for
Psychiatry twice. The dual board resident will meet twice a year to
assess progress with the Director of the Combined Residency.
Research
Research in clinical neuroscience is essential
for improving the diagnosis and treatment for patients with brain
disorders. Experience in research during residency is also important
for increasing critical thinking and providing a more rigorous approach
to patient care. Combined residents are required to complete a data
oriented research project of their own design prior to graduation.
Residents are encouraged to participate in additional research projects
with clinical and basic science faculty during their residency and to
publish case reports, reviews, chapters, and peer-reviewed articles.
Mentorship and close working relationships between faculty and
residents is a consistent feature of research training for combined
residents.
A large number of Brown faculty have mature
research programs devoted to studying neuropsychiatric aspects of brain
disorders. Examples include:
- Treatment of psychosis in Parkinson’s disease (Joseph Friedman and Kelvin Chou)
- Functional MRI in neurological and psychiatric disorders (Jerome Sanes, David Laidlaw, Bill Heindel, Brian Ott, Ron Cohen, Steve Salloway, Paul Malloy, Mark Aloia)
- Predictors of driving safety in dementia (Bill Heindel, Janet Grace, Brian Ott)
- Deep brain stimulation for refractory psychiatric disorders (Ben Greenberg, Larry Price, Steve Rasmussen, Gerhard Friehs)
- New treatments for substance abuse, obesity, and behavioral medicine (David Abrams, Ray Niaura, Rena Wing, Andrew Blum, Curt LaFrance)
- Genetic models of human dementia (Ed Stopa, Stephen Salloway, Justin Fallon)
- Frontal lobe and executive function (Paul Malloy, Ron Cohen, Janet Grace)
- New treatments for stroke (Don Easton, Janet Wilterdink, Ed Feldmann)
- New treatments for epilepsy (Andrew Blum)
- New treatments for nonepileptic seizures (Curt LaFrance)
Program Direction
Stephen
Salloway, M.D., M.S. is the Director of the Combined Training Program. Dr. Salloway is an Associate Professor of Clinical Neurosciences and Psychiatry, and Human Behavior. He graduated Stanford Medical school and completed residency training in neurology and psychiatry at Yale University. His research focuses on developing new treatment for vascular dementia and Alzheimer's disease. He writes and lectures widely on neurobehavioral disorders. A Training Committee made up of Janet Wilterdink, M.D., Director of Neurology Training and Timothy Mueller, M.D., Director of Psychiatry Training, and the Combined Residency Director oversees the Combined Training Program. The Training Committee meets annually to review the curriculum and the progress of each resident.
Qualifications
The combined
program accepts no more than 1 resident each year. Applicants to the
combined program should have an excellent record of academic
performance in medical school, and strong letters of recommendation and
board scores. The applicant's record should demonstrate experience
related to neurology and psychiatry and a strong commitment to pursue
combined training. Prior research experience related to neuropsychiatry
is desirable. Applicants must be able to work well with patients,
staff, and faculty from a variety of backgrounds. Applicants
should be capable of moving easily between different hospital systems
and theoretical frameworks.
Application Process
The Combined
Residency Program participates in the Neurology Residency
Matching Program under the direction of the Central Application Service
(CAS). You can contact CAS at their
website or by calling (415)447-0350. The matching number for the
Combined Residency Program is 182.55 Brown U -PSYCH/NEURO. Interested
applicants should complete the application form for the CAS and mail it
to CAS. A Dean's letter, medical school transcript, and three letters
of recommendation are also required. Doing the PGY I year in Internal
Medicine at Rhode Island Hospital is recommended. If you are interested in
applying to our Medicine program at Rhode Island Hospital for a PGY I
position, you must go through the ERAS. The Medicine program will not
accept paper applications. Once a complete application is submitted we
will then contact you regarding the status of your application, and
selected applicants will be invited for interviews. Interested
applicants are encouraged to do an elective rotation with us in
Neuropsychiatry/Behavioral Neurology prior to the match. This is an
excellent opportunity to meet the faculty and residents involved in the
combined residency and to get an insiders view of combined residency
training at Brown. The contact for the elective is Linda
Bozzario at (401)863-2293.
Graduate Profiles
W.
Curt LaFrance, M.D. is the Director of Neuropsychiatry at Rhode
Island Hospital and Assistant Professor of Psychiatry and Neurology
(Research) at Brown Medical School. Dr. LaFrance graduated the Medical
College of Georgia in 1995 and completed the combined residency at
Brown in 2001. He completed a two-year NIMH-sponsored post-doctoral
fellowship at Brown studying combined treatments of psychological
nonepileptic seizures (NES) supervised by Dr. Keitner, Dr. Miller, and
Dr. Blum. From that research, he submitted and was awarded a K23 Career
Development Award on treatments of NES from the NINDS. He received the American
Neuropsychiatric Association (ANPA) Career Development Award in
2003. Dr. LaFrance is an active member of the ANPA Research Committee
and during the residency was the lead author on a paper on herbal and
alternative treatments in neuropsychiatry, which he presented at the
Annual Meeting of ANPA. Other publications include book chapters and
articles on the neuropsychiatric aspects of epilepsy. He has lectured
nationally and internationally on topics in neuropsychiatry.
Dr. LaFrance's comments about the Combined Program:
"The neuropsychiatric perspective views the brain and the mind as two sides to one coin. This combined perspective is fostered and cultured in the combined training program in neurology and psychiatry at Brown Medical School. Brown's clinical strength in both neurology and psychiatry puts the neuropsychiatric clinical training on a solid foundation. The critical mass of neuropsychiatrists and neuropsychologists at Brown has created an excellent educational environment. With Brown's position as a leader in research, training for a career in academic neuropsychiatry is unparalleled."
Rochelle Woods, MD obtained an MA in Psychology and attended University of Illinois at Chicago Medical School and began the combined program in 1999. She has helped with the identification of a new family with CADASIL, an autosomal dominant form of vascular dementia, and she is worked with Dr. Easton on validating a scale for measuring outcome from intracerebral hemorrhage. She is worked with Dr. Gascon and Dr. LaFrance on the examination for minor neurologic dysfunction.
These are Dr. Woods comments about the program:
"Combined Training--"The field of neuropsychiatry is so explosive that I believe one needs to be comprehensively trained in both specialties to properly approach a patient with both neurological and psychiatric problems. When I first applied to the program my interest was in the neurobiology of schizophrenia, but my career focus has since changed."
"Training at Brown--"I was attracted to the Brown program because over the six years, you are able to master one specialty at a time with an infusion of exposure to neuropsychiatry over the years. I thought this was important, instead of having diluted half-years of neurology and psychiatry over a five year period. The training curriculum has really worked for me."
Additional Information
For more information about the Combined Residency Program please contact Barbara Furtado or call (401)455-6403.
For more information about the Neurology Residency Program please contact Barbara O'Rourke or call (401)444-6183.
For more information about the Psychiatry Residency Program please contact Rita Misek or call (401)455-6375.
For more information about the Brain Science Program at Brown see their website.