Procedural Competence -Neurology Residency Training Program

In the absence of immediate staff supervision, all Neurology residents (PGY2, 3 and 4) who have completed a PGY1 medicine internship may perform the following:

• History
• General Physical exam
• Neurological exam
• Rectal examination
• Interpretation of laboratory studies
• Basic cardiopulmonary resuscitation
• Venapuncture
• Arterial Puncture
• NG tube placement
• Lumbar puncture
• Administration of IV fluids and IV medications

PGY3 & PGY4 residents may perform the following without immediate staff supervision:

• Interpretation of cranial CT, MRI and angiograms
• Interpretation of EEG
• Interpretation of EMG
• Tensilon testing
• Apnea testing for brain death

PGY2 residents may perform the following without immediate staff supervision once they have completed rotations in Neuroradiology and EEG:

• Interpretation of cranial CT, MRI and angiograms
• Interpretation of EEG

PGY2 residents may perform the following without immediate staff supervision once they have completed CD-ROM modules on Myasthenia gravis and Brain Death (usually done in the summer neurological emergencies course):

• Tensilon testing
• Apnea testing for brain death

All residents must have direct staff supervision to perform the following:

• Botox injections for dystonia and spasticity
• Temporal artery biopsy
• Muscle & nerve biopsy
• Intrathecal chemotherapy
• Occipital nerve block
• Cisternal punctures
• Lumbar puncture under fluoroscopy