Pediatric Neurology Training and Experience

Below are descriptions for each rotation the Pediatric Neurology Fellow will perform:

First Year

During this year, the Pediatric Neurology Fellow serves as a junior neurology resident on the Adult Neurology services of the Ohio State University, the Riverside Methodist, and the Mount Carmel Hospitals. During the first two months, a series of orientation conferences is given to acquaint the fellow with procedures, special diagnostic tests, and emergency neurologic management. The Pediatric Neurology Fellow will become competent with the neurological examination, learn how to obtain a neurological history, become familiar with the diagnosis and management of adult neurological diseases, and learn how to present complex cases succinctly. Throughout the first year, the Fellow receives supervision for management of emergencies and for inpatient care and subsequent outpatient follow-up.

Second Year

This year will emphasize clinical training in Pediatric Neurology. The Pediatric Neurology Fellow serves on the child neurology inpatient and consultation service at the Nationwide Children's Hospital. The Fellow runs the inpatient service together with the attending neurologist, provides neurology consultations for the hospital, and assumes a major role in teaching pediatric residents, neurology residents, and students. The Fellow also attends outpatient clinic under the supervision of the faculty. During this year the Pediatric Neurology Fellow will prepare patient presentations and conferences during this time.

Third Year

This year is designed to be flexible to allow for required rotations in child psychiatry and the outpatient clinic, as well as providing the opportunity to rotate through neuropathology, neuroradiology, clinical electrophysiology, neurosurgery, and rehabilitation services. Additional elective rotations or opportunities for clinical or basic research can be developed according to the individual's needs. During the third year, the Fellow gives lectures to residents and staff from other divisions, and organizes clinical conferences for the neurology group.

Conferences

At the University weekly conferences include a basic neuroscience conference, board review, professor's rounds, clinical neurophysiology, neuroradiology conference, and grand rounds. Basic science seminars designed to meet board requirements are scheduled over a three-year period and occur weekly before Neuroscience Grand Rounds at the University. Basic science teaching includes neurophysiology, neuroanatomy, neuropharmacology, and neurochemistry. The seminars are designed for both informal discussion and for active participation. At the Children's Hospital the Pediatric Neurology Division shares a bi-weekly conference with the Neurosurgery division, and there are monthly neuroradiology conferences and Professor's rounds at the Children's Hospital. The Children's Hospital has weekly grand rounds, and regular bioethics and case conferences.

Research

During the third flexible year, there are opportunities to become exposed to clinical or basic research projects within the division. A more extensive research experience is possible, but will likely require an extended period beyond the clinical training fellowship. Within the Neurology division, Dr. Juliann Paolicchi has on-going clinical trials involving treatments for epilepsy. Dr. Ann Pakalnis has on-going clinical trials for the treatment of headaches. Dr. Warren Lo has a laboratory project examining the role of a pro-apoptotic gene, termed p73, in mediating neuronal death during hypoxia-ischemia. There are numerous clinical research projects based in other divisions at the Children's Hospital including treatment of ADHD, injury prevention, and long-term follow-up of head injury.

The relationship between Nationwide Children's Hospital and Nationwide Children's Research Institute (CCRI) provides the venue for amazing research occur. At any given time, approximately 200 different research protocols may be in various stages of development. Basic and applied research is conducted at the Wexner Institute for Pediatric Research. As of January 2002, scientists within CCRI have been reorganized into Centers of Emphasis:

• Center for Biopathology
• Center for Cell and Vascular Biology
• Center for Childhood Cancer
• Center for Developmental Pharmacology and Toxicology
• Center for Gene Therapy
• Center for Injury Research and Policy
• Center for Molecular and Human Genetics
• Center for Vaccines and Immunity

At the same time, the Office of Clinical Science was developed to coordinate the multitude of clinical research that occurs at Nationwide Children's.

Clinical trials using inpatient and outpatient subjects are performed under the auspices of Pediatric Clinical Trials International, Inc. (PCTI), on-site at Nationwide Children's Hospital, as well as off-site at private physician offices, clinics, and even outside Ohio. PCTI is a wholly owned subsidiary of Nationwide Children's that is dedicated exclusively to pediatric and adolescent pharmaceutical industry sponsored clinical research. PCTI was formed in 1998 and has conducted hundreds of Phase I-IV studies. PCTI provides services to a network of sites including Children's Hospital Medical Center of Akron, in Akron, Ohio and Scott & White Memorial Hospital in Temple, Texas. The PCTI conducts 40 - 50 clinical trials at any one time across all therapeutic areas, including neurological disorders. Approximately 100 physicians at Children's Hospital in Columbus participate as principal investigators or sub-investigators in clinical trials with PCTI. The PCTI Study Center contains four exam rooms, a psychological testing room, and a monitor room and 14 dedicated clinical research coordinators, in which eleven are nurse coordinators. There is a patient recruitment department for recruiting subjects for our trials and a large volunteer patient database.

For further information about research at Children's please click the link to Research at Children's, www.ccri.net. For further information about research opportunities at OSU, please click the links for the College of Medicine, medicine.osu.edu/research, the School of Public Health, http://www.sph.ohio-state.edu/, and the Department of Neuroscience, http://medicine.osu.edu/neuroscience/