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April 2021; 11 (2) Commentary

Modification to Neurology Residency Training

The Toronto Neurology COVID-19 Pandemic Experience

View ORCID ProfileRyan T. Muir, Priti Gros, Robert Ure, Sara B. Mitchell, Charles D. Kassardjian, Aaron Izenberg, Peter Tai, Houman Khosravani, View ORCID ProfileDavid K. Chan
First published June 22, 2020, DOI: https://doi.org/10.1212/CPJ.0000000000000894
Ryan T. Muir
Adult Neurology Residency Program (RTM, PG, RU), Division of Neurology, Department of Medicine, University of Toronto; Division of Neurology (SBM, HK), Department of Medicine, Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (CDK, DKC), Department of Medicine, St. Michael's Hospital & University of Toronto; Department of Psychiatry (SBM, AI), Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (PT), Department of Medicine, University Health Network & University of Toronto; Division of Palliative Medicine (HK), Department of Medicine, University of Toronto; and Neurology Quality and Innovation Lab (SBM, CDK, HK), Toronto, ON, Canada.
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Priti Gros
Adult Neurology Residency Program (RTM, PG, RU), Division of Neurology, Department of Medicine, University of Toronto; Division of Neurology (SBM, HK), Department of Medicine, Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (CDK, DKC), Department of Medicine, St. Michael's Hospital & University of Toronto; Department of Psychiatry (SBM, AI), Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (PT), Department of Medicine, University Health Network & University of Toronto; Division of Palliative Medicine (HK), Department of Medicine, University of Toronto; and Neurology Quality and Innovation Lab (SBM, CDK, HK), Toronto, ON, Canada.
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Robert Ure
Adult Neurology Residency Program (RTM, PG, RU), Division of Neurology, Department of Medicine, University of Toronto; Division of Neurology (SBM, HK), Department of Medicine, Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (CDK, DKC), Department of Medicine, St. Michael's Hospital & University of Toronto; Department of Psychiatry (SBM, AI), Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (PT), Department of Medicine, University Health Network & University of Toronto; Division of Palliative Medicine (HK), Department of Medicine, University of Toronto; and Neurology Quality and Innovation Lab (SBM, CDK, HK), Toronto, ON, Canada.
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Sara B. Mitchell
Adult Neurology Residency Program (RTM, PG, RU), Division of Neurology, Department of Medicine, University of Toronto; Division of Neurology (SBM, HK), Department of Medicine, Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (CDK, DKC), Department of Medicine, St. Michael's Hospital & University of Toronto; Department of Psychiatry (SBM, AI), Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (PT), Department of Medicine, University Health Network & University of Toronto; Division of Palliative Medicine (HK), Department of Medicine, University of Toronto; and Neurology Quality and Innovation Lab (SBM, CDK, HK), Toronto, ON, Canada.
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Charles D. Kassardjian
Adult Neurology Residency Program (RTM, PG, RU), Division of Neurology, Department of Medicine, University of Toronto; Division of Neurology (SBM, HK), Department of Medicine, Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (CDK, DKC), Department of Medicine, St. Michael's Hospital & University of Toronto; Department of Psychiatry (SBM, AI), Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (PT), Department of Medicine, University Health Network & University of Toronto; Division of Palliative Medicine (HK), Department of Medicine, University of Toronto; and Neurology Quality and Innovation Lab (SBM, CDK, HK), Toronto, ON, Canada.
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Aaron Izenberg
Adult Neurology Residency Program (RTM, PG, RU), Division of Neurology, Department of Medicine, University of Toronto; Division of Neurology (SBM, HK), Department of Medicine, Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (CDK, DKC), Department of Medicine, St. Michael's Hospital & University of Toronto; Department of Psychiatry (SBM, AI), Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (PT), Department of Medicine, University Health Network & University of Toronto; Division of Palliative Medicine (HK), Department of Medicine, University of Toronto; and Neurology Quality and Innovation Lab (SBM, CDK, HK), Toronto, ON, Canada.
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Peter Tai
Adult Neurology Residency Program (RTM, PG, RU), Division of Neurology, Department of Medicine, University of Toronto; Division of Neurology (SBM, HK), Department of Medicine, Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (CDK, DKC), Department of Medicine, St. Michael's Hospital & University of Toronto; Department of Psychiatry (SBM, AI), Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (PT), Department of Medicine, University Health Network & University of Toronto; Division of Palliative Medicine (HK), Department of Medicine, University of Toronto; and Neurology Quality and Innovation Lab (SBM, CDK, HK), Toronto, ON, Canada.
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Houman Khosravani
Adult Neurology Residency Program (RTM, PG, RU), Division of Neurology, Department of Medicine, University of Toronto; Division of Neurology (SBM, HK), Department of Medicine, Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (CDK, DKC), Department of Medicine, St. Michael's Hospital & University of Toronto; Department of Psychiatry (SBM, AI), Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (PT), Department of Medicine, University Health Network & University of Toronto; Division of Palliative Medicine (HK), Department of Medicine, University of Toronto; and Neurology Quality and Innovation Lab (SBM, CDK, HK), Toronto, ON, Canada.
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David K. Chan
Adult Neurology Residency Program (RTM, PG, RU), Division of Neurology, Department of Medicine, University of Toronto; Division of Neurology (SBM, HK), Department of Medicine, Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (CDK, DKC), Department of Medicine, St. Michael's Hospital & University of Toronto; Department of Psychiatry (SBM, AI), Sunnybrook Health Sciences Centre & University of Toronto; Division of Neurology (PT), Department of Medicine, University Health Network & University of Toronto; Division of Palliative Medicine (HK), Department of Medicine, University of Toronto; and Neurology Quality and Innovation Lab (SBM, CDK, HK), Toronto, ON, Canada.
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Citation
Modification to Neurology Residency Training
The Toronto Neurology COVID-19 Pandemic Experience
Ryan T. Muir, Priti Gros, Robert Ure, Sara B. Mitchell, Charles D. Kassardjian, Aaron Izenberg, Peter Tai, Houman Khosravani, David K. Chan
Neurol Clin Pract Apr 2021, 11 (2) e165-e169; DOI: 10.1212/CPJ.0000000000000894

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Abstract

We describe the University of Toronto Adult Neurology Residency Program's early experiences with and response to the coronavirus disease 2019 pandemic, including modifications to the provision of neurologic care while upholding neurology education and safety. All academic and many patient-related activities were virtualized. This maintained physical distancing while creating a city-wide videoconference-based teaching curriculum, expanding the learning opportunities to trainees at all academic sites. Furthermore, we propose a novel split-team model to promote resident safety through physical distancing of teams and to establish a capacity to rapidly adapt to redeployment, service needs, and trainee illness. Finally, we developed a unique protected code stroke framework to safeguard staff and trainees during hyperacute stroke assessments in this pandemic. Our shared experiences highlight considerations for contingency planning, maintenance of education, sustainability of team members, and promotion of safe neurologic care. These interventions serve to promote trainee safety, wellness, and resiliency.

Footnotes

  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • ↵* These authors contributed equally to this work.

  • NPub.org/COVID19

  • Received April 16, 2020.
  • Accepted June 12, 2020.
  • © 2020 American Academy of Neurology
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  • Article
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