VGH Electives

First Day

On your first day, please join us at 8:00AM on the 5B floor of the Jim Pattison Pavilion South in the fishbowl (the glassed-in area behind the nursing station). The easiest way is to enter via the 12th Avenue entrance, take a left at the information desk and walk towards the elevators.

Credit: Vancouver Coastal Health

Neurology at VGH

VGH has separate General Neurology and Stroke Neurology services, both of which admit patients and provide consultation services to the rest of the hospital. During your elective, you will spend half of your time on each service.

General Neurology

The General Neurology service is a single team responsible for both our own admitted patients as well as patients being seen in consultation. The same staff, residents, and medical students oversee all of the patients. We tend to admit complicated patients with a primary neurologic condition.

Stroke Neurology

The Stroke Neurology service is overseen by two separate staff stroke neurologists, with residents and medical students working with either staff, depending on the case.

The first stroke neurologist is responsible for patients admitted under our service as well as any acute stroke activations. The second stroke neurologist is responsible for patients being followed in consultation, as well as subacute stroke consults.

The stroke service tends to admit sicker / more acute strokes (and certainly if IV tPA or intervention was used). Otherwise, subacute strokes can be admitted under other services (e.g. hospitalist, particularly for elderly patients).

Educational Rounds

There are a number of educational rounds that occur each week during non-summer months.

Tuesday 12 - 1PM: Cerebrovascular Rounds (Diamond Health Center, 2nd floor)
- Lunch is provided!
Wednesday 8 - 10AM: Neuroscience Grand Rounds (Paetzold Auditorium, Jim Pattison 1st floor, behind the information desk)
Wednesday 12 - 1PM: Stroke Rounds (Radiology Seminar Room, Jim Pattison ground floor)
- Lunch is provided!
Thursday 8AM - 12PM: Neurology Academic Half Day
- 8 - 9AM is a case presentation, which everyone tends to attend
- 9 - 12PM are didactic lectures; when the service is busy, medical students will round on the patients with the staff (this is a good opportunity for face-time with the staff!)
Friday 12 - 1PM (sometimes): Movement Disorder Rounds (Diamond Health Center, 2nd floor)
On various afternoons, organized teaching sessions will be given by one of the senior neurology residents. Your senior resident will let you know when these are happening.

NOTE: Some of these rounds are cancelled during the summer, so check with the residents.

Computer Access & Dictations

You should have received an email with a link to instructions for online training. Once you have completed this, you will get login info for PCIS (our EMR) and a dictation ID. It is really helpful to have this done by your first day.

To log into any hospital computer from the lock screen:

Username: pcis
No password

In BC, we have a province-wide EMR (called CareConnect) that only residents/staff have access to. If you need to see documents (e.g. consult notes, investigations) from other hospitals, the residents can help you out with this.

Dictating

All consults and discharge/transfer notes must be dictated within 48h, with copies sent to all appropriate physicians (especially the GP and the neurologist who will be following the patient after discharge). Sign off notes for consult patients do not need to be dictated, though this can be helpful if there's been a huge change in their plan.

For some helpful tips for dictating discharge summaries, visit http://vghneuro.ca/discharge/ .

Common Locations

VGH confusingly has both a First Floor and a Ground Floor. The first floor has entrances from Laurel Street and 12th Avenue. The ground floor has entrances from 10th Avenue. There are two main buildings at VGH: Jim Pattison Pavilion (JPP) and Blackmore Pavilion (formerly Centennial)

Neuroscience Wards (incl. general neurology, stroke, and neurosurgery patients) are the 5th and 6th floors of JPP South. Our home base is 5B.
ER is on the ground floor of JPP North
ICU is on the 2nd floor of JPP North
Internal Medicine / CTU wards tend to be in JPP South
Hospitalist wards tend to be in Blackmore Pavilion

Food & Caffeine

There is a cafeteria is on the 2nd floor of JPP
There is a food court on the ground floor of the Diamond Healthcare Center (DHCC)
Starbucks is at the corner of 12th Ave. and Laurel St.
Cafe Ami (a small cafe) is in the JPP lobby, next to the 12th Ave. entrance
Bean Around the World (coffee shop) is in the Blusson Spinal Cord Center off of 10th Ave.

A Typical Day

8:00AM: The team meets in the morning to get handover from the on-call resident and then split up the patients to be rounded on
8:30AM - 11:30AM-ish: The team splits up to round on our assigned patients. This includes assessing the patient and doing a neurologic exam, reviewing any labwork and investigations, figuring out what the active issues are, and writing a note in the chart. The senior resident will assign new consults to the medical students and residents as they come in throughout the day.
11:30AM - 12:00PM: The team will meet to run the list and discuss each patient's active issues.
12:00PM - 1:00PM: Break for lunch (or one of the educational rounds -- see above)
1:00PM - 1:15PM: Everyone will touch base to figure out what tasks are left to be done and will split up to complete them.
1:15 - 5:00PM: The team will split up to complete any remaining tasks. New consults will be assigned to the med students and residents by the senior resident. We'll review all the new consults with the staff neurologist.

This is just a rough outline of a typical day. The exact times and division of tasks will vary depending on how busy things are (especially on the Stroke Service, when an acute stroke can show up at any time!)

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