Clinical Facilities

The Massachusetts General Hospital

The Massachusetts General Hospital (MGH) is the largest of the hospitals affiliated with the Harvard Medical School. The hospital admitted its first patients in 1821. The original hospital building, the Bulfinch, is now an architectural and historic landmark. The Bulfinch contains the Ether Dome where general anesthesia was first introduced in the United States and where Neurology grand rounds are held. The MGH has a rich and storied history and has been a center of clinical and academic excellence in American medicine for over a century. The hospital currently operates with a capacity of 750 inpatient beds, most in the glass-enclosed Ellison and Blake Towers which were completed in 1990 and 1994, respectively. There is an 19 bed neuroscience intensive care unit in the Blake Tower that was completed in 1998 and houses state of the art equipment, including a portable CT scanner. Outpatient clinics are housed in the modern Wang Ambulatory Care Center.

At MGH, the 12th floor of the interconnected Ellison, Blake, White and Gray/Bigelow buildings is devoted to Neurology and Neurosurgery patients. Inpatient Neurology services maintain an average daily census of approximately 35 with approximately 1700 admissions each year. The MGH Neurology service performs almost 2000 consults per year. It supports a full time Emergency Ward Neurology service and an epilepsy monitoring service. The outpatient Neurology Units are busy with 44,000 visits per year to both general and subspecialty clinics.

The hospital was founded as the Peter Bent Brigham Hospital in 1912, adjacent to and closely tied to the Harvard Medical School. The Brigham and Women's Hospital was formed by a merger of the Peter Bent Brigham, Robert Breck Brigham Hospital (for arthritis and other chronic illness), and the Boston Hospital for Women. It now occupies a patient tower containing 726 beds, which was completed in 1980. Both referral patients and acute care patients from the inner city and greater Boston area are served.

The Neurology Department at the BWH maintains an inpatient service of approximately 20 patients with about 700 admissions per year, and a consult service which sees some 1200 consultations per year. The inpatient service is located in the BWH patient tower sharing space and nursing personnel with neurosurgery. There is a neurology/neurosurgery intensive care unit and an epilepsy-monitoring unit. In the ambulatory center, the neurology department handles over 15,000 patient visits per year, approximately half in general neurology and the rest in various subspecialty units including neuromuscular disease, memory disorders, headache, epilepsy, multiple sclerosis, neuro-oncology, behavioral neurology, stroke and movement disorders.

The VA Hospitals

The Brockton-West Roxbury VA Medical Center has been affiliated with the Brigham and Women’s Hospital since 1945 and generations of Harvard students and residents have received significant portions of their medical training in this institution. The Brockton-West Roxbury VA Neurology Service was founded by Dr. Martin A. Samuels in 1977. Dr. David Dawson became the service chief in 1988 and Dr. Michael Charness in 1996. In 1999 the Harvard-affiliated Brockton-West Roxbury VA merged with the Boston University-affiliated Boston VA (Jamaica Plain) to become the VA Boston Healthcare System. As part of the merger, the Harvard-affiliated and Boston University-affiliated VA Neurology Departments merged under the leadership of Dr. Charness.

The Partners Neurology rotations were redesigned in 1999-2000 to emphasize training in outpatient neurology. The VA furnishes a rich source of neurology patients, efficiently managed clinics, and an unsurpassed, fully electronic medical record. Many residents choose longitudinal clinics at the Jamaica Plain Division, where they are precepted by Dr. Charness. By design, the resident longitudinal clinics are not specialized. Trainees are able to see common and uncommon neurological disorders, functioning as the principal physician and often the first neurologist to see their patients. Typical diagnoses in the resident longitudinal clinic include cervical spondylosis, peripheral neuropathy, dementia, stroke, Parkinson disease and myasthenia gravis.

First year Partners residents spend one month at the VA Clinics training in general neurology and specialty neurology outpatient clinics (stroke, movement disorders, epilepsy, botulinum toxin, pain, multiple sclerosis, behavioral neurology, neurosurgery). During the second year, Partners residents return to the Jamaica Plain Division for a one month rotation in the neurophysiology lab, where they learn to perform and interpret EMGs. During the third year, residents spend two full days per week seeing outpatients at the Brockton Division.

The VA experience provides Partners residents with valuable exposure to the care of neurological disorders in the outpatient setting.