Course/Rotation Title

Course/Rotation Title: NEUROLOGY

Date of Last Review/Update:

3/07

Course/Rotation Director: Alec Kloman, MD

Location of clinical encounters

Inpatient % time = 50%

(Check all that apply)

[X] Wards

[X] ICU

[X] ED

[ ] Other (please specify)

Outpatient% time = 50%

(Check all that apply)

[X] Clinic

[ ] Home

[X] EMG lab, EEG lab

Course/Rotation description with educational purpose/value

The goal of this rotation is to prepare future general internists with the skills and knowledge to appropriately evaluate, treat, and refer, in a timely fashion patients, with acute and chronic neurologic diseases as defined below. As part of the rotation residents will:

·  See office patients; observe techniques of history taking and differential diagnosis formulation. Answer questions on observed findings.

·  Perform inpatient consults & follow ups

·  Attend discussion sessions; Neuro-radiology, neurology, neurosurgery

·  Daily attending rounds

·  Directed reading & video viewing

·  Didactic early morning session for which directed reading will be advised

Types of Clinical Encounters: (PLEASE SPECIFY)

See above

Types of Patients: (PLEASE SPECIFY)

[X] Adults of all ages

[X] Male

[X] Female

[X] Children < 18 years old

Mix of Diseases: (PLEASE SPECIFY ANY ADDITIONAL DISEASES)

·  Aphasia

·  CNS infections

·  CNS malignancies

·  Concussion and post concussive disorders

·  Delerium

·  Dementia

·  Demyelinative Disease

·  Epilepsy

·  Intranuclear Ophthalmoplegia

·  Optic Neuritis

·  Parkinson’s Disease

·  TIA/CVA

·  Vertigo

Types of Procedures: (PLEASE SPECIFY):

·  Lumbar puncture

·  EEG and basics of interpretation

·  EMG and basics of interpretation

Describe the level of supervision by faculty:

[X] Attending staff will supervise and precept all patient care activity directly or indirectly.

[X] Attending staff will provide mid rotation feedback

[X] Attending staff will provide end-of-rotation feedback

[X] Other (please specify): Supervise procedures

Competency Based Objectives/Expectations. Please see Roman Numeral II with additional items specific to this rotation as below:

Patient Care

·  Perform a focused history, review of systems and physical exam on patients presenting acutely or chronically with neurologic problems (both in the inpatient and outpatient arena)

·  Perform an appropriate write up and presentation to the attending neurologists on patients presenting acutely or chronically with neurologic problems (both in the inpatient and outpatient arena)

·  Perform a competent general neurological examination, including a mental status exam.

Medical Knowledge

·  Identify delirium and distinguish it from dementia. Define the treatable dementias, their work-up, and treatment.

·  Recognize the different features of aphasia.

·  Understand the different types of epilepsy.

·  The ability to distinguish seizure from TIA and seizure from migraine phenomenon.

·  Understand the common anticonvulsants, their use and side effects.

·  Understand the syndromes of TIA, including amaurosis, and the concepts of ischemic, embolic, and hemorrhagic stroke with attention to treatment.

·  Learn how to assess patients with headaches, and differentiate the different causes of H/A.

·  Understand the workup and treatment for movement disorders.

·  Understand multiple sclerosis and its complications.

·  Review basic peripheral nerve anatomy and workup/treatment of peripheral neuropathies.

·  Define myopathy and findings.

·  Describe myasthenia, its mechanism, and its clinical presentation.

·  Review and interpret all laboratory data ordered and gain expertise in the interpretation of autoimmune serologic data and CSF interpretation.

·  Interpretation of CT and MRI scans.

·  Management and treatment of closed head injuries.

·  Learn appropriate use of narcotics for pain control and red flags for drug abuse

Practice-Based Learning

·  Identify areas of weakness and read independently.

Interpersonal and Communication Skills

·  Focus on using terminology that is understandable to patients.

Professionalism

·  Dress appropriately at all times with white coat, men should wear ties.

System-Based Practice

·  Understand and help patients with neurologic illness move across a variety of settings including: Physiatry, Memory Clinic, Pain Clinic, Primary Care, etc.

Check Any Methods Used For Teaching and Assessment:

[ ] Ambulatory Clinic (feedback written & verbal)

[ ] Annual In-service Exam (feedback written)

[X] Attending Rounds (feedback written & verbal)

[ ] Board Review (feedback written examination)

[ ] Cancer Conference

[ ] Case Management Evaluation (360 degree written evaluation)

[X] Chart Stimulated Recall & Feedback (feedback verbal)

[X] Direct Observation and Feedback (feedback written & verbal)

[ ] GME Core Curriculum

[ ] Interns Report (feedback written & verbal)

[ ] Journal Club (feedback written & verbal)

[ ] Medical Record Review (feedback written & verbal)

[ ] Mentor Feedback (feedback written & verbal)

[X] Monthly End of Elective Exam (feedback written)

[X] Monthly Mini CEX (feedback written & verbal)

[X] Monthly Competency Based Written Evaluation

[ ] Morning Report (feedback written & verbal)

[ ] Multidisciplinary Rounds Feedback (feedback verbal)

[ ] Nursing Evaluation (360 degree written evaluation)

[ ] Patient Evaluation (360 degree written evaluation)

[ ] Patient Management Discussions (feedback written & verbal)

[X] Procedure Logs

[ ] Performance improvement Multidisciplinary Morbidity and Mortality

(feedback written & verbal)

[ ] Semi Annual Program Director Feedback (feedback written & verbal)

[ ] Student Evaluation (feedback written & verbal)

[ ] Supervised Sign-In Rounds (feedback written & verbal)

[ ] Supervised Sign-Out Rounds (feedback verbal)

[ ] Other ______

Other Policies:

The Course Director recognizes that the trainee is accountable to all BMC Residency and GME Personnel Policies and Procedures. The Course Director recognizes that the residents are expected to attend all continuity clinics and mandatory educational conferences unless excused by the Program Director or Chief Medical Resident with advanced notice.

Check The Educational Materials Used (beyond direct patient care):

[X] Reading List (Please Specify):

·  Neurology Syllabus

·  A pocket source (e.g., Neurology for the House Officer).

·  Neurology text (e.g., Victor & Adams in Harrison’s).

·  Neurology text (Assimoff)

[X] Review of Appropriate Radiology Images (Please Specify):

·  Review of CT and MRI scans with attending neurologists an all consults as appropriate

[X] Review of Appropriate Pathology (Please Specify):

·  Review all pathology specimens on patients as appropriate to their neurologic issues.

[ ] Review of Appropriate Laboratory Data (Please Specify):

·  Review and interpret all laboratory data ordered and gain expertise in the interpretation of autoimmune serologic data and CSF interpretation.

[X] Case Studies

·  Topic oriented review available on Video will be given to each resident for the duration of the rotation.

·  Web based teaching: funduscopic examination.

· 

[ ] Other (Please Specify):

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