Neurology Clerkship Bulletin Board
Your bulletin board is located adjacent
to Tidewater Building Room 1045 and contains up-to-date service assignments,
call schedules, outpatient experience assignments, and seminar schedules.
Also posted is the Neurology weekly schedule. You are welcome at any
event on this schedule including Wednesday noon resident seminars
and dinner meetings of New Orleans Neuro Society. Please check neurology
clerkship Web-site each week as activities available may change. The
update will be done on Friday before 4:30pm for the following week.
This will include "case of the week". You need to review this with
your staff and residents.
What to do if you have Questions, Problems, or
Complaints
Call or go see Marsha Graves, the clerkship
coordinator, and she will help you to resolve the issue. If a personal
or medical issue interferes with your performance on the rotation,
contact Dr. Weisberg or his designee so that we are aware of this
issue at the time of the occurrence not at the end of course. "The
definition of a problem" is any event or action, which makes
the student feel uncomfortable or may interfere with student performance.
A leave of absence for any reason must
be authorized in writing by the Office of Student Affairs and forwarded
to Marsha Graves, or may be obtained by simply talking with Dr. Weisberg
and your resident. If you have authorized absence, let your attending
and resident know.
Safety
- Always observe Universal Precautions when interacting
with patients.
- Do not use your reflex hammer or key to check
for Babinski signs. Your tool could become a vector of serious
disease. Instead, use a clean wooden swab or tongue blade and
throw it away after one use.
- Do not use a hollow or beveled needle (Eg. Gelco)
to test for pinprick because these needle types are too sharp.
Use safety pins and dispose of them after one use in a sharps
box.
- Always guard yourself from crime, patient violence,
and all types of danger. Lock your call room doors. Use the
shuttle to travel between East and West Charity campus. Be street-smart.
- Escort service for on-call:
- TMC 588-5531
- Charity 903-5531
- VA 568-0811 ext. 5105
The course's official textbook is Essentials
of Clinical Neurology by Weisberg, Strub, and Garcia (one copy
on reserve in library; available in the bookstore). You should read
in more depth about your own patients' medical problems. Recommended
for this purpose are Principles of Neurology by Adams and Victor
and Textbook of Neurology by Merritt and the Neurology Chapters
in Harrison Textbook of Medicine, both, which are on reserve
in the library. If you are on the Pediatric Neurology rotation, ask
your attending to direct you to appropriate resources.
Clerkship Requirements
In order to pass this course, you must
fulfill all of the following requirements:
- Fully participate in your assigned service team.
- Participate in On-call twice.
- Participate in Outpatient Experience once.
- Attend Charity Neurology Clinic once each week.
- Attend VA Neurology Clinic once each week.
- Attend all Neurology seminars, whether you are
on Psychiatry or Neurology. Attendance sign-in sheet is available.
One point is subtracted from clinical grade
for each seminar missed without unexcused absence. Participation
is a factor in grading of clinical evaluation.
- Attend Neurology Grand Rounds each week, whether
you are on Psychiatry or Neurology.
- Give a presentation to your service team on
topic of your interest.
- Take the final exam.
Grading
- Sixty-percent of your grade will come from your
clinical evaluation and forty percent from your final exam performance.
A "portfolio" or project is optional. It is submitted at time
of exam. It is used as part of your final assessment to help supplement
your evaluation and final grade. It can be on any topic relating
to neurology and in any format. All are read by Dr. Weisberg.
- Each week your attending is expected to give you
a verbal assessment of your performance so that you will know
your strengths and weaknesses.
If you do not get this assessment, ask for it.
- Your clinical evaluation will be given jointly
by your team's residents and attending at a departmental meeting
and this is reviewed by Dr. Weisberg who makes the final decision
on the final grade. If you have any concerns please discuss with
Dr. Weisberg. Assessment of yourself is also taken into consideration
. We are using the standardized evaluation form developed by the
Dean's office.
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Service Assignments
a. Your responsibilities here include
participating in rounds and taking care of your patients. Taking care
of your patients includes:
-
Doing a complete history and
physical for your own purposes and reviewing all prior records.
-
Forming a care plan for your
patients: Take every opportunity to write the orders for your
patients, but remember these must be immediately signed
by your resident or attending.
-
Checking up on your patient frequently
to assess progress and detect complications.
-
Talking to nurses, therapists,
dietitians, and consultants to get information about your patient.
-
Writing progress notes on
your patients.
-
Following up on all test
results and interpreting these results.
-
Reading in depth about your
patient's medical problems.
-
Participating in morning
report.
-
In an effort to standardize the
clinical experience, the faculty/house officers are required to
review a series of clinical problems in neurology with you. There
are no neurology seminars on Friday afternoon; therefore this
would be an ideal time to conduct this didactic teaching. There
should be no conflicts on Friday afternoon.
The topics include:
- episodic loss of consciousness
- evaluation of the "confused" patient
- assessment of "comatose" patient
- evaluation of new onset headache
- management of acute stroke
- evaluation of "dizzy patient"
- approach to neck and back pain
- meaning of "brain death"
b. Some services require morning
weekend rounds. This is determined by staff and house officers. However,
no medical student is allowed to work more than an average of one
weekend day per week while on neurology, including on-call assignments.
c. You are expected to work a full
day with your team on the day prior to the final exam.
a. You are required to be on-call
at least twice while on neurology. This involves staying overnight
and working with the on-call neurology resident. On-call runs from
5pm to 7am the next morning. Afterwards you will attend Morning
Report, where your resident presents the cases from the night before.
This usually occurs the next morning at 7:30am at TMC Neurology
clinic in Room #7812. If your call night falls on a Friday, Saturday,
or Sunday, Morning Report will not occur until the next week. Ask
your on-call resident when to show up for morning report. Even if
not on call, you are encouraged to attend AM report.
b. You will be given your on-call
schedule during orientation. Contact the resident you're assigned
to work with the day before your call in order to get all the particulars
involved.
c. You are required to stay the entire
night while on-call.
d. Your sleeping room is at MCLNO,
Room #1429. Obtain the key from your resident.
Out-Patient Experience
The purpose of the outpatient experience
is to give you a glimpse of a neurologist in a private practice setting.
You are required to participate in the Neurology Outpatient Experience
once during the clerkship. The orientation packet has the schedule
of clinic dates/times to which each of you has been assigned. Call
your preceptor 1-2 days prior to your scheduled visit.
Charity Adult Neurology Clinic/VA Adult Neurology
Clinic
You are required to attend both of these
clinics once each week during your stay on neurology. Go with your
team's resident on the days of your choice. Of course you are welcome
to go to as many of these clinics as you wish.
a. You are expected to prepare for the
seminars beforehand. Prepare by reading the appropriate sections
of your assigned textbook. Also, read any handouts that are included
in this packet. This includes the clinical problems, which you should
be prepared to discuss at time of seminar. The handouts are labeled
as to which seminar they pertain. On the web site there are clinical
problems and those which apply to the weeks seminar will be updated
weekly.
b. You should attend all neurology seminars,
whether you are on Psychiatry or Neurology. Seminars take precedence
over service duties; no team resident or attending should cause
you to miss seminars for rounds or patient care. If this happens,
bring it to Marsha Graves’ attention immediately.
c. All seminars scheduled will be given.
If the speaker is late, contact Marsha Graves and a substitute speaker
will be obtained.
Grand Rounds
You are required to attend Neurology
Grand Rounds each week while you are on Psychiatry and Neurology.
Neurology Grand Rounds occur every Tuesday from Noon to 1pm at Tidewater
Building Room 1027. As with the seminars, no one should ask you to
miss Grand Rounds for rounds or patient care. If there is a conflict,
let Dr. Weisberg know.
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Neurology Information Goals
It is expected that the student will accomplish
these educational informational goals during the clerkship. This can
be achieved by evaluating patients on the in-patient, consult, and
clinic services as well as participating in clinical problem solving
during the lectures and conferences. The student is expected to know
the clinical history, examination findings and appropriate decision
analysis for patients with the following disorders:
- Headache and face pain
- Dizziness-vertigo and episodic loss of consciousness
- Weakness and gait impairment
- Stupor and coma
- Cerebrovascular disease
- Seizures and epilepsy
- Traumatic injury - brain and spine
- Neurobehavioral disorders, including dementia,
amnesia and aphasia
- Central nervous system infection
- Abnormal involuntary movements, including Parkinsonism
- Demyelinating disorders (multiple sclerosis
and its mimics)
- Neurological complication of medical illness
Student Presentations
You are expected to give a presentation
to your service team on a topic related to clinical neurology in which
you find a particular interest. Your presentation should be five to
ten minutes in length but no longer. You are free to choose any topic
that you wish. You can analyze a case that you encounter while on
the clerkship or give a seminar on a specific topic. There are books
on reserve in the library relating to neurological disorders. They
may be used for your presentation (required) or protfolio (optional).
You are not required to look any further
than these references to make your report. These references will provide
enough information to complete your assignment, but feel free to expand
your research. Your subject matter should be focused. See Suggested
Portfolio Topics, but choose any topic that you wish.
Final Exam
Questions on the final exam will relate
to material found in the assigned textbook, handouts, seminars, and
Grand Rounds. The test might include all of the following formats:
short answer, essay, matching, and multiple choice. The questions
predominantly come from the seminar material and from the textbook
by Dr. Weisberg, Neurology for Psychiatry Specialty Board Exam. Multiple
copies of this book are on reserve in the library. The exact format
of the rotation exam will be determined by vote of the students. To
obtain an "HONORS" grade in the neurology clerkship a grade of 75
or hgher must be achieved on the exam, however the grade obtained
from the portfolio may move your grade to "HONORS" despite lower exam
grade.
