The Department of Neurology offers exceptional educational experience to students, residents and other allied health professionals. The faculty is recognized in the College of Medicine as outstanding teachers. Drs Gretchen Tietjen, Noor Pirzada, Lawrence Elmer and Imran Ali have been the recipient of the Deans Award for Teaching Excellence. In addition each year the graduating class of the College of Medicine recognizes three clinical faculty who are the best teachers. In the last 8 years two of the three clinical awards have gone to the Neurology Faculty each year and two of the last three years all three of the highly coveted Golden Apple Awards have been won by Drs. Noor Pirzada, Lawrence Elmer and Imran Ali. In addition both Drs. Elmer and Ali have received the prestigious Leonard Tow Humanism in Medicine Award. Dr. Tietjen has been recognized and awarded a prize for recruiting the highest number of medical students from a graduating class to the field of neurology in 2001 by the American Association of University Professors in Neurology. Drs. Pirzada and Ali have also received the highly prestigious AB Baker Teacher Recognition Award given by the American Academy of Neurology.
Dr. Ali is also the Chair of the national committee, Consortium of Neurology Clerkship Directors (CNCD) that represents clerkship directors from all 125 medical schools in the US. In addition, Drs. Tietjen, Pirzada and Ali represent UT in numerous national committees and organizations related to undergraduate and post-graduate medical education.
The Neurology Clerkship is a four week required clerkship in the fourth year of the medical school. The clerkship offers students an opportunity to learn neurology with state of the art pedagogy utilizing technological advances and combining it with excellent bedside teaching. The students consistently rate the neurology clerkship as the best in the medical school. The AAMC graduating questionnaire responses indicate more than half of the students consider neurology as an excellent clinical experience which is more than twice the national average. Clinical and Research Electives as well as a formal Acting Internship are also available for those interested. A combined Neurology/Neurosurgery Selective is available in the third year as well as ability to do the required Neurology clerkship in the third year (If approved by Office of the Undergraduate Medical Education). The latter option is usually reserved for those interested in a career in Neurology. Students are encouraged to apply early.
The fundamental goal of this rotation is to develop a correct approach to diagnosis and management of neurological disorders
At the end of the 4-week Neurology Clerkship, medical students will be able to:
All students participating on this clerkship will meet or exceed the institutional standards for professional behaviors as evidenced by:
All of these are linked to EPOs P1-7
LINKAGE OF EDUCATIONAL COURSE OBJECTIVES TO EDUCATIONAL PROGRAM OBJECTIVES
1.Obtain a complete neurological history which allows an appropriate differential diagnosis.
K5- Knowledge of the most frequent clinical, laboratory, radiographic, and pathologic manifestations of common diseases
S3-The ability to obtain an accurate medical history that covers all essential aspects of the history.
2. Conduct comprehensive neurological exam. The student should also be able to describe the anatomic and physiologic basis of the neurological exam.
S4-The ability to perform a physical examination that is both complete and accurate.
K7-Application of basic science knowledge to clinical problems
3. Demonstrate knowledge of the major categories of neurological disease and their primary modes of presentation. Assess the acuity and prognosis of the clinical problem as it relates to the needs for immediate management and requirements for proper intervention.
K3-Knowledge of the various causes (genetic, developmental, metabolic, toxic, microbiologic, autoimmune, neoplastic, degenerative and traumatic) of maladies and ways in which they operate on the body (pathogenesis)
K5- Knowledge of the most frequent clinical, laboratory, radiographic, and pathologic manifestations of common diseases
S8-The ability to construct appropriate common diagnostic and therapeutic strategies for patients with common conditions, both acute and chronic including medical, psychiatric, and surgical conditions, and those requiring short- and long-term rehabilitation.
S10-The ability to recognize patients with immediately life threatening conditions and to institute appropriate initial therapy
4. After each evaluation, develop a differential diagnosis based on history and examination.
K4-Knowledge of altered structure and function (pathology and pathophysiology) of the body and its major organ systems that are seen in various disease and conditions
K5- Knowledge of the most frequent clinical, laboratory, radiographic, and pathologic manifestations of common diseases
S8-The ability to construct appropriate common diagnostic and therapeutic strategies for patients with common conditions, both acute and chronic including medical, psychiatric, and surgical conditions, and those requiring short- and long-term rehabilitation.
5. Appropriately apply diagnostic studies to the evaluation of neurological patients.
S7-The ability to use knowledge of the most frequent clinical, laboratory, radiographic and pathological manifestations to interpret the results of commonly used diagnostic procedures.
6. Demonstrate knowledge of the standard methods of care for the major neurological disorders and form a rational plan of management.
K4-Knowledge of altered structure and function (pathology and pathophysiology) of the body and its major organ systems that are seen in various disease and conditions
K5- Knowledge of the most frequent clinical, laboratory, radiographic, and pathologic manifestations of common diseases
7. Apply knowledge of basic neurobiology to the understanding of the mechanisms of neurological disease and their treatment.
K7-Application of basic science knowledge to clinical problems
8- Review relevant clinical literature as it pertains to specific medical or neurological problems encountered and utilize the information in diagnosis and management of patients.
S11-The ability to retrieve (from electronic databases and other resources), manage, and utilize biomedical information for solving problems and making decisions that are relevant to the care of individuals and populations in order to stay abreast of ongoing scientific advances.
Required Clinical Experiences:
To help learners achieve these goals, requirements for both patient type (diagnostic category) and students’ level of involvement have been established. These clinical experiences will be complimented by assigned readings and didactic sessions related to diagnosis and management of patients in each category.Patient type:
During this clerkship, students are required to recognize symptoms that may signify disease in the following categories, distinguish normal from abnormal findings on physical exam, formulate a differential diagnosis based on signs and symptoms, use and interpret common tests used in diagnosing disease and develop a systematic approach to management of these common diseases. This provides the core of the neurology clerkship experience. The following categories are considered essential as part of an introduction to neurology. Patients are seen in both inpatient and ambulatory settings. Students must log all patient encounters and logs will be monitored to ensure adequate experience. Diagnostic categories marked with an * are desirable but not required for the clerkship experience.
|
Diagnostic category |
Number of patients to be seen | Comments/Explanation |
| Cerebrovascular Disease | 1 | Evaluate at least one patient on inpatient service with cerebrovascular disease (cerebral infarct, intracerebral hemmorrhage, subarachnoid hemmorhage). |
| Cerebrovascular Disease | 2 | Exposure on rounds or in clinic or be involved in a discussion as small group session regarding diagnosis and management. |
| Cognitive Impairment | 1 |
Evaluate Inpatient or outpatient (desirable but not required) |
|
Acute or chronic pain |
1 | Inpatient evaluation as a primary student (desirable but not required) |
|
Epilepsy |
3 | Either on inpatient or outpatient setting |
| Headache | 3 | Evaluate at least three patients with headaches in either outpatient or inpatient setting |
|
Movement Disorder |
2 | Includes Parkinson’s, Huntingtons, and drug induced movement disorder |
|
Multiple Sclerosis |
1 | Evaluate one patient either on inpatient or outpatient with demyelinating disease |
|
Neuropathy |
1 | Evaluate at least one patient with peripheral neuropathy in outpatient or inpatient setting |
Level of involvement:
In addition to seeing patients in the diagnostic categories listed above, how the students are engaged in the encounter is also an important factor in helping students achieve the objectives for this clerkship. Level of involvement is likely to include various types of interaction with patients and the health care team and should be monitored to ensure a complete experience. Levels of involvement will be indicated for logged patient encounters. The logs will be reviewed mid-block to ensure that students have a range of experiences in both in-patient and/or out-patient settings.
Level of involvement during patient encounters will be logged using the following categories:
Level of Involvement of Students in Neurology Clerkships
Students are expected to see as many clinical cases as possible to obtain an optimal clinical experience during the neurology clerkship. The level of interaction with the patient is of equal educational value more so than the number of encounters. A meaningful clinical encounter in a clerkship is defined as an interaction between a patient and the learner that involves history taking (focused or detailed), examination (focused or detailed) followed by a thoughtful assessment and plan discussed with a supervising individual such as a resident or an attending. At the very least 4 new evaluations need to be performed every week of the rotation.
The following clinical experiences would be considered to fulfill these criteria:
Other meaningful clinical experiences would include:
Other Clerkship Experiences:
Students are required to:
In addition to required clinical experiences (patient type and level of involvement), successful completion of the clerkship requires student participation in a variety of additional experiences. These experiences are coordinated through the Department of Neurology.
Students are required to attend and participate fully in the seminar series. These sessions are not didactic lectures, so the student is expected to know the material prior to attending the seminar.
Students are also required to participate in a Clinical Performance Exam with standardized patients. The skills exam includes eliciting appropriate history information and performing a neurological physical exam.
If you have any additional questions, please feel free to contact Joy Wegener, the Clerkship Coordinator at (419) 383-3544 or Imran I. Ali, M.D., Clerkship Director or Gretchen Tietjen, M.D., Chair, Department of Neurology.