The two-week rotation of Neurology during the second year of training
will prepare the resident for recognition, assimilation and mastering
those aspects of neurological diseases that are necessary for daily
patient care. At the conclusion of this training, the resident
should have the knowledge and skills to manage neurological problems
that are commonly seen in Family Medicine and also recognize the need
for proper referral and consultation by a specialist for those problems
that are beyond the scope of practice of a family physician. The
needed skills will be obtained through several resources, including the
attending neurologist’s outpatient private patients, the resident’s
panel of patients at the FMC, Internal Medicine and Family Medicine
Service rotations, didactic lectures and conferences.
Goal I: To provide outpatient learning
opportunities in the area of neurology through a two-week block rotation
in the second year of training and continuous longitudinal experience
throughout the Residency.
Goal II: To provide learning opportunities
in neurology that demonstrate the importance of the Behavioral Sciences
and disease prevention in the comprehensive and continuing care of the
patients and their families.
Goal III: To recognize the need for proper
referral and consultation to a specialist for those neurological
diseases that are beyond his/her capabilities.
Patient Care
Goal
Residents must be able to provide patient care that is compassionate,
appropriate, and effective for the treatment of health problems and the
promotion of health. Residents are expected to:
Competencies
Be able to diagnose
Dementia/Delirium
Seizure Disorders
Herniated Disc
Zoster
Headache
CVA/TIA
Pseudo Seizure
Convulsive Disorder
Myopathy
Peripheral Neuropathy
Objectives
The resident will:
Perform a neurological exam of the adult patient.
Retrieve imaging studies and review with radiologist and
neurologist.
Perform lumbar puncture with assistance from neurology, family
medicine faculty, and radiology.
Residents must demonstrate knowledge of established and evolving
biomedical, clinical, epidemiological, and social-behavioral sciences,
as well as the application of this knowledge to patient care.
Residents are expected to:
Competencies
CATEGORY A
CATEGORY B
1. Acute Trauma to CNS
1. Herpes Zoster
2. Meningitis
2.
Bell's Palsy
3. Alterations in Consciousness
3. Migraine
4. Dementia/Pseudodementia/ Confusion
4. Vertigo
5. Epilepsy/Seizure Disorders
5. Pain Syndrome (Low back/Chronic)
6. Dementia
6. Headaches
7. Guillain-Barre Syndrome
7. Cerebral Vascular Accident
8. Parkinson's Disease
8. Transient Ischemic Attack
9. Multiple Sclerosis
9. Drug Intoxication
10. Myasthenia gravis/polymyositis
11. Neurosyphilis
12. Tourette's Syndrome
13. Meniere's Syndrome
14. Narcolepsy
15. Herniated Intervertebral Disc
16. Subdural/Epidural Hematoma
17. Neurogenic Hysteria
18. Brain Death/Vegetative States
19. Testing Procedures/Evaluation
- Electroencephalogram
- Electromyography
- CT/MRI
- Audiometry
- Angiography
- Vestibular Function
Tests
- Tensilon/Prostigmin
Test
Objectives
The resident will have a basic knowledge of the above by the end
of this rotation
Practice- Based Learning and Improvement
Goal
Residents must demonstrate the ability to investigate and evaluate
their care of patients, to appraise and assimilate scientific evidence,
and to continuously improve patient care based on constant
self-evaluation and life long learning. Residents are expected to
develop skills and habits to be able to :
Competencies
Identify strengths, deficiencies and limits in one’s knowledge
and expertise;
Use information
technology to optimize learning such as: UpToDate and DynaMed that
provides concise family medicine knowledge and care to be utilized.
Complex neurological problems and trauma require an
understanding of the limitations of family physicians.
To recognize the need for proper referral and consultation to a
specialist for those neurological diseases that are beyond his/her
capabilities.
Systems Based Practice
Goal
Residents must demonstrate an awareness of and responsiveness to the
larger context and system of health care, as well as the ability to call
effectively on other resources in the system to provide optimal health
care. Residents are expected to:
Competencies
Work in interdisciplinary teams to enhance patient care, working
with neurologists, social workers, physical therapists, occupational
therapists, nurses, respiratory therapists and family medicine
attendings.
Objectives
The resident will become knowledgeable with the process and
develop abilities to coordinate this type of teamwork.
Professionalism
Goal
Residents must demonstrate a commitment to carrying out professional
responsibilities and an adherence to ethical principles. Residents
are expected to demonstrate:
The resident will be evaluated on his/her compassion by faculty
and preceptors.
Interpersonal and Communication Skills
Goal
Residents must demonstrate interpersonal and
communication skills that result in the effective exchange of
information and teaming with patients, their families, and professional
associates. Residents are expected to:
Competencies
Communicate effectively with patients and families across a
broad range of socioeconomic and cultural backgrounds
Communicate effectively with physicians, other health
professionals, and health related agencies
The above mentioned team will be an excellent training for the
resident as he/she must communicate with other physicians
(neurologists) and health related agencies (rehab hospitals, social
security disability, etc.).
Objectives
Inpatient care, timely transfers, and appropriate consultation
will be monitored at report and on rounds by residency faculty.
Teaching Methods
Direct preceptor/resident interaction in the
outpatient setting.
Assessment Method
At the conclusion of each resident rotation, the
residency coordinator sends a formative-type, rotation-specific
performance evaluation form to the rotations’ supervising physician.
When the completed evaluation is returned, the resident physician and
the resident’s faculty advisor review the evaluation and attest to
reviewing it by signing/initialing the form. Next, the program
director reviews and attests to the document. Once all three have
reviewed and attested the evaluation, it is included in the resident’s
permanent file.
Each resident is asked to evaluate the rotation
and supervising physician(s) at the end of the rotation. The
resident’s faculty advisor and program director review the evaluation
and attest to reviewing it by signing/initialing the form. These
evaluations are filed together by resident year.
Educational Resources
Resources distributed to resident at start of
the rotation:
