Neurology
Neurology Clerkship (Fourth Year)
NURL 45300 | 75 Units
- Selective Type: Neurology
- Primary Instructor: Dr. Arif Dalvi and Dr. James Brorson
- Contact: Marla Scofield | 2-0151 | mscofiel@neurology.bsd.uchicago.edu
- Location on first day: TBA in email sent before start of rotation
- Included in Lottery: Yes
- Last Reviewed: March 26, 2008
Overview
The fourth year neurology clerkship is a two-week rotation at The University of Chicago Medical Center. One week of the rotation is spent on the inpatient setting and the other week is spent on one of several selective offerings, primarily based in the outpatient setting.
During their inpatient week, fourth year students will participate in both the inpatient Epilepsy Monitoring service and in the Neurology Consultation service, Monday through Friday. In the morning hours, they will round with the attending epileptologist, the epilepsy fellow, and the neurology resident on patients on the Epilepsy Monitoring unit, and will review 24 hour EEG recordings and video recording from these patients. In addition, as new requests for neurological consultation are made, the Neurology Consultation service resident will assign fourth year students these patients for evaluation. In the afternoon hours, fourth year students will round with the Neurology Consultation Service attending and resident, presenting new consultation patients and updates on follow-up consultations. Through participation on the Epilepsy Monitoring service, the student will gain familiarity with the presentation, diagnosis, and management of epilepsy, and with the fundamentals of electroencephalography. The consultation service experience will provide experience in the recognition and management of a broad array of neurological problems, including stupor, coma, seizures, and neurological complications of medical diseases.
In the Selective week of the fourth year neurology clerkship, students will choose from assignments to the Neurology outpatient subspecialty clinics, Neuroradiology, Clinical Neurophysiology (Outpatient EEG, EMG, and O.R. Monitoring), and Private Practice Neurology. Some of these selective experiences are limited to 1 or 2 students, which may require assignment of students by lottery if any individual selectives are over-subscribed.
In the Neurology subspecialty clinic selective, students will work with attending physicians in a variety of neurological subspecialty clinics. The goal of this week is to become familiar with common neurological problems and to evaluate several patients with conditions such as MS, sleep disorders, epilepsy, stroke, movement disorders, ALS and diseases of the peripheral nervous system. In the Neuroradiology selective, exposure to diagnostic MRI and CT reading, as well as to cerebral angiography, will be offered. In the Private Practice Neurology selective, students will work with a respected local Neurology private practice group, seeing patients in both inpatient and outpatient settings. In the Clinical Neurophysiology selective, students will observe both the performance and interpretation of neurophysiological techniques including EMG, EEG, and O.R. neurophysiological monitoring.
Objectives
1. Learn to obtain a neurological history and perform a competent neurological examination
• Students will be provided a framework for neurological history taking and examination that they will utilize when examining patients.
• They will also observe attendings and residents perform the neurological examination on inpatient consultation patients and in the clinics.
2. Learn the basics of localization in neurology
• Students will learn about the basics of localization during an orientation session with the clerkship director.
• They will also learn the importance of localization in making a differential diagnosis and guiding imaging studies.
3. Obtain exposure to a variety of neurological disorders
• On the inpatient consultation service will have exposure to acute presentations of stroke, seizures, neurological complications of medical illnesses, and neuromuscular disorders.
• During the outpatient week students have the opportunity to work with attendings in specialty clinics in multiple sclerosis, neuromuscular disease, Parkinson’s disease, neuron-oncology as well as general neurology.
4. Understand the role of diagnostic tests in neurology
• Students will have the opportunity to see patients undergoing EMG and EEG tests as part of their outpatient rotation
• They will also have the opportunity to understand the role of multiple diagnostic modalities including CT, MRI and ultrasound imaging as well as lumbar puncture and other lab investigations relevant to patients seen on the floors and in the clinics.
5. Understand the role of medical and surgical treatment and rehabilitation of neurological disorders
• Students will have exposure to various acute and chronic modalities of medical treatment as applied to patients seen on the floor and in the clinic.
• They will also be exposed to the role of surgical treatment in epilepsy, Parkinson’s disease, and cerebrovascular disorders.
6. Obtain feedback on neurological history taking and examination
• Students on the inpatient consultation service will present patient history and physical examinations to the attending neurologist, and will receive feedback on their history taking and localization skills during these presentations.
• Students will obtain ad-hoc feedback on history taking and examination skills on the floors and in the clinic
Evaluation
Students are expected to be present at all times during the clerkship. They will be evaluated by attending physicians on their ability to perform a complete neurological examination and interpret the abnormal findings, make a diagnosis and understand the agents used in therapy. In addition, oral and written communication and professional behavior will be assessed. They are expected to submit a complete write-up of a case with a section on the differential diagnosis; the write-up should be signed by a resident or attending.
Evaluation of Clinical Clerks
80% Clinical Performance
20% Formal patient case write-up
Offered:
- January
- February
- March
- April
- May
- July
- August
- September
- October
- November
- December
Course Limitations and Prerequisites
Recommend Reading
Overviews of Neurology, suggested as background reading during clerkship (choose one):
- Neurology section of Harrison’s Textbook of Medicine.
- Clinical Neurology. Aminoff MJ, Greenberg DA, Simon RP. 6th ed.
- Blueprints in Neurology (Blueprints Series), by Frank Drislane et al.
- Brief review of neurology as part of USME review series.
Comprehensive textbooks of Neurology, useful for reference purposes:
- Merritt's Textbook of Neurology. Rowland, L.P. 11th ed.
- Adams and Victor’s Principles of Neurology. Ropper AH, Brown R. Eighth Ed.
Maximum Students Enrolled: 6
- Eligibility:
- Fourth year
- Prerequisites:
- Other: Third year Medical Clerkship