Neurosciences

Course #: 801J

Title:  General Adult Neurology

Selective Director(s):  David L. Bachman, M.D. & Faculty

Maximum Number of students per block: 5

LEARNING GOALS AND OBJECTIVES:
At the completion of this clinical rotation, students will be able to:

1. Exhibit skills in performing a neurological examination.
2. Participate in the assessment and care of patients with a variety of neurological conditions.
3. Understand the contributions and limitations of diagnostic imaging (MRI and CT scan) and neurophysiological testing (EEF and EMG) in the assessment of neurological patients.
4. Understand the importance of neuroanatomical localization in the care of patients with neurological disease.

TEACHING METHODOLOGIES AND ROTATION ACTIVITIES:
Students on this rotation will be expected to learn and achieve the educational goals and objectives through the following methodologies and activities:

1. Patient contact with inpatients (MUH, VA) outpatients (MUH,VA) and consults (MUH, VA).
2. One-on-one and/or group discussions.
3. Directed reading and literature reviews on general and selected topics in the Neurosciences.
4. Attendance at Neurosciences Conferences.
5. Case presentations.

PATIENT ENCOUNTERS
Students on this rotation will be expected to work up and/or follow the following minimum number of patients with the specified conditions (i.e, 2 pediatric ear infections, 2 adult migraine headaches):

1. 1 adult neurology patients primary with stroke,
2. 1 adult neurology patient primary with movement disorders
3. 1 adult neurology patient primary with dementia,
4. 1 adult neurology patient primary with epilepsy
5. 1 adult neurology patient primary with headache
6. 1 adult neurology patient primary with neuropathy/myopathy.

EVALUATION AND FEEDBACK:
Students on this rotation will be evaluated through the following methods, and designate by whom for each method:

1. Observation of clinical skills and knowledge by Selective Director or his/her assigned Faculty Co-Director
2. Performance Clinical Core Neurology Shelf Examination

NOTE: The use of the Clinical core Neurology Shelf Examination is for the purpose of familiarizing the student with the types of questions that WILL be asked about clinical neurology on the USMLE Step 2. Historically, neurology topics comprise 10-16% of the total examination questions on Step 2.

Please outline when and how the learners will receive feedback on their performance:

1. Mid-selective and end-of-rotation conference with Selective Director.
2. Final grade = 90% “clinical”, 10% Shelf Exam in Clinical Core Neurology; prepared within 4 weeks from end of rotation.

Course #: 802J

Title:  General Neurosurgery

Selective Director(s):  Sunil Patel, M.D./Jerry Tuite, M.D./Abhay Varma

Maximum Number of students per block: 3

LEARNING GOALS AND OBJECTIVES:
At the completion of this clinical rotation, students will be able to:

1. Recognize clinical neurosurgical diagnoses and discuss their management issues in some of the most common neurosurgical disorders (subdural and epidural hematomas, head/spine trauma, hydrocephalus, AVM, etc.).
2. Perform a focused history and neurological exam for neurosurgical disorders.
3. Discuss basic neurosurgical approaches to common neurosurgical disorders, as well as the post-operative care and long-term management issues.
4. Understand the contributions and limitations of diagnostic imaging (CT, MRI) and neurophysiological testing (EEG, EMG/NCV) in patient assessments.
5. Discuss the non-surgical treatment of neurosurgical diagnoses and the common complications which might occur with/or without neurosurgical intervention.

TEACHING METHODOLOGIES AND ROTATION ACTIVITIES:
Students on this rotation will be expected to learn and achieve the educational goals and objectives through the following methodologies and activities:

1. Patient contact with adults/children in ER, ICU, inpatients, outpatients, and the operating room (observe common neurosurgical procedures).
2. One-on-one and group/team discussions.
3. Directed reading on general and selected topics in the Neurosciences.
4. Attendance at Neurosciences Conferences.
5. Case presentations on selected/directed Neurosurgery topics.

PATIENT ENCOUNTERS
Students on this rotation will be expected to work up and/or follow the following minimum number of patients with the specified conditions (i.e, 2 pediatric ear infections, 2 adult migraine headaches):

1. 6 pediatric or adult patients with common neurosurgical issues, 3 of which were your patient in the OR (you scrubbed on their case).

EVALUATION AND FEEDBACK:
Students on this rotation will be evaluated through the following methods, and designate by whom for each method:

1. Observation of clinical skills and knowledge by one of Selective Director or his/her assigned Faculty Co-Director
2. Performance on Clinical Core Neurology Shelf Examination

NOTE: The use of the Clinical core Neurology Shelf Examination is for the purpose of familiarizing the student with the types of questions that WILL be asked about clinical neurology on the USMLE Step 2. Historically, neurology topics comprise 10-16% of the total examination questions on Step 2.

Please outline when and how the learners will receive feedback on their performance:

1. Mid-selective and end-of-rotation conference with Selective Director responsible for doing Evaluation form.
2. Final grade = 90% “clinical”, 10% Shelf Exam in Clinical Core Neurology; prepared within 4 weeks from end of rotation.

Course #: 803J

Title:  General Pediatric Neurology

Selective Director(s):  David A. Griesemer, M.D.

Maximum Number of students per block: 2

LEARNING GOALS AND OBJECTIVES:
At the completion of this clinical rotation, students will be able to:

1. Develop effective clinical assessment and judgment skills, including recognition of clinical presentations of symptoms that are clinically worrisome and patterns of abnormal findings that are diagnostically important, and distinction between focal and generalized abnormalities.
2. Recognize symptoms that may reflect neurologic impairment:
     a. Seizures or syncope.
     b. Weakness or low muscle tone.
     c. Spasticity or gait impairment
     d. Headache or irritability
     e. Abnormal movements or tics.
     f. Sleep problems.
     g. School or behavior problems.
3. Discuss the use of diagnostic procedures, i.e, MRI scan, EEG, CT scan, EMG/NCV, and neuropsychological testing, in patient care.
4. Discuss the use of treatment modalities, such as baclofen pump, vagus nerve stimulator, botox injections, in patient care.

TEACHING METHODOLOGIES AND ROTATION ACTIVITIES:
Students on this rotation will be expected to learn and achieve the educational goals and objectives through the following methodologies and activities:

1. Patient contact and/or video case presentations.
2. One-on-one and/or group discussions.
3. Case presentations.
4. Directed reading and literature reviews on general and selected topics in the Neurosciences.
5. Attendance at Neurosciences Conferences.
6. Participation in available outreach clinic opportunities.

PATIENT ENCOUNTERS
Students on this rotation will be expected to work up and/or follow the following minimum number of patients with the specified conditions (i.e, 2 pediatric ear infections, 2 adult migraine headaches):

1. 8 pediatric neurology patients with seizures, headaches, etc. and/or neurodevelopmental disabilities (mental retardation, cerebral palsy).

EVALUATION AND FEEDBACK:
Students on this rotation will be evaluated through the following methods, and designate by whom for each method:

1. Observation of clinical skills and knowledge by Selective Director or his/her assigned Faculty Co-Director
2. Performance on Clinical Core Neurology Shelf Examination

NOTE: The use of the Clinical core Neurology Shelf Examination is for the purpose of familiarizing the student with the types of questions that WILL be asked about clinical neurology on the USMLE Step 2. Historically, neurology topics comprise 10-16% of the total examination questions on Step 2.

Please outline when and how the learners will receive feedback on their performance:

1. Mid-selective and end-of-rotation conference with Selective Director.
2. Final grade = 90% “clinical”, 10% Shelf Exam in Clinical Core Neurology; prepared within 4 weeks from end of rotation.

Course #: 804J

Title:  Spine Neurosurgery

Selective Director(s):  Byron Bailey, M.D.

Maximum Number of students per block: 2

LEARNING GOALS AND OBJECTIVES:
At the completion of this clinical rotation, students will be able to:

1. Recognize clinically the common disorders of the spine.
2. Understand the various imaging modalities (MRI, CT) to evaluate spine disorders.
3. Perform the physical and neurological examinations of patients with spinal disorders.
4. Understand the various treatments (surgical and non-surgical) for the common disorders of the spine.

TEACHING METHODOLOGIES AND ROTATION ACTIVITIES:
Students on this rotation will be expected to learn and achieve the educational goals and objectives through the following methodologies and activities:

1. Patient contact with inpatients and outpatients, including selected Neurosurgical OR contact.
2. One-on-one and group/team discussions (Spine Conference).
3. Directed reading on general and selected topics in the Neurosciences.
4. Attendance at Neurosciences Conferences.
5. Case presentations on selected Spine topic.

PATIENT ENCOUNTERS
Students on this rotation will be expected to work up and/or follow the following minimum number of patients with the specified conditions (i.e, 2 pediatric ear infections, 2 adult migraine headaches):

1. 4 patients with spinal disorders.
2. 2 patients undergoing surgical treatment for spinal disorders.

EVALUATION AND FEEDBACK:
Students on this rotation will be evaluated through the following methods, and designate by whom for each method:

1. Observation of clinical skills and knowledge by Selective Director or his/her assigned Faculty Co-Director
2. Performance on clinical Core Neurology Shelf Examination

NOTE: The use of the Clinical core Neurology Shelf Examination is for the purpose of familiarizing the student with the types of questions that WILL be asked about clinical neurology on the USMLE Step 2. Historically, neurology topics comprise 10-16% of the total examination questions on Step 2.

Please outline when and how the learners will receive feedback on their performance:

1. Mid-selective and end-of-rotation conference with Selective Director.
2. Final grade = 90% “clinical”, 10% Shelf Exam in Clinical Core Neurology; prepared within 4 weeks from end of rotation.

Course #: 805J

Title:  Behavioral Neurology/Neuropsychology

Selective Director(s):  David L. Bachman, M.D./Mark Wagner, M.D.

Maximum Number of students per block: 1

LEARNING GOALS AND OBJECTIVES:
At the completion of this clinical rotation, students will be able to:

1. Recognize patients with different types of behavioral and cognitive disorders.
2. Develop skills in performing a detailed mental status examination with the neurological examination.
3. Develop an appreciation for the advantages and limitations of neuropsychological testing.
4. Do in depth study of one neurobehavioral disorder with case presentation and written report on topic of interest.
5. Synthesize history, clinical examination, neuropsychological testing, neuroimaging, and other clinical information into a diagnostic and treatment plan for patients with a variety of behavioral and cognitive disorders.

TEACHING METHODOLOGIES AND ROTATION ACTIVITIES:
Students on this rotation will be expected to learn and achieve the educational goals and objectives through the following methodologies and activities:

1. Direct patient contact and observation of neuropsychological testing.
2. One-on-one and/or group discussions.
3. Directed reading and in depth review of selected topics in the Neurosciences.
4. Attendance at Neurosciences Conferences.
5. Case presentations and/or 5 page paper on specific topic of interest..

PATIENT ENCOUNTERS
Students on this rotation will be expected to work up and/or follow the following minimum number of patients with the specified conditions (i.e, 2 pediatric ear infections, 2 adult migraine headaches):

1. 3 adult patients with behavioral neurology/memory disorders.
2. Observe neuropsychological testing in 3 adult patients with behavioral neurology/memory disorders.

EVALUATION AND FEEDBACK:
Students on this rotation will be evaluated through the following methods, and designate by whom for each method:

1. Observation of clinical skills and knowledge by Selective Director or his/her assigned Faculty Co-Director
2. Performance on Clinical Core Neurology Shelf Examination

NOTE: The use of the Clinical core Neurology Shelf Examination is for the purpose of familiarizing the student with the types of questions that WILL be asked about clinical neurology on the USMLE Step 2. Historically, neurology topics comprise 10-16% of the total examination questions on Step 2.

Please outline when and how the learners will receive feedback on their performance:

1. Mid-selective and end-of-rotation conference with Selective Director.
2. Final grade = 90% “clinical”, 10% Shelf Exam in Clinical Core Neurology; prepared within 4 weeks from end of rotation.

Course #: 806J

Title:  Clinical Neurogenetics

Selective Director(s):  Kenton R. Holden, M.D.

Maximum Number of students per block: 1 (additional students by special arrangement)

LEARNING GOALS AND OBJECTIVES:
At the completion of this clinical rotation, students will be able to:

1. Discuss major topics in neurometabolic-genetic diseases.
2. Develop skills to identify and evaluate possible genetic neuro-developmental disabilities.
3. Know mechanics and application of neurometabolic-genetic diagnostic studies.
4. Participate in the presentation/counseling of an affected patient/family.

TEACHING METHODOLOGIES AND ROTATION ACTIVITIES:
Students on this rotation will be expected to learn and achieve the educational goals and objectives through the following methodologies and activities:

1. Patient contact and/or video case presentations.
2. One-on-one and/or group discussions.
3. Textbook and literature searches on selected topics, as well as general topics in the Neurosciences.
4. Laboratory exposure in metabolic-genetic diseases.
5. Case presentation.
6. Attend Greenwood Genetic Center Monthly Case Conference and MUSC Neuroscience Conferences.

PATIENT ENCOUNTERS
Students on this rotation will be expected to work up and/or follow the following minimum number of patients with the specified conditions (i.e, 2 pediatric ear infections, 2 adult migraine headaches):

1. 1-2 patients with neurodevelopmental disabilities.
2. Video/power-point patient presentations.

EVALUATION AND FEEDBACK:
Students on this rotation will be evaluated through the following methods, and designate by whom for each method:

1. Observation of clinical skills and knowledge by Selective Director.
2. Performance on Clinical Core Neurology Shelf Examination

NOTE: The use of the Clinical core Neurology Shelf Examination is for the purpose of familiarizing the student with the types of questions that WILL be asked about clinical neurology on the USMLE Step 2. Historically, neurology topics comprise 10-16% of the total examination questions on Step 2.

Please outline when and how the learners will receive feedback on their performance:

1. One-on-one weekly and end-of-rotation conference with Selective Director.
2. Final grade = 90% “clinical”, 10% Shelf Exam in Clinical Core Neurology; prepared within 4 weeks from end of rotation.

Course #: 807J

Title:  Geriatric Neuro/Neuropalliative Care

Selective Director(s):  Jerome E. Kurent, M.D.

Maximum Number of students per block: 2

LEARNING GOALS AND OBJECTIVES:
At the completion of this clinical rotation, students will be able to:

1. Discuss principles of palliative care as they apply to patients with life-limiting neurological diseases.
2. Discuss principles of geriatric medicine/neurology.
3. Understand principles of pain and symptom management Rationale for selecting specific medications and dosing requirements for the treatment of pain, dyspnea, delirium and other common symptoms will be introduced.
4. Understand hospice eligibility criteria for patients with terminal neurological diseases.

TEACHING METHODOLOGIES AND ROTATION ACTIVITIES:
Students on this rotation will be expected to learn and achieve the educational goals and objectives through the following methodologies and activities:

1. Patient contact with inpatients and outpatients. This includes supervised visits to hospice patients residing at home and in long-term care facilities with chronic Neurological diseases (Alzheimer’s, Parkinson’s stroke, etc.), and participation in palliative care in-patient consult rounds with focus on patients’ diagnosed with end-stage neurological diseases or with neurological complications of terminal systemic illness (ALS, coma, persistent vegetative state, etc.).
2. Participation in weekly didactic and interactive sessions with preceptor on selected neuropalliative care and geriatric neurology topics.
3. Participation in interactive discussions regarding management of patients with end-stage neurological diseases with hospice interdisciplinary team and palliative care service team members.
4. Completion of directed reading on selected topics in the Neurosciences.
5. Attendance at Neurosciences Conferences.

PATIENT ENCOUNTERS
Students on this rotation will be expected to work up and/or follow the following minimum number of patients with the specified conditions (i.e, 2 pediatric ear infections, 2 adult migraine headaches):

1. 2 adult pain management patients.
2. 2 adult hospice and palliative care patients.

EVALUATION AND FEEDBACK:
Students on this rotation will be evaluated through the following methods, and designate by whom for each method:

1. Observation of clinical skills and knowledge by Selective Director or his/her assigned Faculty Co-Director
2. Performance on Clinical Core Neurology Shelf Examination

NOTE: The use of the Clinical core Neurology Shelf Examination is for the purpose of familiarizing the student with the types of questions that WILL be asked about clinical neurology on the USMLE Step 2. Historically, neurology topics comprise 10-16% of the total examination questions on Step 2.

Please outline when and how the learners will receive feedback on their performance:

1. Mid-selective and end-of-rotation conference with Selective Director.
2. Final grade = 90% “clinical”, 10% Shelf Exam in Clinical Core Neurology; prepared within 4 weeks from end of rotation.

Course #: 808J

Title:  Neuro-Oncology

Selective Director(s):  Bruce Frankel, M.D. or Sunil Patel, M.D.

Maximum Number of students per block: 2

LEARNING GOALS AND OBJECTIVES:
At the completion of this clinical rotation, students will be able to:

1. Recognize, and diagnose the most common brain tumors.
2. Recognize the major types of tumors and various imaging modalities for CNS tumors.
3. Understand the general management of common tumors: gliomas, meningiomas, etc.
4. Know the pathology of CNS tumors and general grading schemes.
5. Discuss non-surgical treatment of the symptoms associated with tumors: seizures, high ICP symptoms (headaches, neurological deficits), etc.
6. Understand the contributions and limitations of diagnostic imaging (MRI, CT) and neurophysiological testing (EEG) in the assessment of brain tumor patients.

TEACHING METHODOLOGIES AND ROTATION ACTIVITIES:
Students on this rotation will be expected to learn and achieve the educational goals and objectives through the following methodologies and activities:

1. Patient contact with inpatients and outpatients, including selected neurosurgical OR contact.
2. One-on-one and group/team discussions (Brain Tumor Board) including selected Neuropathology exposure.
3. Directed reading on general and selected topics in the Neurosciences.
4. Attendance at Neurosciences Conferences.
5. Case presentations on selected Neuro-Oncology topic.

PATIENT ENCOUNTERS
Students on this rotation will be expected to work up and/or follow the following minimum number of patients with the specified conditions (i.e, 2 pediatric ear infections, 2 adult migraine headaches):

1. 4 patients with brain and/or spinal cord tumors.
2. 2 patients undergoing surgical treatment for CNS tumors.

EVALUATION AND FEEDBACK:
Students on this rotation will be evaluated through the following methods, and designate by whom for each method:

1. Observation of clinical skills and knowledge by Selective Director.
2. Performance on Clinical Core Neurology Shelf Examination

NOTE: The use of the Clinical core Neurology Shelf Examination is for the purpose of familiarizing the student with the types of questions that WILL be asked about clinical neurology on the USMLE Step 2. Historically, neurology topics comprise 10-16% of the total examination questions on Step 2.

Please outline when and how the learners will receive feedback on their performance:

1. Mid-selective and end-of-rotation conference with Selective Director.
2. Final grade = 90% “clinical”, 10% Shelf Exam in Clinical Core Neurology; prepared within 4 weeks from end of rotation.

Course #: 809J

Title:  Movement Disorders

Selective Director(s):  Vanessa K. Hinson, M.D.,Ph.D. & Kenneth Bergmann, M.D.

Maximum Number of students per block: 1 (prerequisite for course is completing a general Neurology/Neurological Selective)

LEARNING GOALS AND OBJECTIVES:
At the completion of this clinical rotation, students will be able to:

1. Understand the major issues related to movement disorders neurology.
2. Identify and evaluate movement disorder patients and to develop an appropriate management plan.
3. Understand surgical and injection-based interventions for movement disorder patients.
4. Exhibit improved physical/neurological examination skills while doing a complete neurological exam.

TEACHING METHODOLOGIES AND ROTATION ACTIVITIES:
Students on this rotation will be expected to learn and achieve the educational goals and objectives through the following methodologies and activities:

1. Patient contact with adults/children as outpatients at MUH and VA Medical Center, inpatient consults, and Neurosurgical OR (observe Deep Brain Stimulation procedures and intraoperative neurophysiologic monitoring). This contact includes attendance at the Botox Clinic on a regular basis.
2. One-on-one and group/team discussions.
3. Directed reading on selected topics in the Neurosciences.
4. Case presentation on a selected movement disorder topic.
5. Attendance at Neurosciences Conferences and participate, if necessary, in duties on inpatient Neurology Service if Selective Directors are assigned to those at the time of this Movement Disorder Selective.

PATIENT ENCOUNTERS
Students on this rotation will be expected to work up and/or follow the following minimum number of patients with the specified conditions (i.e, 2 pediatric ear infections, 2 adult migraine headaches):

1. 6 patients with movement disorders, 2 of which were observed during neurosurgical DBS procedures and/or intraoperative neurophysiologic monitoring. One (1) patient should be from those evaluated and treated at the Botox Clinic.

EVALUATION AND FEEDBACK:
Students on this rotation will be evaluated through the following methods, and designate by whom for each method:

1. Observation of clinical skills and knowledge by Selective Director(s).

NOTE: The use of the Clinical core Neurology Shelf Examination is for the purpose of familiarizing the student with the types of questions that WILL be asked about clinical neurology on the USMLE Step 2. Historically, neurology topics comprise 10-16% of the total examination questions on Step 2.

Please outline when and how the learners will receive feedback on their performance:

1. Mid-selective and end-of-rotation conference with Selective Director.
2. Final grade = 100% “clinical”, to include assigned Case Presentation.

Course #: 810J

Title:  Epilepsy-Pediatric Neurology

Selective Director(s):  Robert P. Turner, M.D., MSCR