Clerkship Information

Neurology Clerkship

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 past 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.

Dr. Vicki Ramsey-Williams is the Associate Clerkship Director for the Department of Neurology as well as an Assistant Professor.

The Neurology Clerkship is a five week required clerkship in the third 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.


The fundamental goal of this rotation is to develop a correct approach to diagnosis and management of neurological disorders

At the end of the 5-week Neurology Clerkship, medical students will be able to:

1. Obtain and present a complete neurological history including all relevant components (S1, S3).

2. Conduct a comprehensive and complete neurological exam. The student should also be able to describe the anatomic and physiologic basis of the neurological
examination as it relates to the clinical problem (S4, K4, and K5).

3. Present and document a succinct and accurate neurological history and examination (S1, S5).

4. Appropriately apply diagnostic studies to the evaluation of neurological patients (K5, S7 and S8).

5. After each evaluation, develop a differential diagnosis based primarily on the history and examination (S7, S8).

6. Demonstrate knowledge of the major categories of neurological disease and their primary modes of presentation (K3, K5).

7. Recognize neurological emergencies and the need for immediate management and requirements for appropriate intervention (S10).

8. Demonstrate knowledge of the standard methods of care for the major neurological disorders and form a rational plan of management (S8, S9).

9. Apply knowledge of neurosciences to the understanding of the mechanisms of neurological disease and their treatment (K1, K2, K3, K6 and K7).

10. Recognize neurological issues specifically related to aging (S2).

11. Review relevant clinical literature as it pertains to specific neurological problems encountered and utilize evidence based guidelines in diagnosis and management of patients ( i.e. demonstrate life long learning) (S 11).

12. Identify and discuss ethical issues relevant to care of the patient with neurological disorders (K10).


All students participating on this clerkship will meet or exceed the institutional standards for professional behaviors (EPO P1-7) as evidenced by

1-Adhering to the dress code consistent with clerkship standards.

2-Being punctual for all educational experiences (i.e. exams, clinics, rounds, small group sessions, appointments at the clinical skills center).

3-Fulfilling all educational assignments and responsibilities on time.

4-Displaying honesty in all interactions and situations.

5-Contributing to an atmosphere conducive to learning and is committed to advance scientific knowledge.

6-Establishing and maintaining appropriate boundaries in all learning situations

7-Using professional language being mindful of the environment.

8-Establishing effective rapport.

9-Being respectful at all times of all parties involved.

10- Resolving conflict in a manner that respects the dignity of every person involved.

11- Respecting the diversity of race, gender, religion, sexual orientation, age, disability and socioeconomic status.

12- Exhibiting humanism in all interactions.

13- Protecting patient confidentiality.

14- Being aware of and adapting to differences in individual patients including those related to culture and medical literacy

15- Recognizing personal limitations and seeking appropriate help.

16- Accepting constructive feedback and making changes accordingly.

17- Exhibiting independent and self-directed learning.

 

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 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 category

Number of Patients
to be seen

Comments/Explanation

Cerebrovascular Disease

3

Evaluate at least two patients with cerebrovascular disease (cerebral infarct, intracerebral hemorrhage, subarachnoid hemorrhage).

Cognitive Impairment

1

Evaluate Inpatient or outpatient e.g. dementia or delirium

Epilepsy

3

Either on inpatient or outpatient setting

Headache and

Facial Pain

3

Evaluate at least three patients with headaches in either outpatient or inpatient setting

Movement Disorders

2

Includes Parkinson’s, Huntington’s, and drug induced movement disorder

Multiple Sclerosis/

Demyelinating Disorders

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

Acute or chronic pain

1

Either inpatient or outpatient

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:

  1.  New patient evaluation in ambulatory setting – history, physical, assessment and plan of management
  2.  Return visit encounter-focused history, examination, assessment and plan.
  3.  Inpatient new patient evaluation-detailed history, examination, assessment and plan
  4.  Inpatient follow up evaluation-detailed history, examination, assessment and plan

Other meaningful clinical experiences would include:

  1. Standardized patient exam observed in real time by faculty, with immediate feedback.
  2. Writing an evidence-based review of a clinical vignette assigned at the beginning of the clerkship.

Other Clerkship Experiences:

Students are required to:

  • Use the electronic, web-based, database to keep a log of patient work ups documenting the types of patients seen and the level of responsibility.
  • Obtain mid-block formative feedback concerning individual progress during each 5-week block from an attending and/or resident.

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 morning lecture series. The student is expected to know the material prior to attending the seminar.

Students are also required to participate in an Observation of Clinical Skills with standardized patients. The skills observation includes eliciting appropriate history information and performing a neurological physical exam.

If you have any additional questions, please feel free to contact Teresa Behm, the Clerkship Coordinator at (419) 383-4558 or Imran I. Ali, M.D., Clerkship Director or Vicki A. Ramsey-Williams,  Associate Clerkship Director for the Department of Neurology.

Clerkship

Last Updated: 3/31/15