Educational purpose, rationale or value
The purpose of the Neurology consultation is to train residents in the evaluation and treatment of both acute and chronic neurologic disorders. This educational experience is very important for the resident planning a career in primary care, as neurologic disorders constitute an important part of the problems encountered in practice. In addition, this experience is important for those residents planning to specialize, because all physicians need to have a basic understanding of the evaluation of common neurologic disorders, as an assessment must typically begin prior to consultation with a Neurologist.
Principle teaching methods
The primary teaching is accomplished by daily attending rounds. This service has attending coverage from the department of Neurology. In addition, there is a daily review of the radiologic studies, mainly CT and MRI scans of the head.
Most important educational content encountered
The consultation service assists in the management of patients from a variety of different services, with General Medical, MICU, and Psychiatry being the most common primary services. One of the most important clinical and educational functions of the service is to provide immediate assistance in the diagnosis and treatment of acute mental status changes. Another important service is to assist in the management of seizure patients who are admitted for a different primary diagnosis. The service also teaches the management and work up of newly diagnosed strokes.
Principle ancillary educational materials to be used
The main educational tool in this rotation is attending rounds, although the residents are expected to supplement this education with general readings in Neurology. The recommended sources are the MKSAP Neurology section as well as part fourteen of Harrison 's which is pertinent to Neurologic Disease. In addition, the radiologic material is an important source of learning as the interpretation of both the CT and MRI scan the head are a fundamental part of Neurology.
Methods of evaluation for resident and program performance
The Neurology attending gives feedback throughout the rotation, often pertaining to the performance of the neurologic exam. An ABIM-format written evaluation is completed at the end of the rotation and reviewed with the resident.
Residents evaluate the program and the attending physician using a standard departmental form that provides for comments.
Strengths amd limitations
There are a wide variety of conditions and diagnoses encountered during the rotation, both acute and chronic. The Neurology Attending staff are often experts in their field and are up to date with both diagnosis and treatment. One of the strong features of the rotation is that the service is staffed with both Neurology and Psychiatry residents. This allows for a very open, interactive and educational interaction between residents of different disciplines. Each contributes a unique perspective to the evaluation of patients encountered on the service.
One of the weaknesses of the service is that the WSVA hospital does not have a neurosurgical service and therefore post-neurosurgical problems are not encountered. Another problem is that many of the acute cases are admitted after hours and the immediate work up is not seen by the consultation service residents.
Neurology bibliography
Curriculum: Neurology ConsultationSite: Jesse Brown Veterans Administration Medical Center
Updated 7/7/04
