Course Specifics (The Nitty Gritty)


What to Bring/Wear
  • Penlight
  • Stethoscope
  • Reflex Hammer
  • 128 Hz Tuning Fork for vibtation testing
  • Ophthalmoscope
  • Visual acuity testing card
  • Tongue depressors
  • Cotton Swabs

Attendance

The easiest way to fail this clerkship is to demonstrate a poor attendance record. The clerkship is only 4 weeks in length, which translates to 20 weekdays. No unexcused absences are permitted. Students may have two excused absences for medical illness or residency interviews with proper documentation. Please notify the clerkship coordinator, director and your resident about any planned or unplanned absences. Family emergencies should be discussed directly with a member of the clerkship leadership. Should a student have an unexcused absence, or more than 2 excused absences, they must be made up by taking an extra weekend call during the course. We are very serious about this issue, and have no qualms about enforcing this rule, even if it holds up a studentês graduation.



Clinical Sites
  • New York Presbyterian Hospital
    • Ward, Consult, ICU and pediatric neurology services
  • Memorial Sloan Kettering Cancer Center
    • Ward and Consult services
  • New York Hospital- Queens


Daily Activities

Each student is expected to follow 2-3 patients at any given time. The number of patients is ultimately at the discretion of the chief resident. Students should pre-round on their patients and are expected to present any new admissions or consults they worked up at attending rounds. The schedule of activities at NYH-Q will be reviewed by NYH-Q staff upon arrival of the student(s) assigned to that site. Most activities are part of the annual neurology residency core curriculum, of which the students rotating on clerkship are exposed to one-twelfth. However, these are generally high quality conferences and are required for students. Site specific schedules can be found below.



Daily NYPH Schedule

Time Mon Tues Wed Thurs Fri
7:30am Attending rounds
Ward: 6C
Consult: L6
Attending rounds
Ward: 6C
Consult: L6
Attending rounds
Ward: 6C
Consult: L6
Attending rounds
Ward: 6C
Consult: L6
Attending rounds
Ward: 6C
Consult: L6
8:30am     Grand Rounds (F639)    
8:45am Morning Report (F610) Morning Report (F610)   Morning Report (F610) Morning Report (F610)
9:30am Daily Work Daily Work Daily Work Daily Work Daily Work
11:00am Teaching Rounds Teaching Rounds   Neurosurgery Conf. (W6) Teaching Rounds
12:00pm Noon Conference (F639) Neurosurgery Conf. (W6) Neuromuscular Conf. (F639) Noon Conference (F639)  
1:00pm Daily Work Daily Work Medical Student Neurology Conference Daily Work Student Professor Rounds

Daily Work
4:00pm Sign Out Sign Out   Sign Out Sign Out




Daily MSKCC Schedule

Time Mon Tues Wed Thurs Fri
7:00am Consult attending rounds
(M7)
Consult attending rounds
(M7)
Consult attending rounds
(M7)
Consult attending rounds
(M7)
Consult attending rounds
(M7)
7:30am Ward rounds (M7) Ward rounds (M7) Ward rounds (M7) Ward rounds (M7) Ward rounds (M7)
8:00am     Radiology Conference (M11)    
8:30am Radiology Conference (M11) Radiology Conference (M11) Grand Rounds (F639) Radiology Conference (M11) Radiology Conference (M11)
9:30am Ward attending rounds (M7) Ward attending rounds (M7) Ward attending rounds (M7) Ward attending rounds (M7) Ward attending rounds (M7)
10:00am Neuropath on alternate wks        
11:00am Chairman rounds (M7)     Neurosurgery conf (W6)  
12:00pm Noon conference (F639) Neurosurgery conf (W6) Neuromuscular conference (F639) Noon conference (F639)  
1:00pm Daily Work Daily Work Medical student neurology conference (F610) Daily Work Professor rounds (F610)
2:30pm Neuro-onc Conf (C7)       Daily Work
4:15pm Dr. Posner Clinical Conf Sign Out   Sign Out Sign Out


Outpatient Experince

The neurology clerkship is primarily designed to provide training in inpatient neurology. However, we recognize that much of neurology is ambulatory-based. Therefore, each student is expected to attend one resident clinic per week. Ideally, the student should independently evaluate one new patient and then see the patient thoroughly with the resident followed by the attending. In addition, if a student has interest in a particular subspecialty area (multiple sclerosis, stroke, pediatric neurology, epilepsy, movement disorders, or peripheral neuropathy), he or she can attend this clinic once weekly with the clinic resident. Please arrange this directly with the chief resident. For those interested in more outpatient neurology exposure, a fourth-year elective rotation is available and details are listed in the Cornell elective catalog.



New York Presbyterian Hospital-Queens

Though the objectives of the clerkship at Queens are the same as for NYPH and MSKCC, the approach is slightly different. The neurology in-patient service at Queens is on a consult basis. Student activities will include conferences at NYPH-Queens as well as attending rounds and out-patient clinics. For on call, you will be assigned to a medical resident who is rotating on neurology. Students will also be expected to do the case history write-ups and take the final exam. Transportation to NYPH-Queens: A bus departs for NYPH-Queens from the 68th Street entrance of the New York Hospital at 6:15 am. Buses depart from Queens at 6:00 and 7:50 pm. Please note: On the first day of your rotation, drop by the Medical Education Office in the Student Center at NYPH-Queens to pick up pagers from Mary Marrero. You will meet Emilio Oribe, MD at the Dept. of Medicine office. His phone number is (718) 670-1512.



Calls

Each student is required to take three weekday evening calls and two weekend calls, Weekday calls begin at 5:00pm and end at 10:00pm. Weekend calls are taken on Saturdays or Sundays from 8:00am to 7:00pm. Students are expected to independently evaluate at least one patient per call. Calls should be logged on the clerkship card, with the signature of the resident who supervised the call.



Medical Student Curriculum

In addition to the resident conferences, a specific set of conferences has been designed for medical student education in clinical neurology. Attendance at these conferences is mandatory. The conferences are designed to provide students with a framework for the study and practice of clinical neurology. Focus is placed on teaching methods of approaching neurological disorders. The sessions are interactive and student participation is very important. Therefore, advance preparation for the conferences is necessary. Each conference has a topic, with a specific set of goals and objectives, which are listed in this manual. The first session is an overview and is reviewed at orientation.

The neurology medical student core curriculum takes place every Wednesday afternoon from 1pm-5pm and the schedule is as follows:

  • Week One
    • 1:00pm-2:15pm Headache
    • 2:15pm-3:30pm Cerebrovascular disease
    • 3:30pm-3:45pm Break
    • 3:45pm-5:00pm Clinical Approach to Weakness
  • Week Two
    • 1:00pm-2:15pm Neuro-infectuos diseases
    • 2:15pm-3:30pm Movement Disorders
    • 3:30pm-3:45pm Break
    • 3:45pm-5:00pm Multiple Sclerosis
  • Week Three
    • 1:00pm-2:15pm Delirium and Dementia
    • 2:15pm-3:30pm Seizures and Epilepsy
    • 3:30pm-3:45pm Break
    • 3:45pm-5:00pm Pediatric Neurology
  • Week Four
    • 1:00pm-2:15pm Neurology Review I
    • 2:15pm-3:30pm Neurology REview II
    • 3:30pm-3:45pm Break
    • 3:45pm-5:00pm Palliative Care Neurology

These conferences cover some very important topics in clinical neurology. As this is a clinical clerkship, the conferences are of a very clinical nature. Recall, however, that clinical neurology does not stand alone. It is well-grounded in its underlying sciences, including neuroanatomy, neuropharmacology, neurophysiology and neuropathology. All of these topics were covered in depth in Brain and Mind, and understanding the principles of these subjects is very important in developing an understanding of clinical neurology.


Neurosurgery Lecture Series

As part of the didactic curriculum for the clerkship, the faculty of the department of neurosurgery has put together a lecture series. These lectures take place twice weekly, on Tuesdays at 12:00 noon and Thursdays at 11:00am. A specific schedule is distributed on the first day of the clerkship. The topics include epilepsy surgery, brain tumors in adults and children, carotid artery disease, disorders of intracranial pressure and functional and stereotactic neurosurgery. These lectures are mandatory.



Professor Rounds

Students will meet as a group with Dr. Safdieh on Fridays at 1pm in Whitney-6. One student will formally present a patient. The group and Dr. Safdieh will then discuss the case and demonstrate the neurologic method. The chief residents should assist in selection of the patient.




 
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