2018-2019 M3/M4 Course Syllabi
Physical Medicine & Rehabilitation
COURSE NUMBER:
18 01 07
TITLE:
CLINICAL P M & R -ICE
This rotation is designed to expose students to inpatient, consultative, and outpatient rehabilitation care. Students will refine their skills in the musculoskeletal/neurologic examination and interdisciplinary team management. To count toward ICE requirement, elective must be taken in 4-wk blocks.
PREREQUISITES:
26931373 (INTERNAL MEDICINE CORE CLKSP), 26940373 (NEUROSCIENCE CORE CLKSP)

To fulfill ICE requirements, must be taken in 4-week block.

For the months of July - November this rotation is limited to those applying to PM&R or Peds/PM&R residency programs.  Exceptions will be considered on a case-by-case basis by the rotation director.
expand all

GENERAL INFORMATION

COURSE YEAR:
M4
CREDIT HOURS:
4
CREDIT WEEKS:
4
DOMESTIC VISITING:
YES
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE
COURSE TYPE:
Clinical
STATUS:
Full-Time   
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: YES
COURSE LENGTH:
DIRECTOR:
Ashlee Bolger, MD
Ashlee.Bolger@cchmc.org
513-636-7480
260 Stetson St. , Suite 5200
ADMINISTRATIVE SUPPORT PERSON:
Mary Duke
Mary.Duke@uc.edu
558-7635
Stetson, 5200
INSTRUCTOR:
LesterDuplechan, MD
SITE(S):
Christ Hospital
Drake Center Inc.
PMR Northern KY Offices
UCMC - University of Cincinnati Medical Center
University Hospital
MAX ENROLL:
4  MAX/YR: 24
ROTATIONS:
Rotation Dates Max
1 07/02/2018 - 07/13/2018 3
1 07/02/2018 - 07/27/2018 3
1 07/16/2018 - 07/27/2018 3
2 07/30/2018 - 08/10/2018 1
2 07/30/2018 - 08/24/2018 1
2 08/13/2018 - 08/24/2018 1
3 08/27/2018 - 09/07/2018 1
3 08/27/2018 - 09/21/2018 1
3 09/10/2018 - 09/21/2018 1
4 09/24/2018 - 10/05/2018 1
4 09/24/2018 - 10/19/2018 1
4 10/08/2018 - 10/19/2018 1
5 10/22/2018 - 11/02/2018 2
5 10/22/2018 - 11/16/2018 2
5 11/05/2018 - 11/16/2018 2
6 11/26/2018 - 12/07/2018 2
6 11/26/2018 - 12/21/2018 2
6 12/10/2018 - 12/21/2018 2
7 01/02/2019 - 01/11/2019 2
7 01/02/2019 - 01/25/2019 2
7 01/14/2019 - 01/25/2019 2
8 01/28/2019 - 02/08/2019 2
8 01/28/2019 - 02/22/2019 2
8 02/11/2019 - 02/22/2019 2
9 02/25/2019 - 03/08/2019 2
9 02/25/2019 - 03/22/2019 2
9 03/11/2019 - 03/22/2019 2
10 03/25/2019 - 04/05/2019 2
10 03/25/2019 - 04/19/2019 2
10 04/08/2019 - 04/19/2019 2
11 04/22/2019 - 05/03/2019 2
11 04/22/2019 - 05/17/2019 2
11 05/06/2019 - 05/17/2019 2
12 05/20/2019 - 06/02/2019 2
12 05/20/2019 - 06/30/2019 2
12 06/03/2019 - 06/30/2019 2

NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
8:00am - 5:00 pm Monday - Friday
REPORT 1ST DAY:
260 Stetson Street 5200 8:00 AM Contact Mary Duke 558-7635

INSTRUCTION

LEARNING ACTIVITIES:
  • Case-Based Instruction/Learning
  • Clinical Experience - Inpatient
  • Conference
  • Journal Club
  • Community activity & Multimedia Activity related to PM&R
  • Patient Presentation--Faculty
  • Patient Presentation--Learner
  • Research
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.

The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
ORIENTATION:
Elective director & principal instructor
TEACHING:
40% Attending Physician
10% Senior Resident
40% Junior Resident
10% Other Allied Health Professional(s)
FEEDBACK:
Faculty
ASSESSMENT:
FINAL GRADE:
40% Clinical work performance evaluations
10% Attitude, e.g., professionalism, motivation etc
15% In-house multiple choice or other objective exam
35% Activities (Clinical Activities, Journal articles, Community, Multimedia)
GRADE ASSIGNED BY: Elective director

OBJECTIVES

Attitudes :
  1. Understand how chronic disability affects the disabled patient, his/her family, and the community in a holistic sense.
  2. Appreciate and address the various behaviors of the rehabilitation patient that directly affect the rehabilitation potential and outcome.
  3. Understand ethical implications of allocation of rehabilitation resources in cost effective ways.
  4.  Completion of all expected clinical duties and consistent, punctual attendance in clinical duties and lectures.
  5. Empathetic communication with patients/families experiencing pain and loss.

 
Curricular Resources :
"Chronic Disease and Disability" - A contemporary Rehabilitation Approach to Medical Practice" Editor Ross Hayes, specific chapters
Knowledge/Skills:

Objectives for PM&R

 

 

 

Upon completion of the rotation, the medical student should be able to:


1. Know the World Health Organization’s definition of impairment and disability

2. Be able to differentiate among patients with back pain related to various underlying etiologies including spinal stenosis, radiculopathy, herniated disc, facet pain, and cancer.

3. Be able to distinguish the typical clinical presentation of a patient with strokes of the middle cerebral artery, anterior cerebral artery and posterior cerebral artery.

4. Identify and understand basic treatment of post-stroke complications including neglect, shoulder pain, depression, aphasia and dysphagia.

5.  Know the typical pattern of motor recovery after a stroke

6. Identify and understand basic treatment of common complications following acute spinal cord injury including hematologic, respiratory, urinary, gastrointestinal, and cardiovascular.

7. Differentiate between the following spinal cord syndromes: Brown-Sequard, Dorsal Column, Central Cord, and Anterior cord.

8. Understand the basic uses and limitations of nerve conduction studies and electromyography. 

9. Understand the epidemiology and risk factors related to traumatic brain injury.

10. Know and apply the Glascow Coma Scale and Rancho Los Amigos scale 

11. Identify and understand basic treatment of acquired brain injury complications including seizures, agitation, depression, and cognitive changes.


12. Independently research and succinctly present an overview of topic related to physical medicine and rehabilitation 

13. Identify a structured approach to review of an imaging study typically obtained by a physiatrist 

14. Create a shoulder or knee pain differential & perform appropriate physical exam 

15. Create a low back pain differential & perform appropriate physical exam 

16. Participate in ASIA exam (either with patient or via module) 

17. Observe a PT, OT or SLP session


18. Critically appraise a journal article related to PM&R topics

19. Participate in one community activity associated with PM&R or patients with disability

20. Complete a multimedia activity of their choosing related to PM&R 











































































































































































































































































































































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Main Course Topics :

Rehabilitation

Traumatic Brain Injury

Spinal Cord Injury

Stroke

Musculoskeletal Injuries

Electromyography (EMG)

 

Objectives:

Other Resources - Audiovisuals:

n/a

Other Resources - Computer resources:
n/a
Other Resources - Other :

Optional prosected cadaveric regional anatomy sessions with clinical correlation didactics (Sept-December).

Options for multimedia activities will be provided during orientation

Procedures:
n/a

SAMPLE WEEK

Monday:
8:00AM 12:00PM PMR Resident Clinic* (1/2 of residents) or inpatient/consult service
12:00PM 1:00PM Lunch
1:00PM 5:00PM Clinical Rounds and Floor Work
Tuesday:
8:00AM 12:00PM Clinical Rounds and Floor Work
12:00PM 1:00PM Lunch
1:00PM 3:00PM Clinical Rounds and Floor Work
3:00PM 5:00PM Therapy Rounds
Wednesday:
8:00AM 10:00AM Team Conference
10:00AM 12:00PM Clinical Rounds and Floor Work
12:00PM 1:00PM Lunch
1:00PM 5:00PM Outpatient Clinic
Thursday:
8:00AM 9:30AM PM&R Didactic Lectures
9:30AM 12:00PM Clinical Rounds and Floor Work
12:00PM 1:00PM Lunch
1:00PM 3:00PM Clinical Rounds and Floor Work
3:00PM 5:00PM Therapy Rounds
Friday:
8:00AM 9:00AM PM&R Grand Rounds (wks 1, 2, 3, 4)
9:00AM 10:30AM 9:15-10:15 Didactic Lecture
10:30AM 12:00PM Clinical Rounds and Floor Work
12:00PM 1:00PM Lunch
1:00PM 2:00PM Clinical Rounds and Floor Work
2:00PM 3:30PM Written Test (week 4)
SCHEDULE NOTE:

*Note: A typical four week rotation consists of two weeks on inpatient, one week on consults, and one week rotating through outpatient clinics.  Thus, the "weekly" schedule varies but can be expected to look similar to the provided schedule

Depending on the assigned service, "Clinical Rounds and Floor Work" may include attending therapy sessions with their assigned patients, observing nerve and motor point blocks, and spinal injections, observing electrodiagnostic studies, attending weekly team conferences, and travel to different practice sites with their assigned attending physician to do outpatient PM&R care.

ATTENDANCE AND ABSENCE POLICY

 

Session Attendance for M4 Students

  • Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
  • Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
  • AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
  • Excused Absences - The following will be considered excused absences:
    • Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
    • Personal illness, accident or a major catastrophic event
    • Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
  • Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
  • The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
  • The following items are explained in detail in the Medical Student Handbook:
    • Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work

See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.




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