Neurosurgery
TITLE:
ELECTIVE NEUROLOGICAL SURGERY -ICE
The student is introduced to the diagnosis and treatment, specifically surgical, of patients with neurological disorders. Each student will learn how to perform a neurological examination to assess a patient's neurological status. The student will be introduced to various diagnostic tests, radiographic and laboratory, and to operative procedures used in the treatment of specific neurological pathologies. At completion of the rotation the student will have an understanding and appreciation of neurosurgery as a surgical subspecialty.
PREREQUISITES:
Student must be in the fourth year of medical school. Students with a neurosurgery interest or an interest in a specialty that relates to neurosurgery is preferred, but not required.
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GENERAL INFORMATION
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE
STATUS:
Full-Time
OFFERED AS FULL-TIME AND PART-TIME:
NO
ALLOWS OVERLAP:
NO
DIRECTOR:
Sudhakar Vadivelu, DO
sudhakar.vadivelu@cchmc.org
513-803-9082
CCHMC
ADMINISTRATIVE SUPPORT PERSON:
Penny Schwab
penny.schwab@uc.edu
558-3903
MSB, 5213
SITE(S):
Cincinnati Childrens Hospital Medical Center
UCMC - University of Cincinnati Medical Center
ROTATIONS:
Rotation |
Dates |
Max |
1 |
05/06/2024 - 05/31/2024 |
1 |
2 |
06/03/2024 - 06/28/2024 |
1 |
3 |
07/01/2024 - 07/26/2024 |
1 |
4 |
07/29/2024 - 08/23/2024 |
1 |
5 |
08/26/2024 - 09/20/2024 |
1 |
6 |
09/23/2024 - 10/18/2024 |
1 |
7 |
10/21/2024 - 11/15/2024 |
1 |
8 |
11/18/2024 - 12/13/2024 |
1 |
9 |
12/16/2024 - 01/10/2025 |
1 |
10 |
01/13/2025 - 02/07/2025 |
1 |
11 |
02/10/2025 - 03/07/2025 |
1 |
12 |
03/10/2025 - 04/04/2025 |
1 |
13 |
04/07/2025 - 05/02/2025 |
1 |
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:
Monday - Friday, 5:40 a.m. - 4:00 p.m.
REPORT 1ST DAY:
Student should report to the neurosurgery resident office, UCMC Room 4108 at 5:45 AM.
INSTRUCTION
LEARNING ACTIVITIES:
- Case-Based Instruction/Learning
- Clinical Experience - Ambulatory
- Clinical Experience - Inpatient
- Clinical Experience - Inpatient (Nights)
- Conference
- Discussion-Small Group (Small Group (=12)
- Lecture
- Patient Presentation--Learner
- Peer Teaching
- Research
- Self-Directed Learning (Learners take initiative for their own learning; diagnosing needs; formulating goals; identifying resources; implementing appropriate activities; and evaluating outcomes.)
- Ward Rounds
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.
TEACHING:
25% |
Attending Physician |
25% |
Senior Resident |
25% |
Junior Resident |
25% |
Other Faculty |
ASSESSMENT:
The students are assessed by daily observation
in the outpatient, inpatient and O.R. setting by the resident and faculty. He/she will be assessed on the
following:
1. Perform a comprehensive neurological
examination.
2. Assess clinical level of neurologic dysfunction and propose etiologic
differential diagnosis.
3. Assess skull and spine x-ray films, CT and CTA scans, and MRI, MRA and
MRV scans.
4. Interpret relevant laboratory data including intracranial
pressure, mean arterial blood pressure, arterial blood gases, central venous
pressure, serum electrolytes and osmolality as they relate to proper management
of the neurologically impaired patient.
5. Differentiate between traumatic injury, metabolic disorders, congenital
anomalies, tumors and infections which result in neurologic dysfunction with
specific reference to their manner of presentation and methods of treatment.
6. Determine need for invasive studies, i.e. cerebral angiography.
7. Undertake initial management of the acutely impaired neurologic
patient by assessing the degree of neurologic dysfunction, assessing the
quality of the airway.
8. Undertake management of the acutely impaired neurologic patient in the
NSICU under the auspices of the neurocritical care faculty.
ASSESSMENT METHODS:
Multisource Assessment (a formal assessment of performance by supervisors, peers, patients, and coworkers)
Oral Patient Presentation
Participation
FINAL GRADE:
GRADE ASSIGNED BY:
Principle instructor
OBJECTIVES
Curricular Resources :
- Handbook of Neurosurgery by Mark Greenberg, MD.
-
The Department will provide each student with a loaner copy of this book while he/she is on the neurosurgery service. Other resources (computer programs, activities, videos, slides, etc.)
Instructional Methods:
This is a clinical rotation that uses the following instructional methods to teach the student:
Case-based instruction, hands on clinical experiences in the ambulatory and inpatient setting, weekly educational conferences/lectures, daily small discussion regarding patient's condition and daily plan with the resident team, attending daily rounds on the wards, presenting patients to the resident and faculty team, and self directed learning.
Knowledge/Skills:
1. Perform a comprehensive neurological examination.
2. Assess clinical level of neurologic dysfunction and propose etiologic differential diagnosis.
3. Assess skull and spine x-ray films, CT and CTA scans, and MRI, MRA and MRV scans.
4. Interpret relevant laboratory data including intracranial pressure, mean arterial blood pressure, arterial blood gases, central venous pressure, serum electrolytes and osmolality as they relate to proper management of the neurologically impaired patient.
5. Differentiate between traumatic injury, metabolic disorders, congenital anomalies, tumors and infections which result in neurologic dysfunction with specific reference to their manner of presentation and methods of treatment.
6. Determine need for invasive studies, i.e. cerebral angiography.
7. Undertake initial management of the acutely impaired neurologic patient by assessing the degree of neurologic dysfunction, assessing the quality of the airway.
8. Undertake management of the acutely impaired neurologic patient in the NSICU under the auspices of the neurocritical care faculty.
Main Course Topics :
- Neurological examination of patients.
-
Neurological assessment / management of trauma.
-
Neurological assessment / management of cervical and lumbar pathology.
-
Neurological assessment / management of intracranial lesions (tumors).
-
Neurological assessment / management of cerebrovascular disease.
-
Neurological assessment / management of pediatric patients.
-
Neurological assessment / management of patients in NSICU (ICE students only).
Procedures:
1. Perform a lumbar puncture for cerebrospinal fluid analysis and placement of lumbar drain.
2. Understand the indications for various invasive procedures including antiquated, angiography, intracranial pressure monitoring, and placement of arterial and central lines.
Remediation Plan:
If a student requires remediation, a faculty mentor will be provided to work one-on-one with the student.
SAMPLE WEEK
Monday:
6:00AM |
7:00AM |
Begin rotation with the residen team. UH Room 4108 |
7:30AM |
6:00PM |
Surgery / Faculty clinics |
Tuesday:
6:00AM |
7:30AM |
Rounds with the resident team |
7:30AM |
6:00PM |
Surgery / Faculty clinics |
Wednesday:
6:00AM |
7:00AM |
Rounds with the residents |
7:00AM |
8:00AM |
Journal Club / Case Conference |
8:00AM |
9:00AM |
Neurosurg GR |
10:30AM |
12:00PM |
Tumor Board Conference |
1:00PM |
6:00PM |
Surgery / Faculty clinics |
Thursday:
6:00AM |
7:30AM |
Rounds with the resident team |
7:30AM |
6:00PM |
Surgery / Faculty clinics |
Friday:
6:00AM |
7:30AM |
Rounds with the resident team |
7:30AM |
6:00PM |
Surgery / Faculty clinics |
SCHEDULE NOTE:
- Students should report daily (Monday through Friday) to the UCMC, Neurosurgery Resident Office, Room 4108, at 5:40 a.m. for morning rounds.
-
Students will spend 4 weeks on the UCMC Neurosurgery service.
-
Attend operative procedures whenever possible; however, do not exclude other responsibilities e.g. scheduled conferences, lectures and attending clinics.
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.