UC COM :: M3/M4 Course Syllabi

M3/M4 Course Offerings

2024-2025 M3/M4 Course Syllabi

Neurology

COURSE NUMBER:

26940472

TITLE:

ACTING INTERNSHIP - NEUROLOGY
The student will function as the primary caregiver in the inpatient setting as part of a team of residents and faculty. The student will complete admission orders, history and physicals, diagnosis, follow-up care, and discharge planning under the supervision of attending faculty and senior residents. Will attend neurology resident conferences.

PREREQUISITES:

26940373 (NEUROSCIENCE CORE CLKSP), 26940373 (NEUROSCIENCE CORE CLKSP)

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GENERAL INFORMATION

COURSE YEAR:

CREDIT HOURS:

CREDIT WEEKS:

DOMESTIC VISITING:

INTERNATIONAL VISITING:

GRADED:

Honors/High Pass/Pass/Fail

COURSE QUALIFICATIONS:

STATUS:

Full-Time
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: NO

COURSE LENGTH:

4 wks

DIRECTOR:

Joseph LaPorta
laportjh@ucmail.uc.edu
513-558-0156
Stetson

ADMINISTRATIVE SUPPORT PERSON:

Angela Bustamante
bustamam@uc.edu
513-558-1754
MSB, 7103A

SITE(S):

UCMC - NEURO AI

MAX ENROLL:

ROTATIONS:

Rotation	Dates	Max
1	05/06/2024 - 05/31/2024	2
2	06/03/2024 - 06/28/2024	2
3	07/01/2024 - 07/26/2024	2
4	07/29/2024 - 08/23/2024	2
5	08/26/2024 - 09/20/2024	2
6	09/23/2024 - 10/18/2024	2
7	10/21/2024 - 11/15/2024	2
8	11/18/2024 - 12/13/2024	2
9	12/16/2024 - 01/10/2025	2
10	01/13/2025 - 02/07/2025	2
11	02/10/2025 - 03/07/2025	2
12	03/10/2025 - 04/04/2025	2
13	04/07/2025 - 05/02/2025	0

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:

7 am to 5 pm

REPORT 1^ST DAY:

You will receive an email with detailed information prior to the elective.

INSTRUCTION

LEARNING ACTIVITIES:

Case-Based Instruction/Learning
Clinical Experience - Inpatient
Clinical Experience - Inpatient (Nights)
Conference
Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
Discussion-Small Group (Small Group (=12)
Independent Learning (Instructor-guided learning activities to be performed by the learner outside of formal educational settings.)
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:

45%	Attending Physician
50%	Senior Resident
5%	Other Faculty

FEEDBACK:

Precepting Senior Resident

ASSESSMENT:

While on clinical rounds, students present patients for analysis of differential diagnosis and management strategies.
Attendings and senior residents assess the student’s follow-through on patient management plans, direct interactions with patients and teammates, work ethic and professionalism.
Students complete a quality improvement project and present this in small group.
Senior residents will score the student's self-directed clinical research question which will also be presented to the team.
Formative assessments are ongoing during all contacts between students, and faculty and residents. More formal scheduled formative feedback occurs at the mid-point of the clerkship.

ASSESSMENT METHODS:
Clinical Performance Rating/Checklist
Multisource Assessment (a formal assessment of performance by supervisors, peers, patients, and coworkers)
Narrative Assessment
Oral Patient Presentation
Participation
Self-Assessment

FINAL GRADE:

GRADE ASSIGNED BY: Principle instructor

OBJECTIVES

Curricular Resources :

Neurology for the Non-Neurologist YouTube Series
UpToDate
Primary literature

Instructional Methods:

Case-Based Instruction/Learning
Clinical Experience - Inpatient
Demonstration
Independent Learning
Reflection
Self-Directed Learning
Guided Quality Improvement Project
Attending resident level lectures and Grand Rounds
Rounds

Knowledge/Skills:

The acting intern will be able to:

Patient Care

1. Elicit focused and complete history and physical, acquiring the relevant information that is appropriate for the patient encounter.

2. Obtain supplemental historical information from sources other than the patient.

3. Perform a comprehensive neurologic physical examination in a logical, organized, and thorough manner.

4. Order laboratory test based upon the differential diagnosis for a given patient that is appropriate for the student’s level of training.

5. Implement and follow thru on treatment plans for the patients’ main diagnosis at an appropriate level for the student’s training.

6. Discharge patients in a safe manner, demonstrating the importance of continuity of care to the primary care physician.

7. Interpret laboratory data, EKGs, and radiology films at the appropriate level for the student’s training.

Medical Knowledge

1. Formulate the neurologic differential diagnosis based upon patients signs and symptoms.

2. Use basic neuro-anatomy as the foundation for localization in neurologic disease.

3. Understand the systems of practice for diagnostic modalities, such as lumbar puncture, EEG and MRI.

4. Create and use a list of commonly used medications for the care of stroke, epilepsy, neuromuscular emergencies, and neuro-behavioral issues.

Interpersonal Communication

1. Communicate with patients and families to explain the diagnosis, evaluation, and treatment plan for the admitting problem.

2. Play an active role in discussions with patients and families on goals of care.

3. Use the electronic medical record to document H&Ps, daily notes, and discharge summaries in a detailed, concise, and timely manner.

4. Explain discharge medications, follow-up, and other relevant information to patients and families.

5. Present concise, organized H&Ps and daily notes and modifying the language used based upon whether the presentation is during patient centered rounds vs table rounds.

6. Communicate effectively with consulting physicians in the care of neurologic disease.

Professionalism

1. Recognize the indications for contacting an upper level resident or attending.

2. Dress in professional attire with ID badge always within sight.

3. Arrive at scheduled events on time and prepared.

4. Treat all patients, staff, students, residents, and faculty with dignity and respect.

System Based Practice

1. Participate in the team based approach to patient care, playing an active role in the team.

2. Document and communicate clear discharge instructions for the receiving primary care physician.

3. Actively involve a multidisciplinary approach to patient care, utilizing physical therapy, occupational therapy, nursing, speech therapy, nutrition, respiratory therapy, case management, and social work services.

4. Understand resource utilization and begin to practice efficient and cost effective medical decision making.

Practice Based Learning and Improvement

1. Establish a pattern of lifelong learning by reading on every patient.

2. Critically analyze the medical literature using the principles of evidence-based medicine and biostatistics to apply the best medical evidence to the care of the patient.

3. Exhibits an investigatory approach to knowledge deficits: Generates questions and utilizes available resources to answer the questions.

4. Responds to feedback provided by faculty and senior residents.

Main Course Topics :

1. Cerebrovascular Disease: Ischemic Stroke, Intracerebral Hemorrhage, Subarachnoid Hemorrhage

2. Epilepsy and Seizures

3. Neuromuscular Emergencies: Guillain Barre, Myasthenia Gravis, ALS

4. Encephalopathies, Delirium, Dementia

5. Neuro-Immunology: Multiple Sclerosis, NMO, Auto Immune Encephalitis

6. Neuro-Oncology: Glioblastoma, Astrocytoma

7. Parkinsonism

8. Neuro-Infectious Disease: Meningitis, Encephalitis

9. Neuro-Radiology

10. Neuro-Anatomy

11. Neuro-Pharmacology

Procedures:

N/A

Remediation Plan:

Failure to acheive a passing grade will require student to repeat the clerkship.

SAMPLE WEEK

Monday:

7:00AM	8:00AM	PreRounding
8:00AM	9:00AM	Team Rounds
9:00AM	10:00AM	Collaborative Rounds
10:00AM	12:00PM	Patient Care
12:00PM	1:00PM	Resident Lecture
1:00PM	5:00PM	Patient Care
5:00PM	6:00PM	Sign Out and Transition of Care

Tuesday:

7:00AM	8:00AM	PreRounding
8:00AM	9:00AM	Team Rounds
9:00AM	10:00AM	Collaborative Rounds
10:00AM	12:00PM	Patient Care
12:00PM	1:00PM	Resident Lecture
1:00PM	6:00PM	Long Call until 8pm

Wednesday:

7:00AM	8:00AM	PreRounding
8:00AM	9:00AM	Team Rounds
9:00AM	10:00AM	Collaborative Rounds
10:00AM	12:00PM	Patient Care
12:00PM	1:00PM	Grand Rounds
1:00PM	5:00PM	Patient Care
5:00PM	6:00PM	Sign Out and Transition of Care

Thursday:

7:00AM	8:00AM	PreRounding
8:00AM	9:00AM	Team Rounds
9:00AM	10:00AM	Collaborative Rounds
10:00AM	12:00PM	Patient Care
12:00PM	1:00PM	Resident Lecture
1:00PM	5:00PM	Patient Care
5:00PM	6:00PM	Sign Out and Transition of Care

Friday:

7:00AM	8:00AM	PreRounding
8:00AM	9:00AM	Team Rounds
9:00AM	10:00AM	Collaborative Rounds
10:00AM	12:00PM	Patient Care
12:00PM	1:00PM	Resident Lecture
1:00PM	5:00PM	Patient Care
5:00PM	6:00PM	Sign Out and Transition of Care

SCHEDULE NOTE:

Work hours will be in accordance with those policies set forth by the ACGME for PGY-1 interns (no shift greater than 16 hours, 10 hours in between shifts, work no more than 80 hours per week, averaged over a 4 week rotation, and 1 in 7 days off averaged over a 4 week rotation and no more than 12 days between days off).Students will be on call from 7am-8pm on a Q5 schedule, independent of the junior resident's schedule.

It is the responsibility of each student to be in communication with the attending and senior resident regarding duty hours. In the event that student approaches the maximum duty hour limit (i.e for shift, for week), the attending and senior resident must be notified so appropriate corrective measures may be applied.

Students will be expected to work night shift 5 consecutive nights in a single week.

Students will have all weekends off with the exception of their dedicated nightshift week.

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.