OUTLINE FOR DESCRIPTION OF ROTATION

ROTATION: Neurology

PRECEPTOR: Dr. Sean Jochims or Dr. Darryl Prince

DURATION: One Month

1. GOALS/OBJECTIVES:

· to become familiar with diagnosis of various neurological disorders

· to learn how to utilize neurological studies effectively

· to develop a good clinical systematic neurological exam

· to learn when it is appropriate for a family physician to consult or refer a patient with neurological disease

· to refine skills at differential diagnosis of neurological illness/injury vs. psychiatric illness vs. psychological problems vs. malingering

2. EXPECTATIONS:

Attend Neuro Clinic with both Drs. Jochims and Prince. Work-up hospital admissions and consults that your preceptor has; round on these patients with him. Still attend educational conferences at WFPC.

3. PREPARATION/TEXTS:

· Neurology for the House Officer - quick, easy reference

· Early in the rotation, ask Dr. Jochims to describe his complete neurological exam so you can utilize this throughout the month.

· Review neurological exam in DeGowen and DeGowen prior to rotation

4. TYPICAL DAY/WEEK: (See detailed schedule below)

Either Dr. Jochims or Dr. Prince will be designated as the “primary preceptor” for the month. This means that he will be responsible for your evaluation, any related administrative duties, and serve as a liason with the residency. You will, however, work clinically with both Drs. Jochims and Prince. This will maximize teaching and exposure to different styles of practice. Outlined below are “typical” weekly schedules for both preceptors:

Dr. Jochims:

	Monday	Tuesday	Wednesday	Thursday	Friday
a.m.	8:00 – 5:00 Clinic	9:00 – 2:00		OFF	8:00 - 2:00 Clinic
p.m.			12:00 – 4:00 Clinic	OFF	Hospital Rounds

Dr. Prince:

	Monday	Tuesday	Wednesday	Thursday	Friday
a.m.	9:00 - 2:00 Clinic	EMGs (WMH)	Off	9:00 - 2:00 Clinic	9:00 - 2:00 Clinic
p.m.	Clinic	1:00 - 4:00 Clinic	Off	Hospital Rounds	Hospital Rounds

5. WORK-UPS/WRITE-UPS:

· Clinic notes - per preceptor’s guidance

· Admissions - write up and dictate the admission H&P

· Consults - see the patient, but do not write in the chart until seen by the preceptor; discuss the case with your preceptor then write it up while he dictates

· Progress notes - preceptors prefer that they see patient before you write in the chart; but you will be expected to write notes on the patients you follow

6. PROCEDURES:

· Try to perform as many LPs as possible.

· You will observe EMG's; 1 or 2 half-day sessions per week will be more than enough. These are preferably done at WMH or in the clinic (i.e. not Elmbrook). If possible, it is useful to examine these patients first, so that you can develop skills in determining the lesion/nerve root by exam and correlate it with the EMG findings.

· Consider observing &/or reviewing the results of EEGs with preceptor. Use this opportunity to discuss testing value (ie. Sensitivity/specificity/predictive values) as well as how EEGs may be useful in narrowing one’s differential diagnosis.

7. AVAILABLE EDUCATIONAL EXPERIENCES/CONFERENCES:

Standard. No special neuro conferences. But utilize the time between patients to ask questions, and your preceptor will respond with excellent teaching. If you are able to see patients before the preceptor, jot down your specific questions/ideas and this, too, will help maximize your educational experience. Your initiative goes a long way.

8. IMPACT OF OFFICE SCHEDULE, CONFERENCES, FAMILY PRACTICE MORNING ROUNDS:

Easily able to make all conferences, rounds, etc.

9. CALL AND SHARED CALL:

Available as “co-call” one weekend during the month. This should coincide with the call weekend of your preceptor, if possible. You will be responsible for hospital rounding with him on Saturday morning, and possibly being called in to help with consults/admissions. Let your preceptor know what other evenings you might be available for emergency consults. (This can be a great learning experience; they’ve agreed also, if you’re willing, to call you in only for the “good-learning” cases.)

10. VACATION/TIME OFF:

One week allowed. Schedule ahead of time and let your preceptor know when you begin the rotation.

11. STRENGTHS:

Some excellent one-on-one teaching. See many patients so the opportunity to see many different neurological diseases.

12. WEAKNESSES:

Time constraints between WFPC and other responsibilities often conflict with the neurologists’ schedules. Being flexible and working with both Drs. Jochims and Prince for hospital rounds and their office hours will help maximize the otherwise limited connections.

Created: 02/88

Approved by Faculty: 07/23/98

Reviewed and revised: 5/25/05 – SMK:lmc