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We look forward to helping you build a foundation of knowledge and acumen in this
important field of medicine. You will function as an integral part of the medical team and
we hope that you will take full advantage of this opportunity to make an important
contribution to your patients' care and foster their well-being.
This clerkship is a required four-week rotation, offered during the junior/senior
continuum. Completion of the Medicine Part I clerkship is a prerequisite. Please read this
package carefully. It contains important information that should help you get the most
from the clerkship.
The clerkship objectives are aligned with the *Keck School of Medicine objectives.
During the Neurology Clerkship, the students will be able to:
*Medical Knowledge: Demonstrate knowledge of established and evolving biomedical,
clinical, epidemiological, and social-behavioral sciences, and apply this knowledge to
patient care.
Neurology Clerkship
Demonstrate basic knowledge, based on patient care as well as study, of selected SPP or
“must see” neurologic conditions. For neurology those are:
• Dementia
• Demyelinating disease: MS or GBS
• Disorders of Sleep
• Headache
• Movement Disorders: PD or other
• Seizure
• Stroke
• Myasthenia Gravis (DVD)

*Patient Care: Provide patient care that is compassionate, appropriate, and effective for
the treatment of health problems and the promotion of health including demonstrating
basic clinical skills of history taking and physical examination; appropriate usage and
interpretation of clinical procedures and diagnostic tests; and clinical problem solving,
patient care activities, patient education, and the ability to respond to dynamic clinical

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including an assessment and plan. justice. and health care team member: s using effective nonverbal. Identify alternatives in difficult ethical choices. Act with altruism. Write admission and daily orders for a hospitalized patient *Ethical Judgment: Recognize the ethical dimensions of medical practice and health policy. assessment and plan using a format appropriate to the clinical situation. physical examination. • Demonstrate skill in performing the neurologic examination. honor and integrity in professional and personal life. Demonstrate understanding of ethical principles required for provision of the highest caliber clinical practice as well as those that must accompany research involving human participants. and writing skills. • Demonstrate the ability to deliver timely and appropriate guidance to the patient with a neurodegenerative disorder *Interpersonal and Communication Skills: Listen and communicate clearly with patients. non-malfeasance and respect for autonomy) • Identify alternatives in difficult ethical choices and analyze conflicting considerations. and community at large. • Demonstrate clinical problem solving and the ability to generate an appropriate differential diagnosis. well-organized verbal summary of the patient's history and physical examination findings. clinical setting. families. Page 2 . Collaborate effectively with others in the classroom. Neurology Clerkship • Demonstrate appropriate. Neurology Clerkship • Describe the practical applications of the major ethical principles (i. • Demonstrate skill in patient care activities in both the inpatient and outpatient setting. verbal. analyze conflicting considerations. beneficence.Neurology Clerkship • Demonstrate basic clinical skills of history taking and physical examination in the setting of neurologic disease. timely and compassionate verbal and non-verbal communication skills with patients and their families and visitors • Demonstrate effective oral and written communication with the health care team • Present (verbally) a complete. Demonstrate adherence to ethical principles. • Demonstrate appropriate usage and interpretation of imaging and other diagnostic tests. • Document the history. and execute a course of action that takes into account the ethical complexities. particularly in the setting of coma and brain death *Professionalism: Demonstrate a commitment to excellence in carrying out professional responsibilities.e.

colleagues and staff. Act in a respectful manner toward patients. health care quality. privacy. Neurology Clerkship • Describe and demonstrate behaviors that respect the patient's modesty. and personal responsibility. • Demonstrate behaviors and attitudes that promote the best interest of patients and families and show flexibility in meeting the needs of the patient and family. and present a communitybased project. Identify strengths. issues in the health care system including lifestyle issues as well as those issues enumerated in the KSOM objectives Page 3 . and foster the development of others. deficiencies. implement. Neurology Clerkship • Demonstrate a positive attitude and regard for the educational experience by demonstrating intellectual curiosity. *Community and Systems-Based Practice: Demonstrate knowledge of the social and community contexts of health care and respond effectively to the many factors that influence health. Continuously improve his/her academic performance and patient care based on constant self-evaluation and life-long learning. and disability. • Articulate and demonstrate an understanding of the influence of family. Discuss issues in the health care system including health disparities. • Demonstrate professional interaction with a patient in the setting of the OSCE examination. in presentations and write-ups. and limits in his/her knowledge and expertise. Set learning and improvement goals. Model good leadership in interactions with others. and patient safety. health policy. ethnic. population-based care. • Demonstrate a commitment to the highest standards of patient advocacy and care. • Demonstrate maturity in soliciting. behaviors and lifestyles. and socioeconomic influences. • Actively seek to elicit and incorporate the patient's and family's attitudes into the health care plan. • Demonstrate collegiality and respect for all members of the health care team as well as to the broader community *Lifelong Learning and Experience-Based Improvement: Identify and perform appropriate learning activities. advocacy. honesty.Respect patients’ rights and wishes. community and society on the patient in health and disease • Discuss. Effectively develop. initiative. accepting. faculty. and acting on feedback. Neurology Clerkship • Demonstrate respect for patient and family attitudes. paying particular attention to cultural. Incorporate formative feedback and evaluation into daily practice. and confidentiality. disease.

• Document resources appropriately • Attend Grand Rounds and participate in formal case discussion sessions . There is a monthly schedule of optional conferences on the department site: http://www.*Scholarship: Conduct a focused literature search. Conduct and present a research project. and discharge summaries. progress notes. You are training for a future in which you will be responsible for keeping up to date. CLERKSHIP STRUCTURE: Schedule: Each student receives a personal schedule. as well as with patients and their families. Depending on your location. the schedule assigned to you will include most or all of the following: Morning report Inpatient activity time Attending rounds Grand rounds Faculty didactic lectures (both live and via the internet) Outpatient clinic time Evening and weekend call It is important to remember that an attending or resident must countersign all histories and physicals. Effectively communicate research findings with The Neurology rotation is designed with relatively little call or weekend work in order to allow you to read. LEARNING ACTIVITIES: Page 4 .usc. Neurology Clerkship • Write and submit a case-based patient write up that demonstrates an ability to acquire and organize data. Click on “Grand Rounds and Conferences” on the first screen IV. Develop appropriate research questions for a scholarly project. III. the ability to seek assistance when necessary. and to frame the assessment and plan with reference to the most pertinent literature. It also requires an awareness of personal values and priorities. This takes discipline and planning. and to adapt to changing situations. orders. critically appraise the medical literature and apply best evidence to patient health problems. Describe how clinical research studies and clinical translational research are applied to patient care.

All new admissions and established patients with new problems will be reviewed at the bedside by your attending faculty. B. house officers. number of your patient. D.Anyone who does not feel comfortable with a procedure should express their discomfort. Please refer to the schedule for topics and times. Depending on the number of students in the rotation. E. students are assigned to the following locations: LAC+USC Medical Center USC University Hospital Rancho Los Amigos Hospital Childrens Hospital of Los Angeles Kaiser Sunset or Baldwin Park locations Huntington Memorial Hospital in Pasadena Private neurology practice settings Site-specific information will be provided to students who will be off campus.A. or medical students may give didactic presentations of medical topics relevant to the team’s activities. Work Rounds .. We use a lottery if there is a mismatch between requests and available placements.The entire team will see the team’s established patients. which is determined via student preference whenever possible.F. and an explanation of any procedures or diagnostic studies you wish to be performed in your absence. Work rounds provide an opportunity to determine and implement the plans you wish to carry out for the day: C. Zilkha auditorium.m. You should communicate directly with this physician whether in person or by phone. a brief summary of the medical problems and present therapy. Procedures .It is imperative that you sign out your patients to the physician responsible for the care of your patients when you are outside the hospital. Your resident is expected to instruct and supervise you in any and all procedures you may need to learn. Attendings. Teaching Sessions . A sign out consists of the name and P. A clinically based conference where local experts or guest experts or senior residents-under the guidance of faculty mentors--present interesting cases and didactic overviews.Work Rounds . Page 5 . G. Please do your sign outs in conjunction with your residents. F. Inpatient Neurology Overview Students are assigned to a primary location. You should present your patients and discuss your findings with your resident and/or attending. Faculty Mentor Sessions – Clinical cases are discussed with the medical students during regularly scheduled Tuesday morning sessions. Neurology Grand Rounds – Tuesdays at 9:00 a. Sign Outs .

m. It is an excellent reference for anatomy.m. If there are no new admissions. Outpatient Clinic Overview . Jose Biller: video clips of actual patients with various diagnoses. Be sure to remember to ask the patient if you may examine him/her. regardless of location assignment. Questions and comments are expected. I.H. Students at Rancho Los Amigos Medical Center. and from 8 a. You are expected to remain on duty from 5 p. 7e: http://www. This book is unsurpassed in clarity. CURRICULUM and READING MATERIALS: Faculty Didactic Sessions . Remember that your supervising resident must countersign all of your work. The required textbook is available at USC Medical Bookstore and online. This experience will help you to see cases on your “must see” list that you might otherwise not encounter. concise textbook. to 10 p. Sessions are designed to invite student participation in a problem-solving approach. Clinical Neurology.m. and case discussions. Aminoff MJ.accessmedicine.Exposure to outpatient neurology and to the department’s list of “must see” cases is essential for all students. The clerkship has videotapes of our faculty and/or PowerPoint presentations for all required and some additional topics. MD. These are on the MedWeb site under Education Resources for Neurology. localization and the neurologic exam and is on reserve at Norris library.All students. The call schedule for students at CHLA will be determined in collaboration with the attending physician. system-oriented.aspx?aID=5147390 This is an excellent. Simon RP. Please check your lecture schedule.m. PhD. until 1 p. must attend all required lectures. at Children’s Hospital and at the Huntington and Kaiser hospitals will go to the outpatient clinics at these facilities (refer to your schedule). VI. Grand Rounds. Inpatient Call Students are assigned to inpatient call. Refer to your schedule to find out which days you are scheduled for clinic as well as the time and location. Not required but highly recommended is "Neuroanatomy through Clinical Cases" by Hal Blumenfeld. Please see your schedule handout for a complete list of topics. the student should consult with the resident on call to choose patients to Greenberg DA. when you have weekend call. Students at the LAC+USC Medical Center are assigned to specific faculty members on specific days at the USC Health Care Consultation Center and at the LAC+USC Outpatient Clinic. Page 6 . It is expected that you will assume care of one to two patients each time you are on call. Also on reserve: Practical Neurology DVD Review. when you are on weekday call.

aan. Includes MRIs of normal human brains and of patients with a variety of different types of pathology. some functional systems). histological Additional web sites with a great deal of helpful information are listed below: http://www.Harvard.html A particularly well done atlas of brainstem. basal ganglia and immediately adjacent structures pairing unadorned histological sections with color labeled sections demonstration the location and extent of various structures and pathways.wisc. These can be found at www. and movies that show complex structural relationships http://www. name the lesion labs. Brain and Behavior Course at the University of Rochester School of Medicine.over 100 different species (including humans) representing 17 mammalian particularly helpful in gaining 3D conceptualizations. Also contains a tutorial on vasculature http://www. Links to many other web sites http://www9. This laboratory exercise includes 12 gross and microscopic neuropathological specimens that are correlated with 74 CT or MR Page 7 .com or at www. some correlated with figures from this sectioned and stained brains of mammals .edu/brain/ One of the world's largest collections of well-preserved.You are encouraged to use various other resources available on line (see list of sites below) and at Norris The website of neuroscience/neuropathology websites http://www.html Interactive atlases of the human brain. movies of selected anatomic The University of Rochester's Neuropathology and Neuroimaging Laboratory. including gross Pictorial tours of selected topics (most anatomical. Web Sites: The AAN has issued practice parameters for a number of common neurologic entities. computer-aided reconstructions.washington.dote. which is a web-based collection of 202 images for the a limited MRI based atlas http://www. correlated with single photon emission computed tomography (SPECT) images http://www. thalamus.html MRI atlas of the human brain. with your choice labeled or unlabelled.ufl.medinfo.

B. Specifically with regard to the typed write-ups. Each write up should include the following elements: 1) history of present illness organized chronologically. 3) a comprehensive physical examination with detail pertinent to the patient’s problem. each student will submit a patient writeup for review by the faculty attending.neuroexam. Patient Write Up . omission. below). The preceptor/mentor reviews clinical cases. C. physical. Your analysis of the data and justification for your Page 8 .images. Discussion of the diagnosis and management should reflect your use of Ovid or other resources and reflect a systematic review of current A collection of video clips demonstrating how to do each componet of the neurologic examination http://cnsnewsonline. differential diagnosis. or extraneous information. SH. Fourth year students should focus their efforts on providing a detailed and sophisticated assessment and plan. Third year students should focus their efforts on demonstrating their ability to acquire and organize data. without repetition.. Faculty Mentor Sessions . or extraneous information. and the full write-up should be emailed to the Medical Student Educator. The write-up is due on the third Friday of the rotation. 4) a listing of relevant laboratory information and diagnostic studies.Faculty serve as the preceptors and mentors for the medical students. and the neuroimages also include a clinical vignette http://www. and the students’ history taking. Observed Neuro Exam . physical examination. ADDITIONAL REQUIREMENTS: A. FH. It is the medical student’s responsibility to solicit an evaluation of his/her patient write-up (see C below) during the rotation. 2) other relevant historical information (i. ROS) without repetition. presentation and charting skills.e. Each of these images is accompanied by a description. Please also submit a copy directly to your attending.During the clerkship. assessment and management. Be sure to list references.The faculty attending will observe each student performing neurologic examinations during the clinical experience . An excerpt should be entered into the Clinical Experience Portfolio (see D. special topics in Neurology. The problem list should also be detailed and comprehensive and include concise assessments and plans for each problem identified. (5) a discussion of the likely location of the lesion causing the patient’s complaint. The historical. Meds. Clinical reviews and updates in Neurology and Psychiatry VIII. and laboratory information should be detailed and comprehensive.

the clerkship will provide an alternative experience. Demyelinating disease: MS or GBS 4. Examples may be: review articles. physical examination. Dementia 2. the Clinical Experience Portfolio allows students and faculty to track learners’ experiences with the cases of the Student Practice Profile. and to assure that patient encounters are equivalent across sites. web-based educational programs and interactive links. The rationale for the timely completion of patient encounters is twofold. Movement Disorders: PD or other 5. During the clerkship. The data that are collected and aggregated through the Clinical Experience Portfolio provide a representation of the patient population and clinical sites. diagnostic evaluation.conclusions and plans should be clearly evident. assessment and plan. Seizure 6. It may be that you are provided with an actual patient encounter at another site. or you may be asked to Page 9 . Headache 3.usc. Patient Encounters are brief summaries of the student's interaction with assigned patients. patient encounters and clerkship evaluations are accessed through the system. In addition. Note: In addition. physiology). class schedules. you will be required to enter an encounter for at least one each of the Student Practice Profile (SPP) cases. Disorders of Sleep 8. also known as “MUST SEE” cases.. D.g. Medical Student Documentation of Patient Encounters using the Clinical Experience Portfolio on MyMedWeb. current trends. In addition to providing the student with a readily accessible patient profile. please limit the identifiable patient information to initials and the last four digits of the PF number. and allows the faculty to evaluate and revise the clinical experience as it relates to the core curriculum objectives and competencies. You can focus your search on any aspect of the case that is of interest to you. ALS (DVD case) We hope that you will have an actual patient experience for each of the MUST SEE cases. The patient encounter format is concise and allows the student to describe relevant patient findings reflected through the history. In addition to course materials. complexity and breadth of clinical experiences the student is afforded during the clerkship. basic science-related issues (e. Stroke 7. Myasthenia gravis (DVD case) 9. it enables the faculty to review the number. The “MUST SEE” cases for the Neurology Clerkship are: "MyMedWeb" is a highly specialized information system used throughout the medical school curriculum. etc. If you do not encounter an actual patient with a particular diagnosis or symptom.

“no uncompleted evaluations. FINAL EXAMINATIONS: A. The first evaluation will take place by the second week of the rotation. Page 10 . print the myMedWeb page stating. Please use the following formula to enter the patient’s alias: Patient’s last name is Johnson Patient’s pf# is 1234567 Patients’s alias is son567 Note: Students must have all of their patient encounters completed on myMedWeb no later than 5pm the 3rd Friday of the rotation. etc. Clinical Sciences. You will then document this alternative encounter in the Clinical Experience Portfolio according to the instructions given to you by the MSE or Clerkship Director. It includes a standardized patient experience as well as a cognitive component. Subject Exam. but also to the Associate Dean of Student Affairs or the Assistant Dean of Curriculum and Student Affairs. a “virtual” (paper or webbased) case. All clerkship evaluations (program. G. Practice Neuro Exam: On two occasions each student will be evaluated performing a neurologic exam. To verify completion of your evaluations. OSCE An OSCE session is scheduled for each student during the third week of the rotation. This will be given on the last Friday of the rotation. which must be submitted to the Medical Student Educator no later than the third Tuesday of the rotation.” F. residents) must be entered into myMedWeb no later than 5pm the final Thursday of the rotation. The Clerkship Director or Medical Student Educator will review the patient encounters and determine if the submissions are adequate. attendings. The OSCE follows Keck’s established protocol for an OSCE session. Missing this exam means that you must explain your absence not only to the clerkship. a problem-based learning case. You may also wish to view the Introduction to Clinical Experience Portfolio Instructional Video located at the same site. Feedback will be recorded on the Mid-rotation Feedback Form. For complete instructions on entering patient encounters in the Clinical Experience Portfolio..complete a simulated or alternative experience. listed under Clerkship Learning Resources. please refer to the document entitled “Clinical Experience Portfolio User Instructions” on myMedWeb. 25% of the grade The written final examination is the nationally standardized “Subject Exam” covering neurology and developed by the National Board of Medical Examiners (NBME). VII. a lecture or case discussion.g. e.

colleagues and their supervisors). and to localize and present your results with a differential diagnosis. 50% 1. See general objectives. differential diagnosis. Clinical Experience Portfolio and Patient Write-up: 10% Each student is expected to enter an encounter for each “must see” diagnosis. B. Patient Care 5. Each student will perform a practice neurologic examination for his/her resident or attending. The grade will be reflected in your attending’s myMedWeb evaluation of your clinical performance. Practical Exam: You will be evaluated performing a neurologic exam by your attending. feedback is reflected in the mid-rotation feedback.e. Discussion of the diagnosis and management should reflect your use of resources. Medical Knowledge 2. and management. The write-up is a much more detailed encounter that is also entered into the CEP and should include history. This evaluation will take place during the last week of the rotation at a time to be arranged with your attending. Student-Patient Interaction: This is an all or none grade (i. localization of the lesion. which is in use across the clerkships.B. B. assessment. Using Basic Science in the Practice of Medicine 4. so be sure to include a list references. Initiative and Interest Skill at performing a neurologic exam C. X. Interpersonal and Communication Skills 3. and Prevention 6. will be filled out by the student’s attending and discussed with the student no later than day 11 of the clerkship. This will test your ability to perform an exam correctly. Final evaluations: In addition to the final exams (see above) there are 6 components to each individual’s grade: A. The mid-rotation evaluation. Management. students with marginal performance may pass or fail the clerkship depending on their interaction with patients. paramedical staff. Professionalism 8. Diagnosis. The CEP write-up is due by Friday afternoon of the third week of your clerkship and should be Page 11 . These entries will be reviewed for completeness. EVALUATION AND GRADING: Please see the KSOM Grading Policy that is posted on MyMedWeb Mid-rotation evaluations and feedback: A. Overall clinical skills and attitudes as reflected in performance on the clinical evaluation. physical exam with emphasis on neurological examination. Problem Solving 7.

A sign in sheet will be available at each session. Page 12 . as assigned In summary. your grade will be based on: Clinical skills and performance (including the neuro exam) 50% Subject exam (4th Friday) 25% OSCE (3rd Wednesday) 10% Clinical Experience Portfolio & write-up (due 3rd Friday) 10% Case Sessions: attendance 5% Mid rotation feedback required IMPORTANT REMINDER: YOU MUST COMPLETE YOUR EVALUATION OF THE CLERKSHIP BEFORE YOU SIT FOR THE FINAL EXAM. It will serve as part of your clinical portfolio evaluation. Questions and comments are expected. and copied electronically to the Medical Student Educator. OSCE 10% Students will be evaluated during a standardized patient encounter and will complete a cognitive assessment that relates to the patient situation as well as other SPP cases.submitted to your attending. The case discussion sessions are designed to invite student participation in a problem-solving approach. 5% Attendance at lecture and discussion sessions is mandatory for all students. Attendance and participation in lectures. E. Pass/Fail Exercises: Supplemental exercises. F. either electronically or in hard copy. D. discussions.

Attendance: Each student is required to attend all classroom sessions and to be at his/her assigned clinical site on designated days for approximately 8 hours. Honors: For those students whose final composite score is greater than or equal to 92% B. In the event that the schedule at a clinical site must be changed because of unusual circumstances. for a minimum of 40 hours over five days per week. the medical student educator should be notified and an alternate clinic experience will be arranged. any unprofessional behavior as outlined in the Student Handbook may result in a grade of Fail. Incomplete: Not a final grade. Fail: Students who have a cumulative score less than 69. ILLNESSES AND ABSENCES A. Preceptors are not allowed to give students a day off for study or for other reasons. In addition. Pass: For those students whose final composite score is greater than or equal to 7079%. All absences MUST be arranged through the clerkship office. please do not ask them to do so. The grading is based on a compensatory method: The following grades are possible: A. Please note: A grade of “Fail” will remain on the student’s transcript and become a part of the student’s permanent record. DAYS OFF. F.FINAL GRADE DISTRIBUTION AND POLICY: Unexcused absences from a clerkship may be grounds for failing and/or disciplinary action. C. XI. D.5%. but a designation that is used if a student has been excused from meeting a clerkship deadline. Monday – Friday.” Note: The narrative portion of the final clerkship evaluation will indicate any of the above requirements not met. Page 13 . High Pass: For those students whose final composite score is greater than or equal to 80-92%. Any unexcused absence makes the student ineligible to earn a final grade of “Honors. DUTY HOURS. Remediation of Fail Grades: All or part of the clerkship must be repeated at the discretion of the clerkship director and depending upon which components of the clerkship was/were failed. if a student fails to notify staff or faculty in the clerkship office if they are unable to attend lecture may preclude them from earning a final grade of “Honors.” and may be grounds for failure regardless of final exam or clinical performance evaluations. Additionally. E.

and scheduled academic activities such as conferences. It is essential that we reward their trust by doing our utmost to provide the best care. excused or unexcused. as described in Section V. Given the time constraints. XII. Please remember that all patients are equally deserving of your respect and empathy. Your patients will have diverse ethnic and socioeconomic backgrounds. Your diligence will make an important contribution to your patient's well being. B. no more than 3 days of excused absences (to include official holidays) can be anticipated during the rotation. Page 14 . Absence: Neurology is a core clerkship. administrative duties related to patient care. time spent in-house during call. • Duty hours must be limited to 80 hours/week averaged over a four week period. Please take this opportunity not only to provide a work-up and treatment. the provision for transfer of care. PROFESSIONAL RESPONSIBILITIES AND BEHAVIOR: Also see MedWeb for information about Dress Code Appeal Process Absence Request Form ICM Checklist/ Neuro Exam The medical student plays an important role in patient care. Anticipated absences must be approved in advance by the Clerkship Director or Medical Student Educator and the required Student Absence Request Form must be submitted along with supportive documentation. you will have very limited time off for residency interviews so please plan accordingly. patient care.KSOM policy states that: • Duty hours are defined as all clinical + academic activities. The patients in teaching hospitals provide us with remarkable learning opportunities. All absences. i. One day is defined as one continuous 24 hour period. In order to insure adequate clinical exposure. Duty hours do not include reading/preparation time spent away from the duty site. At least two call experiences are required. must be made up before a passing grade can be assigned. . but to explore and provide for the psychological and social needs of your patients.e. • Students must be provided with one day in seven free from all educational and clinical responsibilities averaged over the course of the clerkship.

Select “Educational Resources” from the drop-down menu Then “Lecture Webcasts” 4. medicine 5. 2. That brings you to the mediasite login page log in: a. and for reference throughout the rotation. At the “Clerkship General Learning Resources” screen. please visit the clerkship's Video Library where you'll find all of the lectures. Log on to myMedWeb in the usual manner. neurology b. 1. Then you can select from the library. PowerPoint slides are also available online under clerkship resources. Page 15 . click on Neurology 3.Appendix For read-ahead.