Neurology is primarily an outpatient specialty. There are many subspecialties of neurology with outpatient clinics that the student may attend. All students will attend two half-day clinics during the rotation, but students can also select a dedicated 2 week outpatient rotation. Many of these clinics are located at the Boston JP VA and the student’s experience is under the direction of Dr. David McCarthy. The student will have the opportunity to see both new and follow-up patients. It is an excellent opportunity to learn about the outpatient diagnosis and management of neurological problems and diagnostic work-up of symptoms of potential neurologic problems. The student will have the opportunity to take an initial or interim history, perform a focused neurologic examination and formulate a diagnostic and/or therapeutic plan. The student will also be involved in patient education.
For students who have not previously rotated at the VA, there is an orientation process that must be completed prior to the start of the outpatient rotation. This process involves fingerprinting, proof of PPD testing, computer training, and filling out several forms. This process must be completed at least one week prior to the start of the outpatient rotation.
The student will be given a schedule of outpatient clinics, based on their preferences, for the 1-2 week rotation.
Depending on the clinic, the student may see the patient independently or with a resident or attending. In both cases, you should write down the key elements of the history and physical examination, localize the lesion, propose a differential diagnosis as well as a diagnostic and/or therapeutic plan. When seeing a patient independently, you should then present the patient to the attending, who will then see the patient with you.
For each patient, you should formulate at least one learning issue to research independently. When seeing a patient independently, you should produce a written note including history, exam, assessment and recommendations. However, this note does not substitute for the resident or attending note.
A log of all patients seen, your learning issue for each patient, and 1 full H&P note per week on this rotation are to be turned in to Dr. David McCarthy at the completion of this portion of the clerkship rotation.
Call is Q4 until 10 pm with the neurology resident in the ED.