Description of rotation:
At the Bronx VA, the Consult Service consists of one Neurology attending, one PGY-3 neurology resident, one PGY-2 neurology resident, one PGY-1 internal medicine resident and one to three medical students. Teaching rounds are held five days a week. The neurology resident is responsible for seeing and examining all patients on whom a consultation is requested and writing a thorough consult note. The resident then presents the case to the attending and together they decide on recommendations. The resident is also primarily responsible for following up diagnostic and therapeutic recommendations, communicating with the primary teams and teaching the medical students. The degree of patient-care involvement of the intern rotator depends on their level of clinical neurology experience, and ranges from learning and observation, to information-gathering, to seeing and examining patients with supervision. The PGY-3 neurology resident has a supervisory role over the PGY-2 resident and the rest of the team.
Goals
To teach the residents to provide comprehensive and effective consultative neurological care to inpatients at the Bronx VA Hospital
To foster the understanding of the VA healthcare delivery system, and to teach residents to work effectively in this environment.
To teach residents to perform consultative duties and communicate collaboratively with members of other healthcare teams in the care of patients with neurologic complaints.
Objectives
The resident will
Gather essential and accurate information on all patients seen in consultation in order to develop and carry out a diagnostic and therapeutic plan, to be overseen by the consult neurologist on service (Patient Care)
Communicate with veterans and families in an effective, caring and respectful way (Patient Care, Interpersonal and Communication Skills)
Collaborate with teams from other medical services to provide the best medical care possible (Patient Care, Interpersonal and Communication Skills)
Effectively utilize the basic features of the Veterans' Administration’s exemplary medical record system in order to research and document all patient interactions (Patient Care, Practice-Based Learning and Improvement, Interpersonal and Communication Skills)
Increase their clinical knowledge of general neurology, especially in those areas of neurologic disease seen most often in the veteran population, such as primary and metastatic CNS cancers, movement disorders and dementing illnesses (Medical Knowledge)
Demonstrate the ability to recognize, diagnose and treat spinal cord compression (Medical Knowledge)
Participate in the education of rotators and medical students on the service (Practice-Based Learning and Improvement)
Integrate formative feedback from attendings, colleagues and students into daily practices (Practice-Based Learning and Improvement)
Write comprehensive and effective consultation and follow-up notes that clearly document the neurological history and exam and provide useful recommendations, educationally and management-wise, for the primary service taking care of the patient (Interpersonal and Communication Skills)
Provide clear and directed performance feedback to medical students on the Bronx VA consult service based on the goals and objectives for their rotation (Interpersonal and Communication Skills)
Demonstrate sensitivity to the needs and challenges of, and serve as an advocate for, the veteran population (Professionalism, Systems-Based Practice)
Recognize the unique factors of, and be able to work effectively within, the VA's health care delivery system (Systems-Based Practice)