Description:
The inpatient Neurology Service at Elmhurst Hospital (Site 2) cares for stroke and general neurology patients in both a regular medical-surgical unit (the B4 unit) and in an acute care step-down unit (the A4 unit). The team is composed of a Neurology Attending, one PGY-3 neurology resident, one PGY-1 Internal Medicine intern, and one to two PGY-1 Psychiatry interns. There are one to two Mount Sinai medical students and one medical student from an outside medical school. Teaching rounds occur six days a week. The PGY-1 Psychiatry and Internal Medicine interns are responsible for gathering interim history, physical exam, laboratory findings and radiographic information and for presenting it to the team. The medical students assist them in collecting this information for the patients they are following. The PGY-3 neurology resident oversees this process closely and helps to coordinate care and make management decisions, in conjunction with the Attending. Teaching occurs throughout rounds, both at the bedside and after the patient care component is completed.
Goals
To build the resident's clinical knowledge and skills in the care of neurology inpatients.
To teach residents to develop the knowledge and skills related to the assessment and management of stroke patients in the acute and subacute setting.
To give residents an opportunity to lead the Neurology Inpatient team and to foster efficient leadership skills.
To provide exposure to comprehensive/interdisciplinary care for patients with stroke and other neurologic disease (including working with nursing, social work, rehabilitation medicine, etc).
To foster an understanding of the complex public health delivery system, and to develop skills in working effectively within it.
Objectives
The resident will:
Solidify their understanding of common neurological inpatient complaints, including uncommon presentations of common problems, and begin to recognize uncommon neurological complaints (Patient Care)
Lead the neurology inpatient team on work and teaching rounds with the attending (Patient Care)
Supervise the work of the medical students on service, particularly overseeing the development of their skills in history-taking, neurological examination, admission and progress note-writing and case presentation (Patient Care)
Supervise the work of the internal medicine and psychiatry interns rotating on the neurology service, particularly overseeing their skills in note-writing, neurological examination, case presentation and patient care (Patient Care)
Provide compassionate and empathetic care to general neurology patients and their families (Patient Care)
Develop throughout the year the ability to recognize, diagnose and manage neurological disorders most common to the Elmhurst Hospital population, including neurocysticercosis, head trauma, tropical infections of the CNS, neurological co-morbidities associated with HIV including PML and HIV dementia, and the neurological effects of substance abuse; self-assess for lapses in knowledge periodically over the year and correct through self-directed reading and patient exposure, if possible (Medical Knowledge, Practice-Based Learning and Improvement)
Develop the ability to locate and assess scientific evidence related to the treatment of neurology patients and incorporate their findings into clinical practice (Practice-Based Learning and Improvement)
Integrate formative feedback from attendings, colleagues and students into daily practices (Practice-Based Learning and Improvement)
Effectively communicate and collaborate with nurses, nurse managers, case managers, social workers, physical therapists and consultants from other medical specialties as part of the interdisciplinary patient care team (Professionalism, Interpersonal and Communication Skills, Systems-Based Practice)
Develop strategies for teaching medical students and interns on the neurology floor service (Interpersonal and Communication Skills)
Provide clear and directed performance feedback to medical students on the neurology inpatient service based on the goals and objectives for their rotation (Interpersonal and Communication Skills)
Provide clear and directed performance feedback to internal medicine and psychiatry interns rotating on the neurology inpatient service based on the goals and objectives of their rotation (Interpersonal and Communication Skills)
Demonstrate respect for patient confidentiality and autonomy (Professionalism)
Demonstrate sensitivity to the needs and challenges of and serve as an advocate for the vulnerable Elmhurst Hospital patient population (Professionalism, Systems-Based Practice)
Practice cost-effectively and allocate resources appropriately, without compromising patient care quality, in keeping with the goals and mission of this city hospital (Systems-Based Practice)
Advocate for the vulnerable patient population serviced by Elmhurst Hospital and help guide them through the system complexities of American health care (Systems-Based Practice)