Goals and Objectives (by Competency)

Goals

1- To train well-rounded clinicians, skilled in the diagnosis and management of all neurological disorders;

2- To train humanistic physicians who are sensitive and empathetic to the needs of their patients;

3- To train future leaders in neurology, from the community to the national level;

4- To prepare individual residents for the next step in their careers, including subspecialty training, research and clinical practice.

Patient Care

The Resident will:

• Master a range of interview and examination techniques, from the standard and basic to the more sophisticated and complex, and be able to tailor these skills to individual patients, situations and settings (Patient Care)

• Be able to synthesize history and examination findings in order to generate a comprehensive, focused differential diagnosis for inpatient and outpatient neurological patients (Patient Care)

• Be able to develop thorough, appropriate and cost-effective diagnostic and therapeutic plans for inpatient and outpatient neurological patients (Patient Care, Systems-Based Practice)

• Recognize the common and uncommon presentations of stroke and TIA (Patient Care)

• Recognize the common and uncommon presentations of inpatient and outpatient neurological complaints such as headache, dementias, movement disorders, multiple sclerosis, myasthenia gravis, meningitis, CNS tumors, ALS and seizures (Patient Care)

• Understand how and when to best use neurological imaging tools, such as CT and MRI, in the diagnosis and management of neurological patients (Patient Care, Systems-Based Practice)

• Provide compassionate and empathetic care to all neurological patients (Patient Care)

• Be comfortable leading a medical team, particularly in the supervision and teaching of residents and medical students (Patient Care)

• Be skilled in working with consulting teams, such as the Emergency Department and other medical services, to collaboratively provide the best patient care possible (Patient Care)

• Be comfortable performing brain death certification examinations (Patient Care, Medical Knowledge)

• Be able to recognize common psychiatric diagnoses and to develop a basic diagnostic and therapeutic plan for these patients (Patient Care, Medical Knowledge)

• Be comfortable in independent clinical decision-making and in communicating their thought process to patients and families (Patient Care, Interpersonal and Communication Skills)

• Be able to anticipate neurological disease course so as to provide care aimed at maintaining functional status and preventing future problems (Patient Care)

• Understand the basic practice management principles necessary to maintain a functioning outpatient practice (Patient Care)

Medical Knowledge

The Resident will:

• Know and be able to apply their knowledge of the biomedical, clinical and biosocial aspects of neurological illness effectively to individual patients (Medical Knowledge)

• Think about patient cases logically and analytically (Medical Knowledge)

• Be able to quickly and effectively evaluate acute stroke patients for possible tPA therapy (Medical Knowledge)

• Know the epidemiology, pathophysiology and treatments of common inpatient and outpatient neurological diseases such as epilepsy, migraine, dementia, myasthenia gravis, multiple sclerosis and CNS tumors (Medical Knowledge)

• Know the epidemiology, pathophysiology and treatments of ischemic, embolic and hemorrhagic stroke (Medical Knowledge)

• Be able to identify key neuroanatomic structures and common neuropathologies, such as strokes, hemorrhages and mass lesions, on CT scan and MRI (Medical Knowledge)

• Be skilled in performing lumbar punctures under a variety of conditions (Medical Knowledge)

• Understand the basic technical and clinical aspects of EEG (Medical Knowledge)

• Understand the basic technical and clinical aspects of NCS/EMG (Medical Knowledge)

• Be able to recognize and effectively manage neurological emergencies (Medical Knowledge)

Practice-Based Learning and Improvement

The Resident will:

• Be able to locate and assess scientific evidence related to the treatment of neurological patients and incorporate their findings into clinical practice (Practice-Based Learning and Improvement)

• Be able to integrate formative feedback from supervisors, colleagues and students into daily practices (Practice-Based Learning and Improvement)

• Be able to objectively self-assess deficiencies in their own knowledge base and correct through self-directed reading (Practice-Based Learning and Improvement)

• Utilize appropriate scientific evidence to guide decision-making in individual cases (Practice-Based Learning and Improvement)

Interpersonal and Communication Skills

The Resident will:

• Be able to 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)

• Be able to effectively communicate and provide education to neurological patients and their families (Interpersonal and Communication Skills)

• Be able to effectively communicate, both verbally and in written form, patient cases to consultants, colleagues and support staff (Interpersonal and Communication Skills)

• Know how to effectively communicate with all patients despite language and cultural barriers (Interpersonal and Communication Skills)

• Be able to work effectively as a member of a medical team, alongside nurses, practice managers and scheduling personnel (Interpersonal and Communication Skills)

• Be able to maintain clear, organized and comprehensive electronic progress notes documenting every patient interaction (Interpersonal and Communication Skills)

Professionalism

The Resident will:

• Demonstrate compassion, respect and cultural sensitivity towards neurological patients and families (Professionalism)

• Demonstrate respect for patient privacy and confidentiality (Professionalism)

• Demonstrate respect for patient confidentiality and autonomy (Professionalism)

• Recognize the complex social, family and community issues surrounding critical illness (Professionalism, Systems-Based Practice)

• Understand the legal, ethical and cultural complexities of decision-making in cognitively-impaired patients (Professionalism, Interpersonal and Communication Skills)

• Demonstrate a commitment to performing their professional responsibilities to the best of their ability (eg writing comprehensive notes, following up test results, presenting on rounds, etc) (Professionalism)

Systems-Based Practice

The Resident will:

• Work to effectively coordinate interdisciplinary patient care to the advantage of the patient (Systems-Based Practice)

• Learn to advocate for patients with and navigate through government and commercial insurance providers in order to ensure optimal inpatient care and post-hospital placement for neurological patients (Systems-Based Practice)

• Learn to practice cost-effectively and to allocate resources appropriately, without compromising patient care quality (Systems-Based Practice)

• Demonstrate sensitivity to the needs of a patient population diverse in terms of language, culture and socioeconomic differences, and recognize when to implement appropriate aides to better facilitate care, such as when it is necessary to use an interpreter or phone translation service (Professionalism, Systems-Based Practice)

• Advocate for patients and help to guide them through the complexities of the medical system (Systems-Based Practice)