Description:
Each neurology resident has a continuity clinic consisting of a panel of new and established patients for which they act as the primary neurologist. They are responsible for interviewing and examining each patient, deciding on the diagnostic and treatment plan, discussing every case with a clinic attending (who cosigns every note), arranging all necessary studies, consultations and referrals, communicating the plan effectively to the patient (being sensitive to barriers of language and culture), writing prescriptions, and determining necessary neurological follow-up.
The Neurology Resident Clinic is closely supervised by attending neurologists who oversee the types of neurological diseases seen by each resident. An effort is made both in general and on specialty clinic days to vary the types of cases seen by each resident, when possible, to ensure a well-balanced learning experience. Patients seen by a resident in either the inpatient setting or a subspecialty clinic (eg, Multiple Sclerosis Clinic, Headache Clinic, Movement Disorders Clinic) are then taken into that resident's ongoing continuity clinic so that they can follow longitudinally with the same resident whenever possible. Patients seen in clinic in follow-up after an inpatient hospitalization are also scheduled with the resident responsible for their inpatient care whenever possible.
Goals
1- To improve the resident's understanding of outpatient clinical neurology.
2- To instruct the resident in developing diagnostic and long-term management plans for outpatient neurological patients.
3- To improve the resident’s understanding of practice management and the business of medicine.
4- To provide outstanding neurological care to the community.
Objectives
The resident will:
Recognize the common and uncommon presentations of outpatient neurological diagnoses, including migraine, seizures, multiple sclerosis, dementia and Parkinson's disease, as well as begin to recognize less common diagnoses (Patient Care)
Become proficient in gathering accurate and pertinent histories and performing focused neurological examinations efficiently (Patient Care)
Become comfortable in independent clinical decision-making and in communicating their thought process to patients and families (Patient Care, Interpersonal and Communication Skills)
Improve skills in counseling and education of outpatient neurological patients and their families (Patient Care, Interpersonal and Communication Skills)
Efficiently and effectively utilize the outpatient clinic's state-of-the-art medical record system (Epic) to access comprehensive patient information and to provide seamless communication between all of the patient's care providers (Patient Care, Practice-Based Learning and Improvement, Systems-Based Practice)
Learn to anticipate disease course so as to provide neurological care aimed at maintaining functional status and preventing problems (Patient Care)
Develop an understanding of the practice management skills necessary to maintain a functioning outpatient practice (Patient Care)
Know and apply their knowledge of the biomedical, clinical and biosocial aspects of neurological illness effectively to individual outpatients (Medical Knowledge)
Learn to think about patient cases logically and analytically (Medical Knowledge)
Identify deficiencies in their knowledge base and correct through self-directed reading and guided patient exposure (Practice-Based Learning and Improvement)
Incorporate formative evaluation feedback into daily practice (Practice-Based Learning and Improvement)
Utilize appropriate scientific evidence to guide decision-making in individual cases (Practice-Based Learning and Improvement)
Work effectively as a member of the clinic team, alongside nurses, practice managers and scheduling personnel (Interpersonal and Communication Skills)
Deliver case presentations that are clear, organized and effectively communicate a patient's history, exam and other relevant information along with the resident's management plan (Interpersonal and Communication Skills)
Maintain clear, organized and comprehensive electronic progress notes documenting every patient interaction (Interpersonal and Communication Skills)
Demonstrate respect and compassion towards every patient (Professionalism)
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)
Demonstrate sensitivity towards culture, age and disability (Professionalism)
Recognize how outpatient neurology specialty care fits into the patient's overall health care plan (Systems-Based Practice)
Advocate for patients and help to guide them through the complexities of the medical system (Systems-Based Practice)
Partner with clinic support staff and management to improve the quality of outpatient neurological care (Systems-Based Practice)