Description:
At Mount Sinai Medical Center (Site 1), the Neurology Consult service consists of a Neurology attending, one PGY-4 neurology resident, one PGY-2 neurology resident, two PGY-2 medicine residents, one PGY-1 psychiatry resident, one to two medicine PGY-2 residents, and one to two medical students. Teaching rounds are held daily, including on the weekend with the covering resident. Teaching rounds are held five days a week. When feasible, afternoon rounds with a teaching attending are held to staff follow-ups or urgent new consults and provide direct teaching.
The role of the Neurology Consult resident is similar at each site. 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 Medicine or Psychiatry 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.
Goals
To teach residents to provide comprehensive and effective consultative neurological care to inpatients at the Mount Sinai Medical Center.
To teach residents to perform consultative duties and communicate collaboratively with members of other healthcare teams in the care of patients with neurologic complaints.
To give residents an opportunity to lead the Neurology Inpatient team and to foster efficient leadership skills.
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)
Lead the consult 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, note-writing and presentation (Patient Care)
Supervise the work of the psychiatry and neurosurgery interns on service, particularly overseeing the development of their skills in history-taking, neurological examination, note-writing and presentation (Patient Care)
Become comfortable in performing brain death certification examinations (Patient Care, Medical Knowledge)
Collaborate with teams from the ED and other medical and surgical services to provide the best medical care possible (Patient Care, Interpersonal and Communication Skills)
Solidify their understanding of the complex relationship between the nervous system and critical medical illness; self-assess for lapses in knowledge and correct through self-directed reading (Medical Knowledge, Practice-Based Learning and Improvement)
Demonstrate their ability to recognize and effectively manage neurological emergencies (Medical Knowledge)
Direct 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 the neurosurgery and psychiatry interns on the consult service based on the goals and objectives of the rotation (Interpersonal and Communication Skills)
Provide clear and directed performance feedback to the medical students on the consult service based on the goals and objectives of the rotation (Interpersonal and Communication Skills)
Demonstrate respect for patient confidentiality and autonomy (Professionalism)
Demonstrate respect and sensitivity towards the complex challenges of age and illness (Professionalism)
Recognize the complex social, family and community issues surrounding acute, critical illness (Professionalism, Systems-Based Practice)
Work to effectively coordinate interdisciplinary patient care to the advantage of the patient (Systems-Based Practice)
Advocate for quality patient care and patient safety (Systems-Based Practice)