Description:
The Floor Service at Mount Sinai Medical Center consists of a Neurology Attending, one PGY-4 neurology resident and one PGY-2 neurology resident. Ten months out of the year, there is also a PGY-1 psychiatry resident on the team. There are one to two Mount Sinai third-year medical students and a variable number (zero to two) of visiting medical students from both US and foreign medical schools. Teaching rounds on the Floor Service occur seven days a week. The PGY-2 neurology residents are responsible for collecting patient histories, exam findings, laboratory results and radiographic information and for presenting this information to the team. Medical students often help with this information-gathering for the patients they are following. The role of the PGY-1 psychiatry resident is comparable to that of the PGY-2 neurology resident, although they typically carry fewer patients. The PGY-4 neurology resident helps to compose treatment plans in conjunction with the Floor Attending. Teaching occurs throughout rounds by both the Attending and the PGY-4 neurology resident both at the bedside and, more formally, after patient care work has been completed.
Goals
To build the resident's clinical knowledge and skills in the care of general neurology inpatients.
To teach residents to develop the knowledge and skills related to the assessment and management of patients with neurologic illness in the acute and subacute setting.
To provide exposure to an interdisciplinary patient care team including nurses, nurse managers, case managers, social workers, physical therapists and consultants from other medical specialties in the care of neurologic patients.
Objectives
The resident will:
Recognize presentations of common inpatient neurological complaints such as seizures, myasthenia gravis, multiple sclerosis exacerbations, meningitis and CNS tumors (Patient Care)
Provide compassionate and empathetic care to general neurology patients and their families (Patient Care)
Become certified in performing lumbar punctures by performing five procedures observed by a senior neurology resident, fellow or attending (Medical Knowledge)
Develop the knowledge and skills to assess and manage the common complaints of inpatient neurology patients (Medical Knowledge)
Demonstrate their ability to obtain a comprehensive history and neurological exam on neurology patients, to be assessed by the senior neurology resident or attending on service (Medical Knowledge)
Demonstrate knowledge of the epidemiology, pathophysiology and treatments of common inpatient neurological diseases such as epilepsy, myasthenia gravis, multiple sclerosis and CNS tumors (Medical Knowledge)
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)
Be able to effectively present patient cases (new patients and interval histories) on both teaching and work rounds (Interpersonal and Communication Skills)
Be able to write comprehensive and effective patient notes (admission and progress notes), to be evaluated by the senior neurology resident or attending on service (Interpersonal and Communication Skills)
Demonstrate effective communication skills and provide effective education in formal and informal discussions with neurology patients and their families (Interpersonal and Communication Skills)
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)
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)
Demonstrate respect and sensitivity towards the complex challenges of age and illness seen commonly in neurology inpatients (Professionalism)
Recognize the complex social, family and community issues surrounding acute, critical illness (Professionalism, Systems-Based Practice)
Learn to advocate for patients and navigate through government and commercial insurance providers in order to ensure optimal inpatient care and post-hospital placement for patients (Systems-Based Practice