The Neurology Clerkship is a required 4-week rotation in the third year that provides a mixture of clinical exposure and conference discussions to provide a well-rounded introduction to clinical neurology. We understand that only a few of you will select neurology as a career, but neurological disorders are seen in almost every specialty, and you will need to know how to assess a patient with a neurological problem, how to determine where in the nervous system that problem might be, how to treat a few common or life-threatening neurological diseases, and when to call neurological consultants for help.

Clerkship Goals

By the end of the rotation, you should be able to:

• Obtain a comprehensive history from patients with nervous system disorders.
• Perform a thorough and organized neurological examination.
• Use neuroanatomical principles to localize a lesion in the nervous system.
• Describe the pathophysiology of common neurological diseases, how to evaluate them and the basics of treatment.

Organization

Students are assigned to one primary clinical site based at UConn John Dempsey Hospital, Hartford Hospital, Saint Francis Hospital, Charlotte Hungerford, and Middlesex Hospital. Each of these sites provides exposures to different neurological subspecialties, patient populations and health systems, providing you with a multifaceted introduction to clinical neurology in a variety of settings. You will also participate in two “Required Observations in Neurology” (RONs) which will help you hone your neurological examination skills, and in 3 half-day (Monday afternoon) didactic sessions. One half-day is dedicated to neuroradiology. At the end of the clerkship, you will have an opportunity to evaluate the entire clerkship experience. We take these comments very seriously and are always looking for ways to improve the educational experience.

Preparation for the Rotation

You should prepare for sessions on the first half-day of the rotation regarding neurological exam techniques, the brain death examination, and lumbar puncture by viewing the assigned videos on HuskyCT prior to those sessions.

Conference Case Discussions

The first conference session occurs on Monday afternoon of the first day of the rotation. You should prepare for this and the following conference one week later by going through the PowerPoint summary slides and videos on HuskyCT. You need to view these independently before each session in order to get the most out of them. Individual readiness assurance tests, (iRATs) are administered prior to the conference sessions. The conference sessions occur on the first three Mondays of the 4-week rotation, from 1 to 5 p.m.

Required Observation for Neurology (RON)

The RONs are an opportunity to perform a complete neurological examination under the watchful eye of an expert clinical neurologist, or a senior Neurology resident. One of the RONs is scheduled to be done at UConn John Dempsey Hospital – either in the Outpatient Pavilion or on the 3rd floor of the Connecticut Tower of the Main Hospital. The second RON is completed at your individual site. The goal of these sessions is to determine your level of competence in performing the exam.

Evaluation of Performance

You will receive feedback on your performance in the Neurology Clerkship from your attending physicians in 3 different settings:

• After the RON sessions, which will help you firm up your neurological examination skills.
• At the mid-rotation point, where strengths and opportunities for improvement will be discussed.
• After your case presentation which is given to a faculty member at your site.

Your performance will be evaluated in 3 ways: Your final grade, comments from your attending physicians posted onto uchc.oasisscheduling.com, and a final narrative summary. Your final grade (including consideration for a grade of Honors) will be based upon your performance on the “Shelf” exam, the attending evaluation (in Oasis), the RONs, the 3 IRATs, and the case presentation.

Clerkship Milestones

• By the end of the first week, you should have completed the pre-block self-assessment questionnaire.
• By the end of your second week of consults, you should have completed your mid-block evaluation with an attending physician.
• By close of business on Thursday of the (final) week, you need to have completed:
  1. Two (2) required observations for Neurology (RONs).
  2. Clerkship Composite Evaluation and Conference evaluations.
  3. An evaluation of a Neurology Attending.
• Before sitting for the final examination on the last Friday morning, you need to have completed:
  1. Your Portfolio, including the post-rotation self-assessment. This includes having entered information into the Required Clinical Encounter database.
  2. Your Case Presentation Assessment with attending signature.

Final Examination

On the last Friday of the rotation, beginning promptly at 8 a.m. you will take the USMLE Neurology Shelf Examination. The NBME Clinical Neurology Exam has 110 multiple choice questions. You will have 2 hours 45 minutes to complete the test. There are a variety of ways to prepare for this examination, including pretest question books, concise neurology textbooks, and other study materials. You will likely do best if you follow the cardinal rules for neurology:

• Localize the lesion
• Think broadly about the differential diagnosis
• Address any potential emergencies or “worst case scenarios”
• Choose the most likely answer

Read advice to medical students studying neurology from the American Academy of Neurology.

Student Interest Group in Neurology (SIGN)

UConn has a chapter of SIGN which is supervised by the clerkship director, Dr. Marie Eugene. Even if you are not considering neurology as a career, joining SIGN has numerous benefits! Learn more about SIGN.