Neurology Objectives

Rotation-Specific Objectives for Neurosurgical Residents on Neurology Rotation

Neurosurgery residents at the University of Toronto are required to spend at least 3 blocks on a clinical neurology service as part of their training. They will rotate to one of three different teaching hospitals within the University: Sunnybrook Health Sciences Centre, Toronto Western Hospital/Toronto General Hospital, and St Michael's Hospital. The following is a description of the rotation-specific objectives for neurosurgery residents undertaking their neurology rotations:

MEDICAL EXPERT

KNOWLEDGE: At the completion of their rotation, the resident will be able to:

• Demonstrate an understanding of the basic principles underlying the interpretation, indications, and potential value of:
  • nerve conduction studies, electromyography, evoked potentials
  • electroencephalography
  • CSF analysis
  • interpretation of imaging studies with a focus on MRI
• Demonstrate an understanding of the clinical features, presenting signs and symptoms, natural history, and prognosis, for the major neurologic disorders including:
  • Vascular disorders
  • Epilepsy and epilepsy syndromes
  • Headache disorders
  • Cranial neuropathies
  • Movement disorders (esp. Parkinson's and variants)
  • Neuromuscular disorders
  • Cerebrovascular disease
  • Demyelinating disorders
  • Peripheral neuropathies
  • Dementia

CLINICAL SKILLS: At the completion of their rotation, the resident will be able to:

• Obtain a complete neurological and pertinent general history from an adult taking into account age and mental state.
• Formulate an appropriate differential diagnosis and provisional diagnosis with respect to common signs or symptoms involving the nervous system.
• Perform a neurological examination of the comatose patient
• Perform lumbar puncture and interpret CSF analysis
• Examine the comatose patient for brain death criteria
• Assess and urgently manage acute stroke patients

COMMUNICATOR: At the completion of their rotation, the resident will be able to:

• Prepare written documentation regarding patient interactions in a timely and accurate fashion, including, consultations and progress notes.
• Establish communication with the patient and family that supports a trusting and open relationship.
• Respond appropriately to patients, families, and colleagues, who express anger, hostility, or a complaint.
• Communicate in a clear, concise and collegial manner with other health care professionals.
• Communicate effectively with nursing managers and administrators, when necessary. 

COLLABORATOR: At the completion of their rotation, the resident will be able to:

• Effectively and respectfully collaborate with other physicians, health care professionals, and community agencies to contribute effectively to interdisciplinary team activities.
• Listen to concerns expressed by others providing care and assist in resolving these concerns if appropriate.

LEADER: At the completion of their rotation, the resident will be able to:

• Demonstrate time management for clinical activity, learning needs and personal activities.
• Prioritize clinical activities in a manner to optimize patient care and the functioning of the clinical service.
• Triage patients and identify emergencies that require prompt and immediate management.
• Delegate responsibilities where and when appropriate.

HEALTH ADVOCATE: At the completion of their rotation, the resident will be able to:

• Identify the important determinants of health that affect their patients.
• Intervene on behalf of patients or the community with respect to the social, economic and biologic factors that may impact on the patients’ health.
• Effectively advocate for practices that enhance health and well-being.
• Demonstrate sensitivity to the needs of patients and their families as they are affected by age, gender, cultural and ethnic perspectives.

SCHOLAR: At the completion of their rotation, the resident will be able to:

• Maintain and enhance professional activities through ongoing learning.
• Critically evaluate medical information and its sources, apply this appropriately to practice and communicate this at weekly rounds.

PROFESSIONAL: At the completion of their rotation, the resident will be able to:

• Deliver the high quality care with integrity, honesty and compassion.
• Fulfill medical, legal, ethical and professional obligations of the specialist.
• Meet deadlines, be punctual, monitor patients, and provide follow-up.
• Demonstrate an understanding of the principles of ethics and apply these in clinical situations.
• Demonstrate self-assessment, seek and accept advice when necessary.