Neurology Rotation

The neurology rotation is a four to six month rotation which includes neuro-ophthalmology. Click here for a list of staff neurologists.

The objectives for this rotation are as follows:

  1. Review functional and clinical neurophysiology and neuro-anatomy, and to correlate patient presentations and clinical pictures into functional anatomical concepts.
  2. Demonstrate proficiency in neurologic history-taking and physical examination.
  3. Discuss headache patterns, differential diagnosis and management.
  4. Demonstrate a complete understanding of the pathophysiology, signs, symptoms, pathology, and clinical syndromes of coma.
  5. Discuss all aspects of speech and language disorders.
  6. Describe all aspects of seizure disorders, including pathophysiology, and the various clinical syndromes, anti- epileptic medications and the principles and interpretation of EEG.
  7. Demonstrate knowledge of all aspects of cerebral vascular occlusive disease, including pathogenesis, the clinical syndromes and management.
  8. Demonstrate knowledge of all aspects of CNS infection, including viral, fungal, parasitic and bacterial disease.
  9. Discuss eye movements and their disorders; the visual pathway and its disorders; and basic abnormalities of the optic discs and retina.
  10. Discuss in brief the major demyelinating diseases and cerebral degenerative diseases.

During the rotation, all residents should fulfill the Royal College’s CanMEDS Competecies.

COMMUNICATOR:

  1. Establish therapeutic relationships with patients and families.
  2. Conduct, document and present neurological history and neurological exam.
  3. With appropriate supervision discuss information on neurological disorders such as stroke, seizures and common degenerative syndromes with patients and family.
  4. To gain familiarity with appropriate indications for neurological service referral
  5. Through observation and performance of relevant neurological consultations,
  6. To observe and participate in effective communication with patients, families and allied health staff in the context of acute illness, serious morbidity and stressful and emotional situations for patients and families
  7. To understand basic principles of communication with allied health staff and relevant terminology
  8. To participate in efficient and effective team handovers

 

COLLABORATOR:

  1. Work/collaborate effectively in an interdisciplinary team, including ICU/pharmacy/Neurosurgery / neuroradiology/neurophysiology personal to manage neurological illnesses
  2. Consult other medical services such as medicine/endocrinology/neurosurgery appropriately
  3. Take part in educational activities and teaching available on the neurology service
  4. Be able to share workload and duties appropriately with resident colleagues
  5. To work and collaborate effectively with other members of the neurology team, physiatrists, pharmacists and other medical services, allied health staff and patients and families to optimize safe and effective care in the acute and chronic care of neurological patients

 

 

 

 

MANAGER:

  1. Effectively utilize, allocate, and prioritize finite resources in context of managing neurologically ill patient.
  2. Manage own time, education and personal life for a balanced lifestyle
  3. Work effectively and efficiently, to learn time management skills in the medical setting
  4. Triage patients being able to identify neurosurgical emergencies that require prompt and immediate management.
  5. To understand the process of transferring patients from other centres without neurological care
  6. To understand appropriate indications for referral for rehabilitation versus long-term care and the wait-times involved

 

HEALTH ADVOCATE:

  1. To appreciate and respond to determinants of neurological health in patients
  2. Advocate for timely and appropriate tests/investigations to minimize wait times in neurologically ill patients.
  3. Contribute to overall patient well-being and outcome
  4. Facilitate return of patient to community/alternate care
  5. Consider and practice preventative measures for neurological illnesses
  6. Appreciate the barriers for underserviced patient groups in accessing tertiary neurological care
  7. To understand indications for screening for family members of patients with inherited neurological disorders

 

SCHOLAR:

  1. Participate in rounds and educational activities, residents are expected to be fully involved in all educational activities of the neurology service.
  2. Identify and seek out personal learning needs
  3. Apply principles of critical appraisal to medical information, be involved in neurology journal club and various rounds including neuroradiology/stroke and epilepsy rounds
  4. Facilitate patients, student and peer learning
  5. Contribute to development of new knowledge, be actively involved in research projects where appropriate in Neurology.
  6. Apply principles of critical appraisal to medical information
  7. To solidify neurological anatomy and neurological syndromes

PROFESSIONAL:

  1. To foster collegial relationships with neurology staff and residents, physiatrists, neuroscience nurses and other allied health professionals
  2. To develop through observation and practical experience professional tactics for effective, honest discussion with patients and families with respect to challenging issues including delivery of grave diagnoses, withdrawal of care and disclosure of medical error.
  3. Exhibit appropriate professional behaviors in practice, including honesty, integrity, commitment, compassion, respect and altruism
  4. Show appropriate respect for opinions of other health care providers
  5. Be able to appraise and identify own limits with respect to knowledge and patient care, and when to ask for assistance and consult effectively