The educational objectives of the outpatient Child Neurology service and Child Consultation service at the VUH are for the second year Neurology and Child Neurology resident to acquire the knowledge, skills, and attitudes to perform a comprehensive neurological exam and diagnose and manage a broad range of acute and non-acute pediatric neurological illnesses. This is accomplished by providing faculty supervised outpatient, inpatient, and inpatient consultative care to pediatric patients presenting with a broad range of neurological illness. The resident will assume an ascending level of responsibility based upon maturation of knowledge, skills and attitudes applicable to the educational goals of this experience. The specific educational goals for this experience include:
• A practical experience in obtaining an orderly and detailed history from the patient or caregiver, in conducting a thorough general and neurological examination, and in organizing and recording data
• An understanding of the indications for and the limitations of clinical neurodiagnostic tests and their interpretation
• The ability to correlate information derived from neurodiagnostic studies with the clinical history and examination in formulating a differential diagnosis and management plan
• Participation in the evaluation of and decision making for patients with disorders of the nervous system requiring surgical management
• Participation in the management of patients with a psychiatric or neuro-psychiatric disorders
• Participation in the management of the patient with acute neurological disorders in the pediatric intensive care unit and participate in family conferences
• To better understand the principles of bioethics and the provision of appropriate and cost-effective evaluation and treatment of patients with neurologic disorders
• Participation in end-of-life palliative care including adequate pain relief and psycho-social support and counseling for family members about these issues
2nd Year Neurology Resident
Residents on this rotation will split time between the pediatric neurology clinics as well as the pediatric neurology inpatient/consultation service.
• Write a complete history and physical exam consultation note that includes chief complaint, history of present illness, past medical history, allergies, medications, family history, social history, complete review of systems, general medical examination, neurologic examination, impression including localization and differential diagnosis, and plan of evaluation, management and treatment.
• Staff all patients with the consult attending physician. The consult attending physician may involve a subspecialty attending physician when appropriate.
• Round daily with the attending physician.
• Write daily progress notes.
• Patients may be admitted to the child neurology service under a neurology attending, however; the neurology resident will still serve as a consultant. The general pediatric team will be responsible for the H&P, D/C summary, all orders, etc.
• Sign out all patients at the end of the day to the resident on call for pediatric neurology.
• Child Neurology night call responsibilities as assigned.
• Attend seven half-day ambulatory Child Neurology clinics. Will have additional Child Neurology night call responsibilities, as assigned by the monthly call schedule.
• One half-day for independent study.
• Never hesitate to contact the senior resident or attending physician if there are questions regarding patient care and/or responsibilities.