Expectation for Medical Students, Inpatient Services (Vanderbilt University medical Center and Nashville Veterans Administration Hospital):
- Help admit and manage some patients on the inpatient service.
- Write a complete admission history and physical exam note that includes chief complaint, history of present illness, past medical history, PMSH, allergies, medications, family history, social history, complete review of systems, general medical examination, neurologic examination, and clinical impression including localization and differential diagnosis. Students will generate the preliminary plan of evaluation, management and treatment, and present it to the Neurology Resident and later to the attending physician for finalization.
- Perform a clinical presentation during rounds of the patients you have admitted and the ones you are following (an average of 3, range 1-5, patients on any given day). It is a good idea to ask the intern, resident and nurse just prior to presentation if there is any new information that they may have.
- Be up-to-date and knowledgeable of the clinical condition of patients assigned to you, including the latest laboratory and/or imaging data, recommendation from consulting services, etc.
- Write daily complete progress notes on the assigned inpatients. This note, in the SOAP format, will include patient complaints, physical and neurologic examination, medications, laboratory and diagnostic results, impression and plan.
- Pre-round on all your patients and enter all daily notes for the assigned inpatients prior to daily attending rounds, allow about 15-30 minutes per patient.
- Clear all clinical decisions first before putting them in motion.
- All orders will be co-signed by the Resident physician before they are executed.
- When admitting a patient, a full History and Physical Exam note must be available within 24 hours.
- Never hesitate to contact the junior or senior resident physician if there are questions regarding patient care and/or responsibilities.
- Develop the habit of signing out your cases everyday to the covering resident and to the on-call student.
Expectations for Medical Students, Outpatient Services (The Vanderbilt Clinic Neurology, Nashville Veterans Administration Hospital):
- This will be a practical experience in obtaining an orderly and basic but pertinent history from the patient, in conducting a detailed neurological examination, and in organizing and recording clinical data.
- The student will discuss and participate in putting in motion the management strategies.
- Participation in the diagnosis and management of patients with psychiatric or neuro-psychiatric disorders, and also conditions requiring neurosurgical intervention.
- To gain basic understanding of the principles of bioethics and the provision of appropriate and cost-effective evaluation and treatment for patients with neurologic disorders.
- Discuss the indications for and the limitations of clinical neurodiagnostic tests and their interpretation.
- To participate in the correlation of the information derived from neurodiagnostic studies with the clinical history and examination in formulating a differential diagnosis and management plan with the Neurology resident and attending.