Introduction
Up
to 10% of patients seen by family practitioners present with neurologic
symptoms and pose neurologic questions to their physicians. Only
16% of the 45 million Americans who visit a physician for a chief
complaint referable to the nervous system are ever evaluated by
neurologists. Clearly, primary care physicians are routinely called
upon to evaluate and manage patients with neurologic disease. Practicing
physicians require a firm understanding of the general principles
of clinical neurology. The most suitable setting in which to lay
the foundation for that understanding is in a neurology clerkship
in the clinical phase of medical school. This document outlines
the essential components of a clinical neurology clerkship.
Goals and Objectives of the Clinical Neurology
Clerkship
Goal
To teach the principles and skills underlying the recognition
and management of the neurologic diseases which a general medical
practitioner is most likely to encounter in practice.
Objectives
To teach or reinforce the following PROCEDURAL SKILLS:
-
the
ability to obtain a complete and reliable history
-
the ability
to perform a complete and reliable neurologic examination
-
the
ability to deliver a clear, concise, and thorough oral presentation
of a patient's history and examination
-
the ability to prepare
a clear, concise, and thorough written presentation of a patient's
history and examination
-
[Ideally] the ability to perform
a lumbar puncture
To
teach the following ANALYTICAL SKILLS:
-
the ability to recognize
symptoms that may signify neurologic disease (including disturbances
of consciousness, cognition, language, vision, hearing, equilibrium,
motor function, somatic sensation, and autonomic function)
-
the
ability to localize the likely site or sites in the nervous
system where a lesion could produce a patient's symptoms and
signs
-
the ability
to formulate a differential diagnosis based on lesion localization,
time course, and relevant historical and demographic features
-
an
awareness of how to use and interpret common tests used in
diagnosing neurologic disease
-
an awareness of the principles
underlying a systematic approach to the management of common
neurologic diseases (including the recognition and management
of situations that are potential emergencies)
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