Goal

Core 3: UH/VA Neuropsychiatry

Overall Design Structure

Core 3 encompasses Neurology and Psychiatry 8weeks total duration

Neurology rotation is 4weeks in length At UH, students spend two weeks on General

Inpatient Neurology and 2 weeks on Neurosurgery or Subspecialty Neurology

At VA, students spend four weeks doing a combination of inpatient/consult service and outpatient clinics

Psychiatry rotation is 4weeks in length At UH, Psychiatry rotation is divided into two 2week

segments At VA, students spend four weeks on an acute

psychiatry ward.

Overall Design Structure - Sites

Neuroscience – UH + Wade Park VA UH Psychiatry locations:

UH main campus, at University Circle Hospital site for C/L clinical experiences Walker Building (corner of Stokes and Euclid) for

orientation, weekly Grand Rounds, weekly didactics UH-Richmond Medical Center

Hospital site for inpatient clinical experiences VA Psychiatry location: Louis Stokes Cleveland

Department of Veterans Affairs Medical Center, Brecksville Division, Building 5

Overall Design Structure – Clinical Services

UH Neurology clinical services: General Neurology Stroke Service Neurosurgery/Neurocritical Care Pediatric Neurology Ambulatory Neurology clinic at various sites

VA Neurology clinical services: Inpatient/consult service Outpatient Neurology clinic

Overall Design Structure – Clinical Services UH Psychiatry clinical services:

Consultation-liaison psychiatry service (UH main)Perform consultations as requested for general

medical, surgical, OB, ICU patients Acute inpatient psychiatry (UH-Richmond)

General adult psychiatry unit = 18yo to ~60yoGeriatric psychiatry unit = ~60yo and over, or

younger if the patient has many medical complications

VA Psychiatry clinical services: Acute adult psychiatry wards with a

predominantly male population aged 18 y.o. and above.

Weekly Schedule

UH/VA Neurology Inpatient schedule depends on service One afternoon per week in outpatient Neurology

clinic with faculty preceptor Conferences

UH Psychiatry: Monday through Friday, 0800-1700*

*Evenings = one evening of call per week, only during the 2weeks that you are on inpatient service at UH-Richmond

M/T/W/Th = clinical experiences VA Psychiatry: Monday-Friday 0800-1630

Lectures/conferences

UH/VA Neurology: Weekly Neurosurgery didactics Grand Rounds Neurology case-based discussion groups Weekly meetings with Dr. Cohen

(Neurosurgery) Neuroradiology W Neuro-Ophthalmology, CPC, Journal Club

Lectures/conferences

UH Psychiatry: Introductory lectures = orientation day AM Other core lectures = each Friday AM after Grand

Rounds, from 0900-1200 Case conferences = Thursdays at 1300 at UH main

hospital, only during the 2weeks that you are on C/L service

VA Psychiatry: Introductory lectures during orientation Didactic series which meets every Thursday from

1300-1615

Design Features

Orientation Learning relationships (faculty + residents) Feedback Direct observation Exposure to career options On call schedules Inpatient-outpatient balance Incorporation of assigned Advanced Core

learning objectives Core 1 – Peri-Op and Acute Pain Core 2 – Prevention + WH (Menopause, osteoporosis,

etc.) Core 3 – Chronic Pain

Design Features

Orientation: Neuroscience:

8-9 am: Neurological history and physical exam review 9-10:30 am: Distribution and explanation of schedules

Psychiatry: General information, schedules, pagers/keys, introductory psychiatry lecturesFirst morning of the rotation at 0830 in Walker Building (8th floor conference room)

Learning relationships Work in typical team setting on inpatient settings, i.e. attending

faculty, residents, interns, and other students Work one-on-one with faculty preceptor in outpatient clinic Students will work with faculty as well as residents/fellows during

their rotation Learning will occur via direct patient contact, patient discussions,

informal and formal learning opportunities, and case conferences

Design Features Continued

Feedback Clinical Assessment System for specific patient-based experiences

and presentations Mid-rotation feedback End-of-rotation feedback (one-on-one with Clerkship Director)

Direct observation History taking, physical exam, and team communication will be

directly observed by faculty, residents, and interns in various inpatient and outpatient settings with feedback verbally and through CAS.

Exposure to career options On the Neuroscience rotations students have opportunity to

preference experiences in Neurosurgery, Pediatric Neurology, or Neurology Subspecialty such as Stroke

During the two parts of your Psychiatry rotation, you will be exposed to clinical faculty and fellows who are pursuing various different career options including Inpatient, consultation, and outpatient settings Younger adult-focused versus geriatric-focused practices

Design Features Continued

On call schedules Neuroscience:

Students required to take 2 calls (until 9 pm) only while on General Neurology service

Students allowed to choose call days, and welcome to take more call as long as stay within duty hours

No overnight call Psychiatry:

One weekday evening of call during each week that you are on inpatient service at UH-Richmond from 5 PM to 10 PM.

Duties: Shadow the on-call resident, participate in ER evaluations, participate in acute consultations, address unit issues/questions as needed

Design Features

Inpatient-outpatient balance Neuroscience - Students see a mixture of

inpatients, consults, and outpatients during their four week rotation, regardless of how they preference their second two weeks

UH Psychiatry: Experience primarily inpatient (either inpatient on the psychiatric unit or in the general medical/surgical hospital arenas), with opportunities available for interested students to visit outpatient psychiatric clinics

Design Features – Incorporation of Advanced Core learning objectives Core 3: Chronic pain

Formal, joint Neuro-Psych conference relating to this topic

On Neurology service, you will see inpatients and outpatients dealing with chronic pain, and didactics will include selected chronic pain topics

On Psychiatry service, you will likely interact with patients for whom chronic pain is a significant issue Psychiatric consultations are often called in

conjunction with the Pain Management team Chronic pain is highly comorbid with psychiatric

illness

What are the unique features of this rotation? UH/VA Neurology:

Relevant and interesting introduction to rotation, with review of the neurologic history and exam, neuroanatomy, neuropathology, and neuroradiology

Ability to spend four afternoons working one-on-one with a faculty neurologist in clinic, with progressive increase in responsibility over the course of rotation

Ability to spend time in unique areas of Clinical Neuroscience, in order to tailor rotation to specific interests

Combination of didactics, case-based discussions, and patient presentations to supplement learning on the wards

What are the unique features of this rotation? UH Psychiatry:

Through diversification of the psychiatric experience, including both inpatient and hospital-based services, students will get broad exposure to psychiatric patients, diagnoses, and treatment options

VA Psychiatry: Students are responsible for the

management of up to four patients. They are expected to do admission notes, daily notes, orders, and discharge summaries for their patients. There are no evening or weekend requirements.

Personnel

UH/VA Neurology personnel: Neurology Clerkship Director

Colleen Tomcik, MD Neurology Clerkship Coordinator

Doris Evans Director of Neurosurgery

Alan Cohen, MD Neurosurgery Clerkship Coordinator

Lois Hengenius

Personnel

UH Psychiatry personnel: Director of medical student education

Kathy Clegg, MD ext 45061 UH site Psychiatry clerkship director

Jeanne Lackamp, MD ext 35656 or pager 38383 (best)

UH clerkship coordinator (schedules, pagers, keys, all routine questions!) Kelly Kelley ext 45987

Personnel (UH Psych cont)

Consultation-liaison faculty David Agle, MD Jeanne Lackamp, MD Joseph Locala, MD

Other personnel C/L coordinator:

Sandy Wallack, RN C/L fellow Residents…

Adult inpatient faculty David Hahn, MD Luis Ramirez, MD

Geriatric inpatient faculty Philipp Dines, MD Irina Korobkova, MD

Inpatient Child faculty Noah Miller, MD

Other personnel Inpatient coordinator Geriatric fellow Residents…

Personnel

VA Psychiatry personnel: Clerkship Director David Blank, MD 440-526-3030, ext.

7882 Clerkship Coordinator Decey Cabarle 440-526-3030, ext. 6955