The Medical Approach to the Patient (MAP) is a 12-week integrated clerkship block that is comprised of Internal Medicine and Neurology rotations. The course is structured to give clerkship students in-depth experience with the diagnosis and management of adult medical issues. Because of the significant clinical overlap between internal medicine and neurology, these two clerkships are combined to form the MAP experience. Student will rotate through eight weeks of internal medicine and four weeks of neurology during their MAP experience. In addition to rotation-specific didactics, students will attend the “Top Ten” series of didactics throughout their MAP clerkship, covering common chief complaints that encompass diagnoses specific to internal medicine and neurology.
The Neurology clerkship is a 4-week experience divided into two 2-week blocks offering students a variety of care settings and subspecialties. Students are matched, based on preferences, with the following services: General Inpatient Neurology Ward, Neurology Inpatient Consults, Stroke, Neurosciences Intensive Care, Pediatric Neurology, Veteran’s Affairs Neurology Service (combination of inpatient and outpatient care) and Yale Outpatient Neurology. While the team structure varies across services, in the inpatient setting students will work with a team consisting of an attending, a senior resident, 1-2 junior residents, and APPs. In the outpatient setting, students will work one-on-one with a faculty preceptor, rotating through various subspecialties during their two-week block.
In addition to attending clinical teaching experiences with their teams, students also participate in case-based subspecialty didactics, small group clinical reasoning discussion sessions, and simulated neurologic emergencies.
Students will receive feedback informally during teaching rounds, as well as formally through mid-clerkship feedback and supervised neurologic examinations. The final grade is based on summative feedback, completion of clerkship requirements, attendance, and a written knowledge examination.
By the end of the clerkship period, students will
- Learn how to obtain an accurate neurological history, how to perform & interpret a neurological exam.
- Learn the appropriate indications for ordering laboratory studies in neurology and how to interpret these studies: EEG, EMG, nerve conduction studies, evoked potentials, lumbar puncture, CT and MR imaging of the brain and spinal cord.
- Learn how to evaluate common neurological problems:
- Neurological Emergencies: Coma, mental status changes, stroke, & seizures.
- Common outpatient neurological problems: Headache, dizziness, back & neck pain, peripheral neuropathies.
- Recognize and understand less common neurological problems, including Multiple Sclerosis, Parkinson’s’ Disease and other movement disorders, neuromuscular diseases, dementia, central nervous system infections and tumors of the nervous system.
- Develop the many personal attributes necessary for becoming an effective physician, including honesty, compassion, reliability, and effective communication skills.
- Demonstrate effective communication strategies and professional behaviors with patients, families, and all members of the health care team (including physicians and non-physician health professionals).
|Students must do the following checklist items||Minimum no. of times||Type of patient|
|Evaluate/help manage a patient with dementia||1||real, video module|
|Evaluate/help manage a patient with multiple sclerosis/transverse myelitis||1||real, video module|
|Evaluate/help manage a patient with a brain tumor||1||real, video module|
|Evaluate/help manage a patient with Parkinson Disease||1||real, video module|
|Evaluate/help manage a patient with an ischemic stroke||1||real, video module|
|Evaluate/help manage a patient with migraine||1||real, video module|
|Evaluate/help manage a patient with Guillain-Barre Syndrome||1||real, video module|
|Evaluate/help manage a patient with seizure/epilepsy||1||real, video module|
|Perform a neurological examination of patient observed by preceptor||2||real|