Goals and Objectives: Postgraduate Year 2 (PGY2):

 

The goals for PGY2 include:

• To become proficient in neurological case formulation.

• To rapidly identify and manage neurological emergencies in the adults setting.

• To evaluate and manage a wide range of neurological conditions in the outpatient and inpatient setting.

• To be proficient in performing lumbar punctures.

• To appreciate the interdisciplinary nature of patients with neurological disease and work as part of an interdisciplinary team.

 

PGY2 Competencies:

 

Patient Care:

• Obtain a complete and relevant neurological history.

• Perform complete neurological exam accurately.

• Discuss general approach to initial treatment of common neurological disorders, including risks and benefits of treatment.

• Identify neurological emergencies.

• Movement Disorders:

  • Identify movement disorder phenomenology and categories (hypokinetic and hyperkinetic)

• Neuromuscular Disease:

  • Identifies patterns of neuromuscular disease Identifies patterns of neuromuscular disease (e.g., anterior horn cell disease, nerve root, plexus, peripheral nerve, neuromuscular junction, muscle)

  • Identifies neuromuscular disorder emergencies

  • Orders NCS (nerve conductive study)/EMG (electromyography) testing appropriately

• Cerebrovascular Disorders:

  • Describes stroke syndromes and etiologic subtypes

  • Identifies cerebrovascular emergencies

  • Lists indications and contraindications for intravenous thrombolytic therapy

• Cognitive/Behavioral Disorders:

  • Identifies common cognitive/behavioral disorders

• Demyelinating Disorders:

  • Diagnoses and manages common demyelinating disorders

• Epilepsy:

  • Identifies epilepsy phenomenology, and classification of seizures and epilepsies

  • Diagnoses convulsive status epilepticus

• Headache Syndromes:

  • Diagnoses and manages common headache syndromes

  • Identifies headache emergencies

• Systemic Disease:

  • Diagnoses and manages common neurologic manifestations of systemic diseases

  • Diagnoses and manages neurologic emergencies due to systemic disease

• Child Neurology:

  • Lists the elements of a neurological examination of infants and children

  • Recognizes broad patterns of neurologic disease in infants and children

  • Lists normal developmental milestones

• Neuro-Oncology:

  • Identifies neuro-oncological emergencies and initiates management

• Psychiatry:

  • Identifies common psychiatric disorders

  • Identifies psychiatric co- morbidities in patients with a neurologic disease

• Neuro-Imaging:

  • Recognizes emergent imaging findings on brain MR and CT

  • Identifies basic neuroanatomy on spine MR and CT

  • Identifies major vascular anatomy on angiography

• Electroencephalography (EEG):

  • Uses appropriate terminology related to EEG (e.g., montage, amplitude, frequency)

• Nerve Conduction Studies (NCS)/Electromyography (EMG):

  • Uses appropriate terminology related to NCS/EMG

• Lumbar Puncture:

  • Lists the complications of lumbar puncture and their management

 

Medical Knowledge:

• Localization:

  • Localizes lesions to general regions of the nervous system

• Formulation:

  • Summarizes key elements of history and exam findings

  • Identifies relevant pathophysiologic categories to generate a broad differential diagnosis

• Diagnostic Investigation:

  • Discusses general diagnostic approach appropriate to clinical presentation

  • Lists risks and benefits of tests to patient

 

Systems Based Practice:

• Systems thinking, including cost and risk effective practice

• Work in inter-professional teams to enhance patient safety

• Cost and Risk Effective Practice

  • Describes cost and risk benefit ratios in patient care

• Inter-Professional Team/Patient Safety:

  • Identifies and reports errors and near-misses

 

Practice Based Learning and Improvement:

• Identify strengths, deficiencies, and limits in one's knowledge and expertise.

• Set learning and improvement goals.

• Identify and perform appropriate learning activities

• Use information technology to optimize learning

• Locate, appraise, and assimilate evidence from scientific studies related to the patient's health problems.

• Self-Directed Learning:

  • Acknowledges gaps in knowledge and expertise

  • Incorporates feedback

• Scientific Appraisal:

  • Uses scholarly articles and guidelines to answer patient care issues

 

Professionalism:

• Compassion, integrity, accountability, and respect for self and others

• Knowledge about, respect for, and adherence to the ethical principles relevant to the practice of medicine, remembering in particular that responsiveness to patients that supersedes self-interest is an essential aspect of medical practice

• Compassion/Integrity:

  • Demonstrates appropriate steps to address impairment in self

  • Consistently demonstrates professional behavior, including dress and timeliness

  • Describes effects of sleep deprivation and substance abuse on performance

• Ethics:

  • Determines presence of ethical issues in practice

 

Interpersonal and Communications Skills:

• Relationship development, teamwork, and managing conflict

  • Manages simple patient/family-related conflicts

  • Engages patients in shared decision-making

• Information sharing, gathering, and technology

  • Effectively communicates during team meetings, discharge planning, and other transitions of care

  • Educates patients about their disease and management, including risks and benefits of treatment options

  • Completes all documentation accurately, including use of EHR, to promote patient safety