Neurology of Central Georgia
175 Water Tower Court, Macon GA 31210 ~~~ Ph (478) 471-6217 ~~~ Fax (478) 471-8663
Neurology Rotation – Medical Students and Residents
Important things to study BEFORE the rotation starts
Since you only have 4 to 6 weeks on the neurology rotation, I have found that most students / residents lose a lot of time trying to “re-learn” the fundamentals of neurology (information that should have been learned during basic sciences).
Hence, BEFORE you start your rotation, please read about and re-learn about the following:
- Read about the different aspects of the “neuro axis”:
- spinal cord
- nerve root
- peripheral nerve
- neuromuscular junction
- What are the UNIQUE hallmark signs and symptoms of a lesion at each point along the neuro axis?
- Review basic neuro-anatomy (cortical lobes, parts of brainstem, tracts within spinal cord, etc)
- Review the sensory and motor pathways (which you learned during basic science lectures)
We will definitely review this information during the rotation. But, without this basic knowledge, your experience in neurology will be limited and constrained.
- On the first day of the rotation, there is an Orientation Webinar at 8:00 am.
- Please come to the office at 7:45 am, and use our office conference room to attend the Orientation Webinar.
- After completion of the webinar, you can jump into clinic to officially start your rotation.
- You can also use our conference room to attend the weekly “Academic Day” webinar meetings – typically on Thursdays
How to assess progress
- You will be required to take a “Neurology Academic Quiz” on the first day of the rotation
- I do NOT expect you to “ace” this test. Rather, it will assess your level of Neurology knowledge at the beginning of the rotation
- You will be required to take another “Quiz” at the end of the rotation
- Part of your “clinic” grade and assessment will be based on how you have progressed during your Neurology rotation
- These quizzes are NOT meant to be stressful. Rather, they are meant to demonstrate your academic growth and help build your confidence in clinical Neurology
Topics to study DURING the rotation
There are a handful of topics which are very common in Neurology, and which I feel are important for all young physicians to fully understand. Many of these topics will probably be discussed during your Neurology lectures, and many others you will probably read while preparing for your Board exams.
I would encourage you to study and try to understand the clinical relevance of these topics while spending your rotation at our office. We will be discussing these topics at random times during the month. The more you read about these topics, the more I can teach you during your clinical rotation.
I will be updating this list on a regular basis, so I encourage you to check this list often.
- The differences between Aphasia vs. Dementia vs. Delirium
- Different types of hydrocephalus
- Common types of headaches
- Types of intra-cerebral bleeds
- Chronic pain vs. acute pain
- What are “scheduled” drugs
- Common types of peripheral neuropathy
- What is “AIDP” and “CIDP”, and the difference between these entities
- Hallmark symptoms of Parkinson’s
- Parkinson’s vs. Parkinsonism
- Seizures vs. Epilepsy
- How to treat status epilepticus
- Concussions and post-concussive syndrome
- Concussion vs Closed Head Injury
- Bell’s Palsy
- Myasthenia Gravis
- Multiple Sclerosis
Some resources which might be helpful in your studying:
- Blueprints Neurology – most students feel this is the most inclusive “review” textbook
- Pre-Test Neurology
- Online Med-Ed
- Case Files Neurology
- During week 1 – Read Blueprints Neurology cover-to-cover, but don’t attempt to memorize all the details
- During week 2 – Re-read Blueprints Neurology, but in more detail, and focusing on the topics we discuss during the rotation
- During week 3 – Start doing sample test questions (Uworld, Pre-test, etc), while continuing to read Blueprints Neurology in detail
- During week 4 – Target-read the difficult topics, continue sample test questions, and start to get ready for Shelf Exam
This 4 week plan on only a suggestion. BUT, over the past few years, students who have followed this plan have been greatly surprised and rewarded with their high achievement on the Shelf Exam.
- Bring a cell phone or mini-tablet with internet browsing capability ( we have wifi in the office)
- Please keep cell phone on “vibrate” mode
- DO NOT use cell phone or tablet in front of patient – this would be very rude, and a sign of dis-respect to the patient
- The only tool you would need would be a neuro hammer, but do not buy one.
- Most students & residents purchase the wrong type of hammer. I will show you which one to purchase. You can buy one after the rotation starts
- Business casual attire, with your white coat and name tag
- Arrive at office around 7:45 am
- You should be able to leave office around 4:00 to 4:30 pm
- Monday’s are our “late days” – be prepared to stay till around 5:30 pm
- Park at LEFT side of building, in covered parking area
- Enter thru side door – staff will have unlocked side door
- Consider bringing lunch – we have a kitchen with microwave and fridge
- Many eateries are within driving distance (Arby’s, Burger King, Fresh Market, Kroger’s, Starbucks, etc)
- Wear comfortable shoes
- This is an out-patient rotation, with no call and no weekend responsibilities
- If you have a lecture commitment, just let me know, and you can break away for the lecture and return when you are done with the lecture.
- We have a conference room where you can watch your lectures and grand rounds
- I will assign reading and “homework” during the rotation – you are an adult, so I expect you to keep up with these assignments
- Although my typical workweek is around 70 hours, your typical workweek in the clinic will be around 30-35 hours
- Since this is not a very time-demanding rotation, I EXPECT you to read and learn Neurology when not in clinic
- There should be absolutely no excuses for not reading neuro related material during the rotation
- You will be working with me, Dr. Athni, directly – so please leave any “laziness” attitude at home and bring your “A” game to the rotation
- REMEMBER: You will get out of this rotation what you put into it
- This might be your only exposure to Neuro, so take advantage of the rotation.
- The more you learn, the more you demonstrate an interest to learn, the more you ask, the more I will teach
Many students and residents are “afraid” of neuroscience and Neurology. Come with an open mind, and you will quickly find that Neurology is a lot of fun.
This is not a physically-challenging rotation (no sleep deprivation, no excessive walking, no call, no after hours, etc), but be prepared for an academically challenging rotation, in a low stress environment. So, don’t stress over this rotation. Bring your “A” game, and you will learn more than enough to earn an “A” on your shelf exam, while also becoming well prepared for the Neurology component of the Step 1 and Step 2 exams.
You never know, you may decide that a Neurology career might be in your future.
I am looking forward to having you work in our office and hopefully learn a little bit of neurology.
Mon: 8:30 am to 4:30 pm
Tues: 8:30 am to 4:30 pm
Wed: 8:30 am to 4:30 pm
Thurs: 8:30 am to 4:30 pm
Fri: 8:30 am to 12 Noon
Weekends – Closed
Holidays – Closed
If you are receiving Ocrevus, Lemtrada, Gilenya, Mayzent, Mavenclad, or Rituxan, please make an appointment with Dr. Athni to discuss your individual situation. For all other medications, including IVIG, Tysabri, Tecfidera, Aubagio, Copaxone, Avonex, Betaseron, Rebif, and Plegridy, Dr. Athni feels it should be safe to continue with your various neuro-medications.
If you are receiving Ocrevus, Lemtrada, Gilenya, Mayzent, Mavenclad, or Rituxan, please make an appointment with Dr. Athni to discuss your individual situation.
For all other medications, including IVIG, Tysabri, Tecfidera, Aubagio, Copaxone, Avonex, Betaseron, Rebif, and Plegridy, Dr. Athni feels it should be safe to continue with your various neuro-medications.