Neurology core clerkship

The Geisinger Division of Neurology offers third-year core clerkship and fourth-year electives in adult and pediatric clinical neurology. The department has had a rich tradition in medical student and resident education. The practice cares for more than 900 inpatients and more than 9,000 outpatients per year. The high volume of patient encounters provides for opportunities for exceptional neurological care while allowing for clinical teaching in a wide variety of neurological diseases. Rotating students will learn an organized symptoms approach to the evaluation and management of neurologic diseases.

Students will gain a broad exposure by rotating on the inpatient service, consult service, and outpatient subspecialty clinics during their neurology clerkship. There are no on-call or weekend responsibilities. However, the typical work day is an 11-hour day. Consult and inpatient students can expect some late days, working until patient care is completed (equivalent but not identical to an on call experience).

Goals & objectives

Students will learn to obtain an appropriate history and physical examination needed to develop an organized differential diagnosis for common neurologic diagnoses. Using historical and examination data, students should be able to localize and differentiate lesions at the following levels:

• Cerebral hemisphere
• Posterior fossa
• Spinal cord
• Nerve root/plexus
• Neuromuscular junction
• Muscle

Students will become familiar with the appropriate indications for common neurologic tests including:

• Brain imaging (computed tomography, magnetic resonance)
• Electroencephalogram
• Electromyography
• Cerebrospinal fluid analysis

Students will learn to formulate a cogent differential diagnosis for common neurologic symptoms including:

• Weakness and/or sensory loss
• Gait disorder and incoordination
• Cognitive complaints
• Visual loss and diplopia
• Dizziness
• Pain in limb (back/neck pain, limb pain)
• Headache
• Paroxysmal disorders
• Movement disorder/tremor
• Cranial nerve disease
• Neurologic emergencies (i.e. acute alteration in consciousness, coma)

Students will become familiar with treatment options (pharmacologic and nonpharmacologic) for common neurologic problems including:

• Seizure management
• Stroke management
• Movement disorder management
• Pain management including headache, spinal stenosis
• MS/Autoimmune disease
• Neurologic emergency management
• Neuromuscular disease management
• Dementia/delirium management