Neurology Clerkship

The typical Neurology day starts around 7:30am to 8am depending on the site.  There are 3 sites through which the students rotate:  NMH, ENH and the VA hospital. 

At the NMH site there are 3 subrotations.  Each student will rotate in 2 week blocks between 2 subrotations.  In addition each student will have an outpatient clinic schedule and will attend one half day clinic session a week.  The three subrotations are Stroke, Ward and Consult services.   The day starts with morning report from Monday through Thursday at 7-7:30am depending on the day.

On the NMH Stroke service, the students are expected to pre-round on their 2-3 patients, prior to attending morning report.  Daily rounds with the team are usually between 8:30-10:30am.   The students will usually have time after rounds and in the afternoon to take care of patient care issues, write notes etc.  They are excused to attend noon conferences.  Afternoon sign out rounds for this service usually starts from 4:30 and may last till 5-5:30. 

On the NMH Ward service, students will have time to pre-round on their patients after morning report.  Daily rounds on the patients usually take place between 10am till noon.  Students will be excused to attend noon conferences, and will have time to take care of patient care issues, write notes etc in the afternoon.  Sign out rounds will take place at around 4:30pm. 

On the NMH consult service rounds may take place between 10am to noon or start in the afternoon after noon conferences.  Students will be assigned new patients to work up.  They are expected to follow-up on their 1-2 patients, as well as work-up new patients.  They will have time before or after rounds, but may occasionally have to break off from rounds to see new patients.  Consult rounds can be very lengthy.  Afternoon sign out rounds usually take place after 4:30pm. 

At the ENH site, there are again 3 subrotations:  consultation, ward and outpatient clinics, and the students rotate equally between the 3.  

On the ENH Consult service, the students are expected to pre-round on patients their patients prior to morning rounds which may start between 9 or 10am.  They will also be assigned new patients prior to rounds, in the afternoon or during rounds.  They will be given time to evaluate the patient.  They will have time to write notes and take care of patient care issues after rounds.  Afternoon sign out rounds usually start at 5pm.   

During the ENH Clinic rotation, students will shadow doctor(s) in clinic.  During the rotation, they will be excused to attend morning and noon conferences as available.

The ward rotation consists of rounding on patients on a daily basis.  The time of daily rounds may vary.

The VA site consists of consultation, ward and outpatient experience.  The students rotating at the VA hospital will attend morning report at NMH from Monday through Thursday.  They will then be expected to pre-round on their patients prior to rounds which start at about 9-10am.  Students will be assigned patients from both the ward and consult services.  The rounds are also conducted on both the consult and ward services.  Students are excused to attend classes and conferences at NMH.  They will have time to write notes and follow-up on patient care issues after rounds.  The VA students will also attend one outpatient clinic per week. 

Regardless of the rotation:

• If there are any immediate care issues with your patients after working hours, you are expected to take care of them or sign off to the resident on call.
• Depending on the patient load or the urgency of patient care issues, rounds may run past usual working hours.
• Students will be excused from rounds or other activities to attend scheduled classes and conferences unless they are in the middle of urgent patient care issues, such as administering CPR etc.