Neurosurgery Junior Medical Student Elective

GOAL:  The goal of this elective is to provide the student with a broad exposure to a neurosurgical practice, and diseases treated.

OBJECTIVES:
General Skills

1. To perform a competent neurological evaluation including relevant history and pertinent neurological examination.
2. To understand the fundamentals of x-ray and computerized (CT, MRI) imaging of the spine and head, including normal and common pathological entities.
3. To be able to identify and differentiate between patient presentations that requires emergent evaluation and those that don’t.
4. To be able to communicate verbally to another physician your interpretation of imaging studies of a patient.

Intracranial Disease

1. To recognize the spectrum of mild and severe head injury and to diagnose and initiate its management.
2. To understand the broad categories, presenting symptoms and management principles of intracranial disease (brain tumors, abscesses, stroke, etc.) including indications for biopsy and surgical intervention.
3. To differentiate common headache syndromes with emphasis on recognition and diagnosis of subarachnoid hemorrhage and intracerebral hematoma, and their acute management.
4. To recognize presenting symptoms and signs of occlusive cerebrovascular disease, and general diagnostic and treatment strategies including indication for carotid surgery.

Spinal Disease

1. To evaluate, diagnose and initiate acute management of spine fracture, dislocation and spinal cord injury.
2. To evaluate and initiate management of spinal degenerative disk and spondylotic disease, and to recognize neural compression syndromes and indications for surgical intervention.
3. To understand the broad categories of primary and metastatic neoplastic disease of the spine, common presenting symptoms and principles of acute management.
4. To understand the basic modalities and there indications for conservative management of low back pain.

Peripheral Nerve Disease

1. To diagnose and initiate the management of peripheral nerve injury and common nerve entrapment syndromes.

Other Common Neurosurgical Problems

1. To identify signs and symptoms of hydrocephalus and spinal dysraphism (such as Chiari Malformation), and know the management options in children and adults.
2. To recognize surgically treatable pain syndromes, and understand the broad indications for surgical intervention for pain, movement disorders and epilepsy

SUGGESTED READINGS

Essentials of Surgical Specialties, Second Edition, pp. 356-418.
Handbook of Neurosurgery, Mark S. Green, MD, Volume One, pp. 1-459.
Handbook of Neurosurgery, Mark S. Green, MD, Volume One, pp. 460-964.

Participating Faculty:  Jose Espinosa, Dennis Mollman, Margaret MacGregor and Brian Russell.

Course Description

Inpatients:  The student will follow at least three inpatients at Memorial Medical Center or St. John’s Hospital.  The student will be expected to write daily progress notes on his/her patients and discuss them with the attending as appropriate.
Outpatients:  The student will be expected to attend at least one outpatient clinic per week with the full-time SIU Faculty.
Operating Room:  The student will have the opportunity to scrub on all surgical cases that occur.  Postoperative orders will be reviewed for each case, as appropriate.

Number of Students: 1                       
Contact Person: Resident on service.  If no resident contact:   Susan Hall at office # 545-8172 (8:00-4:30)

Evaluation:  The student will be asked to submit a history and physical with a discussion on up to three patients that were seen each week.  These will be reviewed and returned to the student before he or she leaves the rotation.  The student will be evaluated at the end of the elective, using the standard evaluation form of the Department of Surgery.

Call Requirements:  Twenty-four hours a day, seven days a week during the elective.