Neurology

The accrued knowledge about the scientific basis of neurological disease is transforming the clinical practice of neurology in unprecedented ways. Identification of the genetic causes or cellular mechanisms underlying Huntington’s disease, the inherited ataxias, Alzheimer’s disease, multiple sclerosis, stroke, Parkinson’s disease, and neuromuscular disorders have already led to new approaches to diagnosis and treatment. The Department of Neurology at BU Chobanian & Avedisian School of Medicine is committed to the integration of new understanding of the neurobiology of disease into the clinical practice of neurology and the training of neurological physicians, in order to provide better healthcare for patients with neurological diseases. The primary missions of the Department of Neurology are:

1. To provide excellent, state-of-the-art medical care to patients with neurological diseases;
2. To contribute to the advancement of new knowledge through basic and clinical neuroscience research;
3. To train physicians who will possess the skills to deliver comprehensive neurological care and advance new knowledge in the clinical neurosciences.

These missions are executed at Boston Medical Center and the VA Boston Healthcare System. These institutions have been the source of significant contributions to the history of American neurology and, today, are busy clinical services that provide care to patients with a broad range of acute and chronic neurological diseases. This tradition of scientific investigation, training, and patient care continues within active programs in behavioral neurology, memory disorders, neuroepidemiology, movement disorders, sleep medicine, neurogenetics, stroke, neurocritical care, and epilepsy. See the Neurology website for more information.

Residency Program and Subspecialty Fellowships

The primary goal of our residency program is to provide house officers with the knowledge and skills to competently diagnose and care for patients with neurological disease. Our large and diverse faculty encompasses a wide range of interests in neurology and strives to instill a sense of learning, teaching, and cooperation through instruction and supervision of each resident. Each resident has a chance to see an abundant and appropriate clinical case material, presenting the “many faces of neurologic disease.” Our program offers the resident experience in all facets of neurological study through exposure to the strengths of each affiliated institution, resulting in the highest quality of neurological training available anywhere. The link below is intended to be an information resource for staff, current residents, prospective applicants, and medical students: www.bumc.bu.edu/neurology/residencyprogram.

The department also offers neurological subspecialty fellowships: Cerebrovascular Disease and Stroke, Neurocritical Care, Movement Disorder, Sleep Medicine, Behavioral Neurology, and Sports Neurology. The Sports Neurology fellowship is a BUMC/VA combined program.

Chobanian & Avedisian SOM Medical Student Neurology Clerkship

The clerkship in Neurology runs for four weeks. The goal of the clerkship is to teach the students how a neurologist thinks about disease. Students participate in inpatient and outpatient experiences. Students become proficient at the use of the lumbar puncture simulator and demonstrate expertise in a chosen area of neurology through an oral presentation to their peers. There are additional opportunities for exposure to interventional neurology, pediatric neurology, intensive care neurology, and the subspecialty neurology clinics.

The objectives include:

1. The ability to perform a detailed neurological history and examination and to record the results.
2. The ability to interpret historical information and abnormalities found on examination so that the lesion may be localized in the nervous system (where’s the lesion?).
3. Familiarity with common neurological diseases so that knowledge of location of the lesion can lead to the generation of a differential diagnosis (what’s the lesion?).
4. Familiarity with the presentation and pathophysiology of common neurological disorders and disorders associated with common medical and surgical conditions.
5. An understanding of the rationale for the treatment and prevention of neurological disease.
6. Familiarity with the prognosis, psychosocial, and economic aspects of long-term neurologic impairment and disability.
7. The ability to assess, formulate a differential diagnosis, and propose initial evaluation and management for patients with common neurological disorders.
8. The ability to recognize the indications and the information obtained from routine neurological tests such as lumbar puncture, electroencephalography, electromyography, computerized tomography, and magnetic resonance imaging. Also, familiarity with the possible complications of these tests.
9. The ability to describe how end-of-life, cultural competency, and domestic violence issues are addressed in neurologic patients.
10. The ability to discuss how healthcare disparities can affect underserved populations and impact medical care.

The learning objectives and core competencies are addressed via interactive hands-on and simulated sessions such as

• The Lumbar Puncture Workshop
• Bedside Skills Exercise—a one-on-one observed interview and neuro examination of a patient with a neurological disease
• Clinical Reasoning in Neurology interactive cases on didactic days

Each student will be assigned to one of several clinical sites where a coordinator will oversee the clerkship. The course objectives, core reading material, and student evaluation policy will be provided to the students in the online material.