Stony Brook Neurosurgery Medical Student Rotation Curriculum
The Department of Neurosurgery is a teaching service in Renaissance School of Medicine at Stony Brook University. The purpose of the two week rotation for 3rd and 4th year medical students in neurosurgery is to train medical students to participate in the care of neurosurgical patients in accordance with the overall goals and objectives of the neurosurgery medical student training program.
Neurological surgery is a discipline of medicine and the specialty of surgery that provides operative and non-operative management (i.e., prevention, diagnosis, evaluation, interpretation of imaging, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes that modify the function or activity of the nervous system, including the hypophysis; and the operative and non-operative management of pain. As such, Neurological Surgery encompasses the surgical, nonsurgical and stereotactic radio-surgical treatment of adult and pediatric patients with disorders of the nervous system; disorders of the brain, meninges, skull, including skull base, and their blood supply, including the surgical and endovascular treatment of disorders of the intracranial and extracranial vasculature supplying the brain and spinal cord; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those that may require treatment by fusion, instrumentation, or endovascular techniques; and, disorders of the cranial, peripheral, and spinal nerves throughout their distribution.
Our current approach to curriculum is training and evaluation on a mentorship model. The educational needs of the medical students on our neurosurgery rotation entail an introduction to the evaluation and care of patients with neurosurgical problems. We have a large case volume (1200 cases/year) of adult and pediatric patients that provides an extensive educational opportunity. We have full physician extender coverage for our neurosurgical service, so the purpose of the medical student rotation is wholly educational. We also have a very active cerebrovascular neurosurgery service, utilizing both traditional open neurosurgical operative procedures as well as sophisticated endovascular procedures. This service provides extensive educational opportunity for medical students on the cerebrovascular neurosurgical service, in addition to the general neurosurgery opportunities.
Goals and Objectives
The medical student neurosurgery rotation has delineated general goals and specific measurable objectives for the overall medical student experience. The goals and objectives are organized according to the six competencies. The medical student rotation is two weeks in duration.
Objectives of Training and Rotation Philosophy
The mission of the Stony Brook Medicine 3rd or 4th year rotation in neurosurgery is excellence in neurosurgical education, scholarship, and patient care at the medical student level. Program goals are established by which satisfaction of the mission may be judged. Students will establish foundations in fundamental clinical skills, including neurological examination and the acquisition of basic skills in diagnosis and management of neurosurgical patients. Upon completion of the neurosurgery rotation, each student will be skilled in basic evaluation of neurosurgical patients and familiar with the basic management of common neurosurgical problems.
During the rotation, students will prepare and submit reports (1-2 pages) of two neurosurgical patients that the students have cared for on the service during the rotation. One report will be on a patient with a cranial disorder, and the other report will be on a patient with a spinal disorder. Each report will include a chief complaint, history, physical exam, diagnosis and treatment, as well as a brief (1-2 paragraph) discussion of the literature relevant to the patient’s diagnosis and management.
Core Competencies
Neurosurgical medical student education in the Stony Brook Medicine program is organized according to the six Core Competencies. The rotation requires its students to obtain skill in the six competencies to the level expected of a competent medical student. Toward this end, the program defines the specific knowledge, skills, and attitudes required and provides educational experiences as needed in order for the students to demonstrate the following:
Patient Care:
The student will work to develop the ability to:
- Take and document a comprehensive neurosurgery history and do a physical examination on patients with neurosurgical disorders
- Understand when to order pre-surgical laboratory studies and imaging and what the results of such studies mean in the context of treatment for patients with neurosurgical disorders.
- Develop and implement appropriate care plans for patients with neurosurgical disorders in consultation with the physician extenders and faculty
- Counsel patients with neurosurgical disorders on the risks, goals, limits and alternatives to both simple and more complex neurosurgical procedures in collaboration with physician extenders and faculty
- In some circumstances, perform selected neurosurgical procedures (e.g., placement of intracranial pressure monitors, etc.) under direct supervision of faculty
- Second assist in major neurosurgical procedures that are appropriate for his or her level of interest and acquisition of skill
- Work with other health care professionals on the neurosurgery team and health care professionals from other disciplines who are involved in a patient's care
Medical Knowledge:
The student will develop the ability to:
- Demonstrate a foundation of knowledge of anatomy, physiology and pharmacology related to neurosurgery patients appropriate to a medical student
- Correctly interpret basic laboratory and radiological studies
- Demonstrate increasing familiarity with aspects of the neurosurgery literature commensurate with level and duration of training
- Demonstrate a foundation for neurosurgery problem-solving and decision-making
Practice-Based Learning and Improvement:
The student will develop the ability to:
- Demonstrate an ongoing and improving ability to learn from errors
- Locate, appraise, and assimilate evidence from scientific studies related to common neurosurgical problems
Interpersonal and Communication Skills:
The student will develop the ability to:
- Provide compassionate care as determined by patients, families, colleagues and auxiliary health professionals in the hospital and outpatient settings
- Work effectively as a member of a health care team
- Communicate effectively with other health care professionals on consulting services
Professionalism:
The student will develop the ability to:
- Demonstrate sensitivity and responsiveness to patients' culture, age, gender and disabilities
- Demonstrate integrity and a commitment to patients that supersedes self interest
System-Based Practice:
The student will develop the ability to:
- Advocate for quality patient care and assist patients in dealing with system complexities
- Practice cost-effective health care and resource allocation by using evidence-based medical practice that does not compromise quality of care
