MD Courses — Neurology

First year

Selectives

M04 5017 01 CLINICAL CORRELATIONS IN NEUROSCIENCE
Instructor: Allyson Zazulia, MD, 362-2560
Clinical faculty for this selective are members of the following departments or divisions: Neurology, Pediatric Neurology, Neurological Surgery, Neuro ICU, Radiology, Pathology and Immunology, and Psychiatry. Students will shadow physicians, attend rounds and meet for seminars and demonstrations to discuss particular patient cases and research studies. Teaching Objective: to gain exposure to medical career options involving neuroscience.

M04 582 01 ALZHEIMER’S DISEASE IN THE CLINIC AND THE LAB
Instructors: John C. Morris, MD, and other faculty affiliated with the Knight Alzheimer’s Disease Research Center, Department of Neurology. For information, contact Jennifer Phillips at 286-2882 or phillipsj@abraxas.wustl.edu
Alzheimer’s disease (AD) affects more than 5 million Americans, and will increase substantially as our population ages. Of the top 10 causes of death in the United States, AD is the only disease without any way to prevent, cure or slow the progression. The cost of caring for AD patients has been estimated at over $172 billion annually, and the human toll on patients and family members can be devastating. Patients and families turn to primary care and specialist physicians (e.g., neurologists, psychiatrists, geriatricians) for answers to their plight. The good news for physicians is that research on AD is moving at a rapid pace. Exciting advances in our understanding of AD etiology, early diagnosis and treatment are changing the landscape of dementia care.

Students in this course are offered a dynamic and interactive overview of the most exciting areas of AD clinical and science research from one of the top Alzheimer’s disease research centers in the world. Find out how amyloid plaques and other AD-related abnormalities form in the brain and new discoveries about their possible reversal! The course includes lecture and student presentation components, plus opportunities to observe patients and families in an active neurology memory disorder clinic, participate in neuropathology evaluations of demented individuals, experience and administer psychometric evaluation tools and interact with investigators from the fields of molecular genetics, cell biology and neuropathology.

Second year

M35 632 DISEASES OF THE NERVOUS SYSTEM
Instructor: Allyson Zazulia, MD, 362-2560
The goal of this course is to provide an introduction to diseases of the central and peripheral nervous systems, including their clinical manifestations, pathology, pathophysiology and pharmacotherapy. The course includes reading assignments, lectures, laboratories, conferences and clinical presentations.

Third year

M35 720 NEUROLOGY CLERKSHIP
Instructor: Robert Naismith, MD, 362-3998
A full-time, four-week clerkship is provided on the inpatient neurology services at Barnes-Jewish Hospital south. Patients are assigned to students, who evaluate and follow them with the resident staff and discuss them regularly in conferences with the senior neurological staff. Students also work in the neurology clinic under staff supervision and attend a series of lectures on neurosurgical problems. The goal of this rotation is to gain expertise in the evaluation and treatment of patients with neurologic diseases.

Up to two students may elect to obtain their clerkship experience on the neurosurgery service. Up to two students may elect to obtain their clerkship experience on the inpatient  pediatric neurology service. Students participate in the neurology specialty clinics at St. Louis Children’s Hospital, working under the supervision of pediatric neurology fellows and senior staff.

M25 730 PHYSICAL MEDICINE AND REHABILITATION CLERKSHIP
Coursemaster: Neringa Juknis MD, 454-7757
The clerkship in PM&R for third-year medical students provides an opportunity to gain basic knowledge and clinical skills in evaluation and management of a wide range of neurological and musculoskeletal diseases and conditions that require specialized rehabilitative medical and therapeutic care. Students spend two weeks on the Spinal Cord Injury Unit (SCI) and two weeks on the Brain Injury (BI) and Stroke Unit at The Rehabilitation Institute of St. Louis. Students are expected to be a part of the rehabilitation team, follow two to three patients, participate in daily morning rounds, participate in performing consults and attend team meetings and family conferences.

Students are required to attend several outpatient clinics such as SCI, BI, Amputee and Stroke. During the entire rotation, students work together with PM&R residents and fellows, and under direct guidance of the neurorehabilitation faculty. The usual duty hours are 7-7:30 a.m. to 5 p.m. on weekdays and 8 a.m. to noon on Saturdays. There is no night call.

Students are required to attend all PM&R curriculum lectures and conferences. On the first day of rotation, students meet briefly with the PM&R program coordinator. Students will meet with the coursemaster at The Rehab Institute during their first week to go over goals, objectives. Upon completion of the rotation, students are required to provide written email feedback regarding the rotation experience.

Fourth year

Electives

SCHOOL OF MEDICINE STUDENTS

M35 827 / NEUROLOGY SUB-INTERNSHIP FOR WASHINGTON UNIVERSITY SCHOOL OF MEDICINE STUDENTS
Instructor(s): Director: Robert Naismith, MD, 314-362-3998
Location: Barnes-Jewish Hospital or St. Louis Children’s Hospital
Elective Contact: Chrissy McIntosh, 362-3998

Other Information: Completion of the WU neurology clerkship is a prerequisite for this elective. WU medical students will not repeat clerkship orientation and student-specific neurology conferences. Students will present to their team at the beginning of day one, and will attend resident-oriented conferences (i.e. Morning Report, Journal Club, Clinical Neuroscience).

Enrollment limit per period: 2
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This four-week elective will be customized to include inpatient and outpatient experiences desired by WU students who have completed the WU Neurology Clerkship. Students may choose this elective to further improve their Neurology knowledge and skills. Students considering Neurology as a career may also desire additional exposure to supplement their prior clerkship experience.

The elective is split into two 2-week rotations which may include:

  1. Adult Inpatient General Service (with 1 clinic/week)
  2. Adult Inpatient Stroke Service (with 1 clinic/week)
  3. Adult Inpatient Consult Service (with 1 clinic/week)
  4. Pediatric Neurology Consult Service (with 1 clinic/week)
  5. Adult Neurology ICU (with 1 clinic/week)
  6. Outpatient Clinics (with 8-10 clinics/week)

Student time distribution: Consult Service: Inpatient 90%, Outpatient 10%; Inpatient Service: Inpatient 90%, Outpatient 10%; Inpatient 90-50% (with 2 clinic/week); Outpatient 10-50% (with 2 clinic/week)
Major teaching responsibility: Consult Service: Single attending and resident; Inpatient Service: Single attending, chief resident, junior resident
Patients seen/weekly: Consult Service: 10-12; Inpatient Service: 8-12
On call/weekend responsibility: Consult Service: No call. Work one day per weekend; Inpatient Service: Every 4th night

M35 828 / NEUROLOGY SUB-INTERNSHIP FOR VISITING US MEDICAL STUDENTS
Instructor(s): Robert Naismith, MD, 314-362-3998
Location: Barnes-Jewish Hospital
Elective Contact: Christy McIntosh, 314-362-3998
Other Information: Visiting students will attend Orientation on the first day of the elective, in addition to Neurology Clerkship student conferences.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This four-week elective for fourth-year visiting students from a US medical school provides the option (space permitting) of four weeks of Adult Inpatient Service (Stroke for 2 weeks, General Neurology for 2 weeks), or two weeks on an Adult Inpatient Service and two weeks on the Adult Consult Service.

Students on the inpatient service will function as a Sub-Intern under the supervision of their junior resident, chief resident, and attending physician. The student will also attend weekly clinical conferences and a weekly outpatient clinic experience. This elective is suitable for visiting fourth-year students interested in Neurology, who wish to improve their Neurology knowledge and skills.

Student time distribution: Consult Service: Inpatient 90%, Outpatient 10%; Inpatient Service: Inpatient 90%, Outpatient 10%
Major teaching responsibility: Consult Service: Single attending and resident; Inpatient Service: Single attending, chief resident, junior resident
Patients seen/weekly: Consult Service: 10-12; Inpatient Service: 8-12
On call/weekend responsibility: Consult Service: No call. Work one day per weekend; Inpatient Service: Every 4th night

M35 830 / NEURO-ONCOLOGY
Instructor(s): David H. Gutmann, MD, PhD, 362-7379
Location: Suite C, 6th Floor CAM Building
Elective Contact: David H. Gutmann, MD, PhD, gutmannd@neuro.wustl.edu, Kristi Bullock, 362-7379
Other Information: Students should email Dr. Gutmann at least one week prior to the start date of elective.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Provide an outpatient-oriented combined pediatric and adult neuro-oncology experience for 4th year medical students. (1) Attend multidisciplinary adult and pediatric neuro-oncology clinics and case conferences (tumor boards); (2) Attend adult and pediatric radiation oncology clinics; (3) Attend neuropathology brain tumor review; (4) Participate in subspecialty brain tumor clinics; (5) Attend monthly brain tumor research conferences.

Student time distribution: Outpatient 90%, Conferences/ Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Team teaching in clinic
Patients seen/weekly: 50 patients
On call/weekend responsibility: None

M35 851 / CLINICAL ASPECTS OF AGING AND DEMENTIA
Instructor(s): Joy Snider, MD, PhD, and John C. Morris, MD
Location: Knight Alzheimer’s Disease Research Center (ADRC), 4488 Forest Park Ave. (two-story brick building at intersection with Taylor)
Elective Contact: Jennifer Phillips, MPA (coordinator), 314-286-2882, phillipsj@wustl.edu
Other Information: Please contact Jennifer Phillips to discuss what type of elective experience you would like to have.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 9, 13, 17, 21, 33, 37 and 41.

This elective provides the opportunity to learn about clinical research and clinical care in health brain aging and dementia. Students should contact Dr. Morris or Dr. Snider to discuss this, as this elective is customized based on student interests. This can be a two-week or four-week elective. Students can gain proficiency in interviewing techniques and in the neurologic examination of the geriatric patient, and be introduced to neuropsychology, neuropathology, biomarkers, neuroimaging, genetics, and other biomedical procedures important in the diagnostic evaluation of older adults.  The Knight ADRC is an interdisciplinary group, so students have the opportunity to interact with physicians, nurse clinicians, psychologists, and social workers, and to explore the neuropsychology, neuropathology, biomarkers, neuroimaging, genetics, and other biomedical procedures used in the diagnosis of dementing disorders such as Alzheimer’s disease, dementia with Lewy bodies, frontotemporal dementias, cerebrovascular disorders, and affective disorders.

Student time distribution: Varies based on student interest: a typical distribution would be Research and Clinical Patient Evaluation 80%, Conferences/Lectures 20%, Subspecialty Care 100%
Major teaching responsibility: Attending neurologists, psychiatrists, and geriatricians involved in the evaluation of memory and aging
Patients seen/weekly: 6-12
On call/weekend responsibility: None

M35 859 / NEONATAL NEUROLOGY
Instructor(s): Chris Smyser, MD, 314-454-6120, smyserc@neuro.wustl.edu
Location: 1260 Northwest Tower
Elective Contact: Chris Smyser, MD, 314-454-6120, smyserc@neuro.wustl.edu
Other Information: Meet at St. Louis Children’s Hospital NICU, West Library, 8:30 a.m. first day of the elective.
Enrollment limit per period: 1
Valid start weeks for two-week blocks are: Weeks 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, and 43.

The Neonatal Neurology elective will consist of a combination of inpatient and outpatient experiences designed to provide medical students with comprehensive exposure to the field. Through the rotation, students will actively participate in all aspects of patient care, acquiring the knowledge and skill necessary to effectively manage infants with neurological disorders, including encephalopathy, stroke, seizures, hypotonia, intraventricular hemorrhage, and periventricular leukomalacia, among others. Clinical activities will be tailored to fit the interests and goals of the individual student and include a combination of inpatient and outpatient exposures. Inpatient activities will occur in the St. Louis Children’s Hospital Neonatal Intensive Unit as part of the Neonatal Neurology Consultation service. Outpatient activities will occur in the St. Louis Children’s Hospital Outpatient Clinics. Students will also attend educational conferences specific to the field during the rotation, including Neonatal Neurology Clinical Conference and Neonatal Neuroradiology Conference.

Student time distribution: Inpatient 60%; Outpatient 30%; Conferences/Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Pediatric Neurology faculty attending on consult service and in outpatient clinics
Patients seen/weekly: 25-30
On call/weekend responsibility: None

M35 860 / PEDIATRIC NEUROLOGY
Instructor(s): Douglas Larsen, MD, MEd, 314-454-6042
Location: 12th Floor, Suite 1260 Northwest Tower
Elective Contact: Christy McIntosh, 314-362-3998
Other Information: Students report to Dr. Larsen on the 12th floor, Suite 1260 Northwest Tower, 8:00 a.m. first day of elective for orientation.
Enrollment limit per period: 1 (Inpatient); 1 (Consultation Office Service)
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The senior elective experience in child neurology is designed to adapt to the individual goals and objectives of students. The elective takes place in two 2-week blocks that occur among five possible venues as chosen by the student: (1) Outpatient clinics, (2) In-patient ward service, (3) In-patient general consult service, (4) NICU consult service, and (5) Video EEG (VEEG) monitoring service. The combination of services and experiences will be arranged directly between the student and the Course Master prior to beginning the rotation. In the outpatient clinics, students will rotate between a variety of subspecialty clinics and work with a variety of attendings in order to experience the breadth of outpatient pediatric neurology. Students rotating on the inpatient ward service will have a different role than the third-year student on pediatrics. The fourth-year student will focus solely on neurology patients and work closely with the pediatric neurology resident to develop neurology-specific care plans. No call or weekend duties will be expected on this rotation. On the general consult services, students will work with the consult attending and pediatric neurology residents on that team to see consults in the PICU, CICU, ER, and other hospital floors. The NICU consult team focuses on infants in the NICU. Student rotating on the VEEG monitoring service will focus on learning the indications and uses of VEEG and basic EEG reading skills. All students choosing a pediatric neurology elective will arrange their specific schedule with the Course Master beforehand.

Student time distribution: Inpatient rotation 80%; Outpatient rotation 80%; Conferences/Lectures 20%; Subspecialty Care 100%
Major teaching responsibility: Inpatient: Single attending and senior resident; Outpatient: Multiple attendings
Patients seen/weekly: Inpatient: 5-9; Outpatient: 20-25
On call/weekend responsibility: None

M35 861 / NEUROLOGY/NEUROSURGERY ICU
Instructor(s): Raj Dhar, MD, 314-362-2999
Location: 10400B Barnes-Jewish Hospital
Elective Contact: Liz Vansickle, 314-362-2999
Other Information: Students report to 10400 ICU, 7:30 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The student will be integrated into the Critical Care Team that provides care in the Neurology/Neurosurgery ICU. Diseases frequently encountered include intracerebral hemorrhage, head trauma, subarachnoid hemorrhage, and stroke. The student will follow patients, participate in rounds and perform some procedures under supervision. Didactic sessions will be provided as conferences or lectures from the ICU attending.

Student time distribution: Inpatient 80%; Conferences/Lectures 20%; Subspecialty Care 100%
Major teaching responsibility: Fellows and residents
Patients seen/weekly: 25
On call/weekend responsibility: Variable

M35 865 / ADULT AND PEDIATRIC EPILEPSY
Instructor(s): Edward Hogan, MD, 314-362-3944
Location: 11400 EMU Barnes Jewish Hospital
Elective Contact: Donna Theiss, 314-362-7845, theissd@neuro.wustl.edu
Other Information: Students should meet on 11400 EMU 9:00 a.m. first day of elective.              Enrollment limit per period: 2
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Students will learn how epileptologists diagnose and manage epilepsy in adults and children.  They will learn how to use the history and physical exam and laboratory studies such as EEG, MRI, PET, and SPECT to diagnose and manage patients with new onset epilepsy, established epilepsy, and medically intractable epilepsy.  They will become familiar with the medical management of epilepsy as well as the treatment options for medically intractable epilepsy including surgery, the vagus nerve stimulator, and the ketogenic diet.  They will also learn how to manage the co-morbid conditions that accompany epilepsy such as depression, behavioral problems, cognitive impairment, sleep disturbance, and non-epileptic events.  Students will accomplish these goals by attending epilepsy clinics and rounding on the inpatient epilepsy service with the epilepsy team at Barnes-Jewish Hospital and St. Louis Children’s Hospital. They will attend the Adult Epilepsy Conference, the Pediatric Epilepsy Conference, and Neurology Grand Rounds. Students will also have the opportunity to observe epilepsy surgery if they wish. They will have the option to present one 15-30 minute talk on a topic relevant to epilepsy.

Student time distribution: Inpatient 70%; Outpatient 10%; Conferences/Lectures 20%; Subspecialty Care 100%
Major teaching responsibility: Attending faculty, fellows
Patients seen/weekly: 40
On call/weekend responsibility: None

M35 871 / CLINICAL NEUROIMMUNOLOGY & MULTIPLE SCLEROSIS
Instructor(s): Becky Parks, MD, parksb@neuro.wustl.edu
Location: Various clinic locations
Elective Contact: Nanette Bladdick, 314-362-3307
Other Information: Contact Dr. Parks by email to arrange time and location to report on first day of elective.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 5, 13, 17, 21, 25, 29, 33, 37, and 41.

Students will have the opportunity to interview and examine patients with multiple sclerosis or related neuroimmunological disorders.  They will become familiar with the differential diagnosis of MS, appropriate laboratory evaluation and common MRI findings in MS.  This elective will also familiarize students with the disease-modifying therapies used to treat MS. They will gain practical knowledge about evaluation and treatment of spasticity, neurogenic bladder, fatigue and other common symptoms.

Third-year medical students rotating as part of a core rotation will attend the required conferences for third-year students.  Students choosing this elective to gain additional experience in the field of Neurology will attend Neurology Grand Rounds on Friday morning.  Students may also attend our MS Journal Club and the MS Patient Care conference held on the first and third Thursdays of every month, respectively.

Student time distribution: Inpatient 0%; Outpatient 90%; Conferences/Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Becky Parks, MD
Patients seen/weekly: 30+
On call/weekend responsibility: None

M35 872 / MS CENTER/OUTPATIENT – MISSOURI BAPTIST
Instructor(s): Barry Singer, MD, 314-996-7966
Location: Missouri Baptist Medical Center, 3009 N. Ballas Rd,  Building B, Ste. 207B, St. Louis, MO 63131
Elective Contact: Barry Singer, MD, 314-996-7966
Other Information: Students meet at 8:00 a.m., Missouri Baptist Medical Center, 3009 N. Ballas Rd,  Building B, Ste. 207B, St. Louis, MO 63131, first day of elective.
Enrollment limit per period: 2
Valid start weeks for 4-week blocks are: Weeks 5 and 9.

Students will develop their skills in taking histories and performing neurological examinations on patients with multiple sclerosis under direct supervision of multiple sclerosis specialists.  Localization of neurological findings and symptoms to the neuro-axis will be emphasized.  A major goal for the students will to increase the understanding of comprehensive patient management including disease treatment, symptom management, adjunctive therapy services, and psychosocial issues.

The outpatient rotation will be four weeks at The MS Center for Innovations in Care at Missouri Baptist Medical Center with Dr. Barry Singer and Dr. Mark Tullman.  An additional goal for students will be to understand process of clinical research and translation into approved therapies.  The center has been a leader in clinical trial development of therapeutics that have been or will soon be FDA-approved as new medications for multiple sclerosis.

Student time distribution: Outpatient 100%; Subspecialty Care 100%
Major teaching responsibility: Barry Singer, MD, Mark Tullman, MD
Patients seen/weekly: 20
On call/weekend responsibility: None

M80 807 / PHYSICAL MEDICINE AND REHABILITATION
Instructor(s): Neringa Juknis, MD, 314-454-7757, juknisn@neuro.wustl.edu
Location: Suite 2304, Rehabilitation Division, Neurology Department, 4444 Forest Park
Elective Contact: Donna Barbier, 314-454-7757, barbierd@neuro.wustl.edu
Other Information: Students report to Suite 2304, Rehabilitation Division, Neurology Department, 4444 Forest Park, 9:00 a.m. first day of elective.
Rotation location: The Rehabilitation Institute of St. Louis, 4455 Duncan Ave.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The elective is designed to provide the student with a broad introduction to the field of Physical Medicine and Rehabilitation. Major objective of this clinical elective is to achieve greater knowledge of the neurological and musculoskeletal diseases and their treatment, and gain understanding of basic principles of rehabilitation. The student will learn the clinical and rehabilitative care of patients with strokes, traumatic brain injury, spinal cord trauma and diseases, and limb amputations. Student will gain clinical skills in evaluating in management of functional impairments. Students will be expected to participate in daily rounds on inpatient rehabilitation units with the clinical care team, follow 3-5 patients, attend multidisciplinary team conferences and family meetings, attend outpatient rehabilitation clinics in spinal cord, stroke, traumatic brain injury, and amputee. Teaching and supervision is provided by the physiatry and neurology faculty of the Division of Rehabilitation. Rehabilitation and neurology residents are involved in student teaching as well. Students are required to participate in didactic teaching conferences within the PM&R residency.

This rotation is particularly useful for students considering careers in rehabilitation, neurology, geriatrics, primary care, neurosurgery, or any other field that will require experience in the evaluation and management of patients with physical impairment and disabilities.

Student time distribution: Inpatient 80%; Outpatient 10%; Conferences/Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attending faculty and residents
Patients seen/weekly: 20
On call/weekend responsibility: None