MDC7800
NEUROLOGY CLERKSHIP

NEUROLOGY CLERKSHIP SYLLABUS
2025 – 2026
Visit our website to find more info… https://neurology.ufl.edu/education/4th-year-clerkship-in-neurology/

Goals and Objectives

During the next four weeks, you will be exposed to the depth and breadth of the nervous system. We are eager to provide a stimulating educational environment where you can acquire the knowledge, skills, and attitudes important in the care of neurologic disorders. The Department of Neurology places the highest priority on your education. We expect you will display an eagerness to learn, ability to teach yourself and others, and appreciate the special nature of patients with neurologic conditions. We want you to be the best!
We have set the following as goals for you to accomplish during this experience:

Goals

• Provide an educational program that helps prepare our students for any residency they may choose as part of the general professional education.
• Prepare students to be exemplary house officers (AKA residents).
• Acquisition of the clinical application of basic knowledge of the nervous system.
• Development of communication skills that will facilitate the clinical interaction with patients with neurologic disorders and their families and thus ensure that complete, accurate data are obtained.
• Development of competency in the single system neurological examination.
• Acquisition of the knowledge necessary for the diagnosis and initial management of common acute and chronic neurological conditions.
• Development of clinical problem-solving skills.
• An understanding of the influence of family, community, and society in the care of people with neurological conditions.
• Development of strategies for health promotion and prevention of neurological damage.
• Development of the attitudes and professional behaviors appropriate for clinical practice.
• An understanding of the approach of neurologists to the health care of people with neurologic conditions.
• Begin to understand an educational plan for continuous learning throughout your medical career.

Objectives
The Department’s expectations of your performance are in line with the College of Medicine’s institutional learning outcomes. There are several objectives, both general and specific. You will experience, be taught, and evaluated specifically in the following competencies:

• Professionalism (P)
• Practice-Based Learning (PBL)
• Patient Care (PC)
• Interpersonal Communication (ICS)
• Medical Knowledge (MK)
• System Based Practice (SBP)

General:

• Demonstrate the professional conduct necessary for a successful clinical interaction with patients and families (P.02, P.06).
• Demonstrate respect of patient and family differences in attitudes, behaviors, and lifestyles, paying particular attention to cultural, ethnic, and socioeconomic influences (P.02).
• Demonstrate intellectual curiosity, initiative, responsibility, honesty, and reliability (P.03, P.06).
• Demonstrate solicitation, acceptance, and action on feedback (P.05).
• Demonstrate collegiality and respect for all members of the health care team (P.05, P.06).
• Evaluate patients in a variety of clinical settings, establishing rapport with the patient and family in order to obtain a complete history and physical examination (ICS.02) (PC.01).
• Summarize history and exam findings, especially the key elements. (PC.02, PC.03).
• Prepare a complete written summary of the history and physical and orally present the case in a chief complaint focused and chronological manner (PC.02, PC.03) (ICS.04).
• Identify clinical problems and outline an initial diagnostic and therapeutic plan (PC.02, PC.03).
• Recognize when hospitalization and diagnostic tests are indicated (PC.02, PC.03).
• Identify the most useful diagnostic tests and be aware of their costs and limitations (PC.02), (SBP.04).
• Effectively communicate information about the diagnosis and treatment to patients and families (ICS.02, ICS.07).
• Obtain updated information relevant to the diagnosis and treatment of the patient, performing a literature search and critical review of the literature (PBLI.01).

Specific:

Neurologic Assessment

• Obtain a complete and relevant neurologic history (PC.01).
• Perform a complete neurological exam accurately (PC.01).
• Perform a screening neurological exam (PC.01).
• Perform a coma and brain death examination accurately (PC.01).
• Describe basic neuroanatomy (MK.01).
• Localize lesions to general regions of the nervous system (PC.02) (MK.01, MK.02).
• Identify relevant pathophysiologic categories and combine with history, localization, and time course to generate a broad differential diagnosis (PC.03) (MK.01, MK.02).

Neurological Emergencies

• Identify and approach the main neurological emergencies (e.g. Stroke, GBS, Myasthenia Gravis, Status epilepticus) (PC01, PC.02, PC.03) (MK.01, MK.02).

Disturbances of Senses (visual, hearing, and balance)

• Recognize when a patient may have a disorder of senses (PC.01, PC.02, PC.03) (MK.01, MK.02).
• Diagnose and manage common sense disorders (PC.01, PC.02, PC.03) (MK.01, MK.02)

Movement Disorders

• Identify movement disorder phenomenology and categories: hypokinetic and hyperkinetic (PC.01, PC.02, PC.03) (MK.01, MK.02).
• Identify movement disorder emergencies (PC.01, PC.02, PC.03) (MK.01, MK.02).

Neuromuscular Disorders

• Identify patterns of neuromuscular disease – e.g. anterior horn cell disease, nerve root, plexus, peripheral nerve, neuromuscular junction, muscle (PC.01, PC.02, PC.03) (MK.01, MK.02).

Cerebrovascular Disorders

• Describe stroke syndromes and etiologic subtypes (PC.01, PC.02, PC.03) (MK.01, MK.02).
• Identify cerebrovascular emergencies (PC.01, PC.02, PC.03) (MK.01, MK.02).
• List indications and contraindications for intravenous thrombolytic therapy (PC.01, PC.02, PC.03) (MK.01, MK.02).

Cognitive/Behavioral Disorders

• Recognize when a patient may have a cognitive/behavioral disorder (PC.01, PC.02, PC.03) (MK.01, MK.02)
• Identify common cognitive/behavioral disorders (PC.01, PC.02, PC.03) (MK.01, MK.02).

Demyelinating Disorders

• Recognize when a patient may have a demyelinating disorder (PC.01, PC.02, PC.03) (MK.01, MK.02).
• Diagnose and manage common demyelinating disorders (PC.01, PC.02, PC.03) (MK.01, MK.02)

Epilepsy

• Identify epilepsy phenomenology, and classification of seizures and epilepsies (PC.01, PC.02, PC.03) (MK.01, MK.02).
• Diagnose convulsive status epilepticus (PC.01, PC.02, PC.03) (MK.01, MK.02).

Headache

• Diagnose common headache syndromes (PC.01, PC.02, PC.03) (MK.01, MK.02).
• Discuss when neuroimaging is required in headache disorders (PC.01, PC.02, PC.03) (MK.01, MK.02).
• Manage common headache syndromes (PC.01, PC.02, PC.03) (MK.01, MK.02).

Neuro-Oncology

• Recognize common clinical presentations of a brain or spine mass (PC.01, PC.02, PC.03) (MK.01, MK.02).

Management

• Demonstrate basic knowledge of management of patients with neurologic disease (PC.01, PC.02, PC.03) (MK.01, MK.02).
• Discuss general approach to initial treatment of common neurologic disorders, including risks and benefits of treatment (PC.01, PC.02, PC.03) (MK.01, MK.02) (ICS.02, ICS.04).
• Demonstrate general knowledge of diagnostic tests in neurology (MK.01, MK.02).
• Discuss general diagnostic approach appropriate to clinical presentation (PC.03) (MK.02).
• List risks and benefits of tests to patient (ICS.02, ICS.04) (PC.02, PC.03) (MK.02).
• Identify situations in which it is appropriate to request neurologic consultation (PC.02) (SBP.04).

Neuroimaging

• Identify basic neuroanatomy on brain and spine MRI and CT (MK.01).
• Recognize emergent imaging findings on brain MRI and CT (MK.01) (PC.02).

Lumbar Puncture

• List the indications and contraindications for lumbar puncture (MK.01) (PC.02, PC.04).
• List the complications of lumbar puncture and their management (MK.01) (PC.02, PC.04).
• Demonstrate the ability to perform a lumbar puncture (PC.04).

Organization & Sites

Administration

Department Chairs:
Michael Jaffee, MD (GNV)
Ramon E. Bautista, MD, MBA (JAX)

Clerkship Directors:
Chris Robinson DO, MS (GNV)
Shannon Laboy, MD (JAX)

Assistant Clerkship Director:
Pouya Ameli (GNV)
Constance Katsafanas, DO (JAX)

Clerkship Coordinators:
Kelly Martin (GNV)
Frances Lusad (JAX)

Gainesville Sites

Inpatient

UF Health Neuromedicine Hospital (NMH or HVN)
1505 SW Archer Road
Gainesville, FL 32610
(352) 265-0111
Hospital Neurology Inpatient: Patients on 5th Floor Wards, 5600 and 5700; Workroom: 5528
Consult/Access Neurology: Patients Everywhere; Workroom: 5528
Stroke: Patients mostly on 5th Floor Wards, 5600 and 5700; Workroom: 4560
NeuroICU: 4th floor: Patients in 4700 primarily (4600 also); Work area in back of ICU
Neuromedicine Clinic 1st floor (Across from Opus): Rooms 73 and 74 for Afternoon Clinic with Dr. Singh

Norman Fixel Institute for Neurological Diseases
3009 Williston Road
Gainesville, FL 32608
(352) 294-5400
Fixel Rooms 36 and 38 for Afternoon Clinic with Dr. Montalvo

Malcolm Randall VA Medical Center
1601 SW Archer Road Gainesville, FL 32608
(352) 376-1611
Neurology Resident Workroom: VA Bed Tower (new tower), 3rd Floor, Room H-315

Jacksonville Sites

Inpatient

Shands Jacksonville Hospital 655 West 8th Street Jacksonville, FL 32209
(904) 383-1022
Neurology Wards: 4th Floor

Outpatient

Shands Jacksonville Tower I 580 West 8th Street Jacksonville, FL 32209
(904) 383-1022
Neurology Clinic: 9th Floor

Total Care Clinic
1833 Boulevard POB
Jacksonville, FL 32206
Neurology Clinic: 5th Floor

Neurology Clerkship Grading Breakdown
50% Clinical Core Competencies
While rotating on the Neurology Services, you are responsible to participate fully in the team activities. Try to practice your H&Ps with first time patients and follow a minimum of four patients during your clerkship. You will be observed and evaluated by faculty, fellows, and/or residents. These assessments are based on the six ACGME Core Competencies:

1. Medical Knowledge: knowledge about different neurological conditions, especially those commonly seen in the clinic or inpatient service.
2. Patient Care: history taking, physical exam, clinical reasoning
3. Practice-Based Learning: seeking feedback, intellectual curiosity, eagerness to learn, application of EBM, teaching others
4. Interpersonal & Communication Skills: rapport with patient and family, oral presentations
5. System-Based Practice: helpfulness to the team

The Neurology Clerkship Feedback and Clinical Evaluation Form Clerkship Feedback Eval Form will be used to grade these six Core Competencies. These evaluations will be completed online (New Innovations) by the faculty, fellows and/or residents that worked with you. You can find these evaluations online or attached on the welcoming email. The Evaluation Forms comprise 50% of your total clerkship grade.

10% Neurology Clerkship Bedside Skills Evaluation form (BSE)
During the clerkship you need to complete one neurology clerkship beside skills evaluations Neurology Clerkship Bedside Skills Eval. These evaluations should be done with neurology faculty or a SENIOR NEUROLOGY Resident and can include an inpatient or outpatient (clinic) case. The aim is to assess your clinical skills via direct observation in 4 major categories: history gathering, neurologic examination, humanistic, professional qualities and presentation and clinical reasoning skills. The evaluation should ideally be completed during the 2nd week of the clerkship.

15% Portfolio Compilation
The intent of the portfolio is to ensure a well-rounded education experience as well as evaluate your medical writing abilities. The following required items are intended to assist in the development of your medical skills and medical writing by providing opportunities to practice newly acquired skills and attain feedback on your progress. PDF formats of the evaluations listed below are provided at the end of the syllabus, online, and attached on the welcoming email.

1. NBME Neurology STEP Preparation:
   Within CANVAS, two 40 point NBME shelf preparation examinations have been prepared. Completion of these examinations is required. NBME examination I is to be completed by Friday of the 2nd week and NBME examination II is to be completed within the 4th week of the clerkship. The examinations themselves are a formative in nature. Though completion of the examinations is required, the point total obtained by the medical student does not count towards the final grade. The goal of these examinations is to prepare the student for the required shelf examination and provide formative feedback for shelf preparation. Students completion of the examinations will be seen within canvas and a completion grade will be made within the portfolio. Failure to complete these examinations will result in a reduction in the portfolio grade.
2. Neurology Clerkship Required Clinical Experiences: Please complete the “Neurology Clerkship Required Clinical Experiences” Clerkship Required Clinical Experiences form to document that you have seen all of these important neurological physical findings. Notify the clerkship director if you have not seen all of them. Watching a video or picture of the physical finding also qualifies as a positive observation. Please return the form to the clerkship coordinator for placement in your portfolio.
   
   Helpful online resources to watch and learn neurological examination with videos: http://library.med.utah.edu/neurologicexam/html/home_exam.html http://neuroexam.com/neuroexam/ https://www.youtube.com/playlist?list=PLHdemSStztKaB0A_iqfdiepvRwljoI1dF (University College of Dublin Neurology)
   https://stanfordmedicine25.stanford.edu/videos.html http://movementmodules.yale.edu/ (Movement disorders modules from Yale Univ) http://fn.med.utoronto.ca/index.html (Functional Neuroanatomy Atlas) http://headneckbrainspine.com (Neuroanatomy imaging)
   http://casemed.case.edu/clerkships/neurology/neurorads.html (Neuroradiology teaching Case Western)
   
3. Status Epilepticus Simulation: The students will participate in a simulation of status epilepticus. This activity aims to assess knowledge, leadership, teamwork, and communication in the management of status epilepticus. The students can read the material posted in CANVAS to prepare for the simulation. At the end of the activity, there will be a debriefing session. This activity is not graded. We value your feedback at the end of the simulation.
   
4. Acute Stroke Simulation: The students will participate in an acute stroke simulation. This activity aims to assess knowledge, leadership, teamwork and communication in the management of acute stroke. The students need to read in advance about the management of acute ischemic and hemorrhagic stroke. This activity is not graded. We value your feedback at the end of the simulation.
   
5. Formative Clinical Neuroanatomy Session: Each clerkship block, students will be required to attend a 1 hour clinical neuroanatomy session with Dr. Rarey. The session will include 4 unique modules relating to clinical neurology and clinical neuroradiology through utilization of radiographic technology and cadaveric teaching. Students are required to bring their GATOR ONE cards for attendance. The session will be outlined in the monthly session. The session will take place in the Communicore building CG-83 from 12pm-1pm. All students are excused from clinical duties for this learning opportunity.
   
6. Self-Directed Learning Modules: We have developed several self-directed learning modules for review throughout the clerkship. Each module will accompany your required lectures and be available for continuous review throughout the clerkship. The lectures accompanying each module will be case-based and assume review of the material has been completed.
   
7. Clerkship Evaluations: Help us make this the best Clinical Clerkship! Although not graded, we expect you to complete at least 5 evaluations by the end of the clerkship. These evaluations include one program/clerkship director evaluation and at least 4 faculty, fellow, resident evaluations. Evaluations of the clerkship will be done using New Innovations and GatorEvals. Students will be notified when the evaluation period opens, and can complete through the email they receive from GatorEvals, in their Canvas course menu under GatorEvals.

25% Medical Knowledge Examination
The efforts on the NBME shelf exam comprise 25% of the total Neurology Clerkship score. There is not a minimum exam pass score for the clerkship. However, students who score below the 10th percentile nationally need to meet with the clerkship director to discuss whether a test taking remediation plan should be developed to promote improved performance. Shelf exams are usually scheduled on the last Friday of the Clerkship and will occur IN PERSON.
To prepare for the shelf exam in addition to the clerkship tests, we recommend the following resources based on clinical questions and common neurology cases:

1. PreTest
2. Case Files
3. Blueprints
4. U-World
5. First Exposure to Neurology
6. GunnerGoggles Neurology Shelf Review
7. https://ravenneurologyreview.com/

CANVAS modules: Please review all pre-recorded self-directed learning modules for additional preparation.

Other resources to help you not only prepare for the shelf, but to improve your general knowledge in Neurology, include:

Victor and Adams, Companion Handbook to Principles of Neurology and Principles of Neurology Victor and Adams in Harrison’s textbook Principles of Internal Medicine
Greenberg, Aminoff and Simon, Clinical Neurology
Joynt’s Clinical Neurology (available in the Gainesville Neurology Library and on CD on the residents’ computer in Gainesville)

You may also find the textbook and notes from your Neuroscience course especially helpful. We want you to excel in this area so if you are feeling underprepared or overwhelmed, let us know! We are here to help.

BOG Attestation Regarding Clerkship Instructional Materials
Instructional materials for this course consist of materials reviewed, selected, and assigned by the instructor(s). The instructor(s) is only responsible for these instructional materials. Based on self-assessment of learning needs, students may identify other credible resources to augment the identification, analysis, and synthesis of relevant information.

Computer Requirement:
Students are required to bring their laptop to the rotation. Laptops can be safely stored in all neurology workrooms and in the fellow workroom in the neuro ICU. Laptops will be used on all rotations and are a core expectation for this rotation.

Feedback

Mid Clerkship Feedback
Students will complete the ONLINE Mid Clerkship Feedback form the 2nd and 4th Thursday of the rotation. The link and QR code for the Mid Clerkship Neurology Clerkship Feedback form is: https://ufl.qualtrics.com/jfe/form/SV_cUNKB9QEcMShCbI

All students will meet with the clerkship director at GNV or JAX at the end of the 2nd week or the beginning of the 3rd week of the clerkship to discuss their progress in terms of evaluations, portfolio and receive pertinent feedback. The students need to bring their first completed Bedside Skill Evaluation (BSE) form Neurology Clerkship Bedside Skills Eval and what they have advanced of the Clerkship Required Clinical Experiences form Clerkship Required Clinical Experiences. The meetings will be scheduled by the clerkship coordinator at each site. The clerkship director will complete the Mid-Clerkship Feedback form Neurology Mid Clerkship Feedback.
When obtaining formative feedback from faculty or house staff you should print out the formative feedback evaluation form, reflect on your performance. Next, for areas you feel you are struggling brainstorm 1-2 ways you might be able to improve your performance in these areas. If faculty/resident ratings don’t align with your evaluation this is a natural time to ask the faculty/resident how you can improve performance.

Final Grade Determination
The Neurology Clerkship uses a Clerkship Grading Committee. The GNV and JAX Clerkship and Associate Clerkship Directors, GNV Neurology Vice chair of Education, and 3 GNV neurology faculty interested in education compose this Committee. The Grading Committee reviews all the evaluations, portfolio documents, and exam grades. In addition, they can ask evaluators for additional information before assigning a clinical core competency grade and a final grade.

The Grading Committee determines your final grade based on clinical evaluations, examination scores, and required assignments as outlined in the grade explanation. “Coaching up” faculty (telling them that certain numeric scores on their evaluation correlate to the grade) is misleading, unfair to the majority of students who do not do this, and is considered unprofessional behavior. Engaging in this behavior will result in a lower professionalism evaluation and could affect your grade and the comments submitted for the MSPE.

The final grade of the Neurology Clerkship Program is determined by the outcomes of these five sections: Core Competency Evaluations, Bedside Skills Exam, Portfolio Compilation, and Medical Knowledge Examinations.

Total Grade (100%) = Clinical Core Competency (50%) + BSE (10%) + Portfolio (15%) + NBME Exam (25%)

Professionalism:

Professionalism Mini Evaluation Exercise (P-MEX)
The Professionalism Mini Evaluation Exercise (P-MEX) is an instrument used to assess professionalism in clinical training. The evaluator rates the trainee on 24 different directly observable items of medical professionalism over four different skill areas: doctor-patient relationship skills, reflective skills, time management, and interprofessional relationship skills.
You will be required to obtain the following over the course of the rotation:

• 2 to be completed be a faculty or resident with whom you closely work. You will solicit these yourself, which will be aimed at providing real-time formative assessment
• IM/OB/Peds/Surg 1 peer evaluation, which the clerkship administrative team will assign to a peer with whom you work closely on one of your core inpatient teams
• Up 1 from the clerkship coordinator. The administrative team will assign these such that you receive two over the course of the year.

Students with Professionalism concern will receive a grade of incomplete (I). Professionalism concerns will be referred to the Academic Status Committee (ASC) for remediation. Once remediated, the maximum grade will be B.

Policies and Procedures

Policy on student evaluations

• Each student must complete at least 75% of all assigned faculty, resident, and small group leader evaluation forms associated with a course/clerkship in each year of enrollment. There is an expectation of 100% completion on overall course and clerkship evaluations.
• Every student is expected to respond in a professional manner to each item which she/he feels qualified to answer.
• Strict confidentiality of responses is assured. Evaluation data (numerical ratings and student comments) is de-identified. However, the completion of evaluations will be tracked.

COLLEGE OF MEDICINE POLICIES AND PROCEDURES HANDBOOK

The following topics are covered in the College of Medicine Policies and Procedures Handbook

General Academic Schedule

You will be getting your final schedule via email the week before starting the Clerkship.