Download Neuroscience Specialized Educational Pathway Proposal

Neuroscience Specialized Educational Pathway
University of Cincinnati College of Medicine
Neuroscience Specialized Educational Pathway Goal:
To provide an enriched exposure in the neurosciences to those students that
demonstrate a strong interest. This enhanced experience will be accomplished
through a multi-disciplinary, longitudinal approach that bridges the pre-clinical
and clinical years of student training.
Background:
Startling breakthroughs in molecular biology and basic neuroscience have defined
the cause of many diseases of the nervous system, and are transforming the practice of
neurology, neurosurgery, neuropathology, and rehabilitation. Basic research is giving
new information regarding how the brain works and how brain injury occurs-and how it
can be prevented or improved. Recognizing the exciting opportunities now available to
medical students to better understand nervous system function and to design new
treatments for neurological diseases, we’ve developed an interdepartmental program: The
Neuroscience Specialized Educational Pathway (NSEP). This pathway will provide
additional exposure to the neurosciences, including adult and pediatric neurology,
neuropathology, neurosurgery, and physiatry, by creating a four-year program of
additional activities for the motivated medical student in the clinical and basic sciences.
Specific Elements of the Program
Faculty Mentoring:
One of the most important facets of this educational pathway is the emphasis on
mentoring. Upon entrance to the program, each student with be paired with a clinical or
basic neuroscientist in the field of their interest as a faculty mentor. The mentor will be
specifically chosen because of their track-record in mentoring and education. This
mentor will meet with the student on a regular basis to discuss topics ranging from
research issues and new approaches to treating neurological disease to career
opportunities. Mentors will help student select summer research experiences, or even
help arrange longer research periods if requested, and help develop opportunities for indepth study. In addition, the student will be assigned a resident mentor as well as a
faculty mentor. While residents are of course under time constraints, they are closest in
age/position to the medical student and can provide a valuable perspective. Meetings
with resident mentors will be much less formal and structured. By the end of the second
academic year the student should have a good idea of the discipline, both academically
and “socially”.
Faculty Track Coordinator and Advisory Board:
Dr. John Quinlan will be the Neurosciences Track Coordinator. Dr. John
Quinlan, also serves as the medical student clerkship director in the department of
neurology. He will be assisted in his responsibilities by a Neurosciences Faculty
Advisory Board, consisting of representatives from each of the specialties included in the
pathway. Dr. Quinlan will be responsible for the overall implementation of the program,
including troubleshooting and scheduling of conferences and programs. The Advisory
Board will assist in the selection of candidates, and development and refinement of the
overall curriculum.
Enrollment:
Enrollment will be limited to 4 students per year. This enrollment limit is
flexible, and will be reassessed after the program is established. This limit is in place to
allow adequate resources to be devoted to each student. An application process will be
established, and candidates will be expected to apply either upon matriculation into
medical school, or within the first year of study. Candidates will be selected for the
program based on their interest in the neurosciences, prior exposures to the
neurosciences, and a personal statement.
Pathway Content
The NSEP program allows a wide breadth of exposure to the
neurosciences. Since the students are committing to this pathway early in their training,
they do not have to have decided on a particular specialty within neuroscience, only that
they are interested in the nervous system. Once their specific interests develop, the
curriculum is flexible enough to allow them intensified exposures within their specialty
of interest, while still allowing a broad exposure to other integrally related neuroscience
fields. The specifics of the curriculum are summarized by year of training below:
Year 1:



Students will meet with their designated faculty mentors once a month to
discuss their future interests and research projects. Dr. Quinlan will also
meet with the students at least twice during the first year to monitor their
progress.
Pathway students will be assigned to an enriched section of Brain and
Behavior I, which will provide special opportunities for delving into
interesting aspects of recent studies pertinent to course material. Special
clinical case presentations, literature reviews, or additional laboratory
and/or problem sets will be part of this enriched section. Opportunities for
outside research will be provided for interested participants.
One hour per month clinical exposure will be expected of the NSEP
students. Clinical exposure for medical students will be graduated. UC-I
students will receive a general overview of the discipline and be
introduced to various aspects of clinical neuroscience including
ambulatory care private practice clinics, clinical wards, outpatient
procedures, Emergency Department consultations, and the operating room.



In the second half of the year UC-I students will be introduced to the
neurological examination while they are participating in Neuroscience I.
This will include shadowing of their mentor in their clinics and hospital
work.
One hour per month of didactic sessions will be expected of the NSEP
students. Lectures appropriate to their level of training will be selected
from all of the departments included in this proposal and psychiatry (see
attached list of topics). Lectures in the first year will focus on anatomy
and basic science.
A “longitudinal” elective in neuropathology will be offered. During such
rotations, students participate in diagnostic studies of brains and spinal
cords with their coverings and of nerves and muscles. They have
opportunities to study gross and microscopic anatomy and to learn related
pathology individually, in small groups and in seminar sessions. The
attendance of select departmental and college-based conferences is
encouraged. The student forms a team together with residents and fellows
from various specialties who also may be on Neuropathology rotation.
The program is kept flexible to adjust to the individual's specific interests,
needs and level of competence. This longitudinal elective will meet
occasionally during the first three years of training, with a more structured
lecture series during the summer months between first and second years.
Clinical correlations and brain cutting will also be incorporated.
NSEP students are encouraged to participate in the frequent meetings of
the Student Interest Group in Neurology, the Pediatric Neurology Student
Interest Group, or other departmental student interest groups. These
meetings will allow extracurricular exposure to the “real-world” of the
neurosciences. Activities in the past have included private practice
seminars, patient interviews, community service, and clinical ward rounds
among other topics. These groups are student-run with faculty advisors.
Summer Experience:
 Every student enrolled in NSEP must actively participate in a summer
research project. This research project should be hypothesis driven.
Submission of a research plan will be required in the months before the
summer begins.
 The neuroscience summer research can be either in basic or clinical
research. Other projects, including community-based experiences or
international experiences will be considered on a case-by-case basis.
 The student will be expected to work a minimum of 200 hours over the
summer between first and second year. A formal evaluation process will
also be instituted to give the student feedback regarding their research
skills as the summer progresses.
 All students must write a summary of their experiences during the summer
and submit a written report to the advisory board. In addition, an abstract






Year 2:



should be submitted to the relevant neuroscience society meeting and
when possible, the student should present their work in person. An
example of this would be the student summer research scholarship for the
American Academy of Neurology (AAN), with a subsequent abstract
submission to the AAN annual meeting.
One student will be awarded the NSEP Outstanding Summer Research
Award, which will be awarded in the fall of that year, and recognized
during the graduation ceremony of that student.
Students are encouraged to perform 2-5 hours of community service
related to the neurosciences during their summer. These activities could
include educational activities for children about the brain, volunteering in
indigent care clinics, or giving talks to the community about neuroscience.
All activities will be supervised by the faculty mentor.
During the summer, students will be invited to make clinical rounds or
attend outpatient clinics with neuroscience faculty and residents.
Several neuropathology lectures will be offered during the summer for
those NSEP students participating in the longitudinal pathology elective.
Students will receive a research stipend from the department in which they
choose to perform research. They will be expected to work with their
research supervisors early enough to allow for applications for funding,
including the University of Cincinnati Training Grant.
Students will also be expected to apply to attend the Association of
University Professors of Neurology(AUPN) and the National Institute of
Neurological Disorders and Stroke (NINDS) symposium designed for
medical students in Bethesda, Maryland. This symposium focuses on
neuroscience research, and how to successfully combine clinical practice
and neuroscience research into future careers. Expenses for this trip are
covered by the AUPN. Students do not have to commit to neurology as a
specialty to attend this conference.
Students will meet with their faculty advisors once a month as in their first
year. They will also meet with Dr. Quinlan at least once during the year,
and more often if needed.
Pathway students will be assigned to an enriched section of Brain and
Behavior II, which will provide special opportunities for delving into
interesting aspects of recent studies pertinent to course material. Special
clinical case presentations will be part of this enriched section.
Opportunities for outside study will be provided for interested participants.
Students will be expected to attend, and participate, in the monthly
departmental journal clubs of the specialty of their choice. Each student
will be expected to present one article independently to the group each
year, and will be expected to have read the article and be prepared to
discuss on other journal club days. Journal club meetings discuss topical
neuroscience articles in a collegial setting over lunchtime. Articles chosen


will be recent “landmark” papers that demonstrate molecular, cellular, and
systems approaches to studying the nervous system.
One hour per month clinical exposure will be expected of the NSEP
students. This will include shadowing of their mentor in their clinics and
hospital work. However, this will also include other experiences for the
group, including difficult case conferences, ward rounds, and observation
of procedures. As the students’ clinical knowledge increases, they will be
given more “hands-on” opportunities to interact with patients.
Students will be expected to present their work from their summer
research at the Cincinnati Translational Neuroscience Symposium in
March of their second year. This highly successful symposium attracts
speakers of national importance, and several members of the NIH/NINDS,
and would represent an excellent networking opportunity for interested
students.
Year 3:
Students are expected to meet monthly with their faculty mentors. Toward
the end of the student’s third year, faculty advisors will provide a detailed
letter chronicling the student’s participation and performance within the
track for inclusion in the student’s Dean’s letter and residency training
program applications.
o A four week Clinical Neuroscience option is strongly encouraged for
NSEP students. This allows students to get early, high intensity clinical
exposure in neurology, neuropediatrics, neurosurgery and PM&R. This is
more in depth exposure than currently experienced by the fourth year
selective students. This rotation would be an inpatient month, working
side-by-side with the residents and attendings on the inpatient service.
Students will take call until 11pm every fourth night during this rotation.
Each student will evaluate, present, and write-up their patients that they
admit while on-call, and will follow them throughout their hospitalization.
Students will also present and follow consult patients seen with their team.
In addition, students will be expected to attend the outpatient neurology
clinics with their resident teams, evaluate new patients, and present them
to the clinic attending. Students will participate in various teaching
conferences of the department of neurology or pediatric neurology,
including daily work rounds with the residents, didactic teaching sessions
with the attendings, and lunchtime educational conferences.
Two week selective in neurology, physical medicine and rehabilitation
and neurosurgery are still offered.
o Two week required selective of radiology: NSEP students will be given
special access to neuroradiology, and tutorial in interpretation of brain
MRI and CT, as well as observation of cerebral angiograms and
interventional procedures such as coiling of aneurysms or embolization of
AVMs. Observation of research imaging, including functional imaging of
the brain is also planned.
Year 4:
 The current four-week selective in neuroscience would not be required for
pathway students. Instead, they will be encouraged to consider additional
electives in the neurosciences (stroke, epilepsy, neuroscience intensive
care, etc.), and mentors will help in schedule planning. Opportunities for
completing at least one month of clinical elective work in the
neurosciences will be provided for pathway students. NSEP students will
have additional requirements during these electives, such as an additional
presentation or literature review on a topic.

Graduation


Regardless of which curriculum option is eventually implemented,
students will be expected to meet with their mentors on a monthly basis
throughout the fourth year as well.
NSEP students will receive special recognition during the graduation
ceremony, and the Outstanding NSEP Research Prize recipient will also
receive recognition.
NSEP participation, and detailed comments from faculty advisors will be
included in the dean’s letter as students apply for post-graduate training
programs.
Evaluation and Feedback
To ensure that this mentoring experience is positive and educational for the
student, an evaluation process will be put in place that is similar to the evaluations for
current faculty lectures and clinical teaching. In addition, the students will be expected to
create an educational “portfolio”, detailing their experiences throughout their four years.
Like an educational scrapbook, this portfolio will include lectures given, research
experiences and clinical exposures. This will allow the student and the faculty member
to provide feedback regarding their experience in this new pathway, and to give
constructive feedback to the student as they progress. In addition, the track coordinator,
Dr. Quinlan, will check in with all students in the pathway every few months or more
frequently if problems arise. In addition, an exit interview with Dr. Quinlan or other
Advisory Board member will take place. Each year, after review of feedback received
from students, faculty and resident mentors, the curriculum will be revised by the
Advisory Board to allow continuous quality improvement in the program.
Clinical and Didactic Lecture Opportunities for NSEP Students:
Department of Neurology:
Grand Rounds
Challenging Case conference
Clinical Conference series
Journal Club
Morbidity and Mortality Conference
Epilepsy Conference
Neuromuscle Conference
Neuroanatomy
Clinical Pharmacology
Neurovascular Radiology Conference
Neuro-ophthamology Lecture series
Student Interest Group in Neurology meetings
Department of Physical Medicine and Rehabilitation:
Grand Rounds
Resident Lecture series
Journal club
Evening Anatomy sessions
Summer Introduction to PM&R
Department of Neurosurgery:
Grand Rounds
Professor’s Hour
Journal Club
Morbidity and Mortality
Department of Pediatric Neurology:
Pediatric Neurology Interest Group
Basic Neurosciences
Case Conference/CPC
Neuroradiology Conference
Department of Neuropathology:
Brain-cutting
Introduction to neuropathology lecture series
Department of Psychiatry:
Psychiatry Club
Psychiatry Journal Club
Psychiatry Resident lecture series
Clinical Rotation Opportunities in 3rd and 4th year for NSEP Students
Department of Neurology
3rd year: (recommended) 4-week Neurology (Neuroscience Selective)
4th year: Cerebrovascular elective
Epilepsy elective
Neuroscience Intensive care elective
Department of Physical Medicine and Rehabilitation 2 week electives:
Drake inpatient spinal cord injury service
Drake inpatient brain injury service
Drake outpatient musculoskeletal and neurorehabilitation clinics
University Hospital consult service
Department of Neuropathology
Longitudinal elective in neuropathology
4-week elective in 4th year neuropathology
Department of Neurosurgery
3rd year: 4 week selective in neurosurgery at University Hospital (clinics,
wards, and operating room responsibilities)
4th year: 4 week elective at University Hospital (clinics, wards, on-call,
operating room and independent study responsibilities)
Department of Pediatric Neurology
3rd Year: (recommended) 4-week pediatric neurology inpatient rotation
at Children’s Hospital
4th year: 2 and 4 week electives in pediatric neurology