Download Rotation Goals and Objectives

UNIVERSITY OF MICHIGAN NEUROLOGY RESIDENCY PROGRAM
GOALS AND OBJECTIVES
Epilepsy Clinic Rotation
Afternoon
LTM – Adult (4B UH)
Wednesday
Morning
Epilepsy clinic
(Minecan or Mihaylova)
Continuity clinic for Adult
Neurology Residents (Gelb)
or
* Epilepsy Clinic (Beimer)
Conferences
Thursday
LTM – Pediatric (12W Mott)
Friday
Epilepsy clinic (Glynn)
2:30 pm – Refractory Epilepsy
Conference (DeJong Library)
Epilepsy clinic
(Selwa or Beimer)
Monday
Tuesday


*
Epilepsy Clinic (Beimer)
Epilepsy clinic (Selwa)
During Epilepsy Clinic half days, the resident will see patients in the Taubman Neurology Clinic.
Typically, the resource assignment to which patients are scheduled is TC NEU RESIDENT EPILEPSY 02
(the 01 provider is usually the resident in the mixed clinic).
When on LTM (Adult or Pediatric) the resident is to report to the Epilepsy Fellow EEG reading rooms on
either 4B (UH) or 12W (Mott) to receive assignments for following 1-2 scheduled epilepsy admissions
that half day. Responsibilities may include taking a targeted history and physical examination, reviewing
the baseline EEG study, formulating a management plan based upon the indication for admission, and
discussion/staffing the patient with the Epilepsy Attending on service.
Exceptions for Pediatric Neurology Residents
 Continuity clinic varies and resident will be excused from any responsibilities above during regularly
scheduled continuity clinic
 Tuesday morning will be an Epilepsy Clinic half day staffed by Dr. Beimer
Additional Goals and Objectives -Epilepsy
The goals and objectives are identical to those for the Neurology Resident Clinic Rotation, with the following
additions:
Patient Care:
1. Manage the delivery of the diagnosis of epilepsy, including provision of education about reproductive,
legal, and employment responsibilities.
2. Generate notes for patient visits that meet new standard guidelines for epilepsy care.
3. Learn indications for referral for inpatient monitoring, and consider referral for epilepsy surgery in
appropriate candidates.
Medical Knowledge
1. Learn indications for starting and stopping treatment with seizure medications
2. Learn indications and side effect profiles for seizure medications
3. Learn what the surgical evaluation entails, and the likelihood of seizure control in different clinical
syndromes and settings.
4. Learn to recognize MRI concomitants of epilepsy including mesial temporal sclerosis and cortical
dysplasias.
5. Complete the assigned multiple choice test in MedHub by the end of the first week and review with
the Epilepsy Clinic faculty coordinator during the second week.
Practice-Based Learning and Improvement
1. Participate in journal clubs and Refractory Epilepsy conferences when possible that allow continuous
evaluation of your won skills in epilepsy management.
2. Develop the skills needed to evaluate unusual epilepsy syndromes based on evidence available in recent
journals.
Interpersonal and Communication Skills
1. Learn to interact sensitively and effectively with patients who have been given the diagnosis of nonepileptic seizures.
2. Learn to discuss care issues between teams on inpatient and ambulatory epilepsy rotations.
3. Consider participating in refractory epilepsy conference about patients known to you from clinic to
provide cross-disciplinary information.
4. Ask about mental health issues in a fashion that encourages open communication.
Professionalism
1. Write letters and notes for documentation as required for patient needs, possibly including notes on long
term monitoring patients, as well as clinic notes.
2. Respond to patient calls about seizures in a timely and effective manner, asking for advice where needed.
Systems-Based Practice
1. Understand the structure and timing of consultations and requests for care involved in referral for epilepsy
surgery.
2. Understand potential routes for obtaining epilepsy medications for indigent patients.
3. Interact with surgical and medical services to determine what needs are best served by LTM.
Required Readings
1. Krumholz A, Wiebe S, et al. Evidence-based guideline: Management of an unprovoked first seizure in
adults: Report of the Guideline Development Subcommittee of the American Academy of Neurology and
the American Epilepsy Society. Neurology. 2015 Apr 21;84(16):1705-13.
2. St. Louis EK, Cascino GD. Diagnosis of Epilepsy and Related Episodic Disorders. Continuum (Minneap
Minn). 2016 Feb;22(1 Epilepsy):15-37.
3. Abou-Khalil BW. Antiepileptic Drugs. Continuum (Minneap Minn). 2016 Feb;22(1 Epilepsy):132-56.
4. Nair DR. Management of Drug-Resistant Epilepsy. Continuum (Minneap Minn). 2016 Feb;22(1
Epilepsy):157-72.
5. Gerard EE, Meador KJ. Managing Epilepsy in Women. Continuum (Minneap Minn). 2016 Feb;22(1
Epilepsy):204-26.
6. Chen DK, LaFrance WC Jr. Diagnosis and Treatment of Nonepileptic Seizures. Continuum (Minneap
Minn). 2016 Feb;22(1 Epilepsy):116-31.
7. Grover EH, Nazzal Y, Hirsch LJ. Treatment of Convulsive Status Epilepticus. Curr Treat Options Neurol.
2016 Mar;18(3):11.
8. Berg, A, Berkovic, SF, et al. Revised terminology and concepts for organization of seizures and epilepsies:
report of the ILAE commission on Classification and terminology. Epilepsia 2010 51(4):676-85.
9. Hirsch, LJ, LaRoche, SM et al, American Clinical Neurophysiology Society’s standardized critical care
EEG terminology:2012 version J Clin Neurophysiol 2013;30:1-27.
10. Fountain, NB, et al. Quality improvement in neurology: Epilepsy Update Quality Measurement Set.
Neurology. 2015 Apr 7;84(14):1483-7.
Revised 9/12/2016