Neuropsychiatry and Behavioral Neurology

Sites: Brigham Behavioral Neurology and Neuropsychiatry Group Brigham and Women's Hospital Dana-Farber Cancer Institute
Director(s): Erik Alexander, Gaston Baslet
Prerequisites: HMS Principal Clinical Experience (Core Clinical Clerkships including Psychiatry and Neurology) or equivalent
Offered: Full time every month. Not offered in July, November, January, February, May or June 2017
Location: BWH - Brigham and Women's Hospital (23)
Open to Exclerks: US/Canadian
Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Gaston Baslet,, for approval to enroll. This elective is designed to increase students� knowledge and recognition of brain-behavior relationships in a clinical setting, and to increase their skills in assessing and treating behavioral and cognitive presentations due to neurological illness. It includes concentrated clinical experience with patients with behavioral and cognitive complaints in the context of neurodegenerative illnesses, epilepsy, multiple sclerosis, cerebrovascular disease, developmental disabilities, traumatic brain injury, conversion disorder and other brain disorders. Students will also learn how to communicate with patients and their families about a neurobehavioral diagnosis and to discuss therapeutic and management options. Students see patients within the Neuropsychiatry and Behavioral Neurology services at Brigham and Women�s Hospital (BWH) and are supervised by faculty within the BWH Neuropsychiatry group and Behavioral Neurology group. Students work closely with senior residents and Behavioral Neurology/ Neuropsychiatry fellows, and attend multiple weekly multidisciplinary rounds with attendings, residents and fellows within different subspecialty clinics and weekly journal club and relevant didactic activities. Students are also required to present a scholarly project at the end of their rotation, consisting of a written case report or a written literature review. There is no call responsibility.
Incorporation of Basic Science Content and Evidence-Based Medicine:
Discussion of findings from relevant basic science and clinical studies are incorporated into weekly rounds through Behavioral Neurology and briefly after each outpatient session that students attend in Neuropsychiatry and Behavioral Neurology. For selected cases, students review relevant articles and summarize them with the clinic attending or fellow. Basic science topics that are covered include brain function localization based on functional neuroimaging studies, genetic predisposition towards neurodegenerative illnesses and mechanism of action of neuropsychopharmacological agents. Existing evidence for supportive tests assisting in diagnosis clarification and effective therapeutic interventions for cognitive and neurobehavioral syndromes constitute a significant emphasis of the rotation.
Grade Criteria:
Honors with Distinction: Student demonstrates all the competencies listed for a �honors� grade. In addition, student shows an exceptional capacity for empathy, communication, diagnostic acumen, clinical judgment and treatment planning. Student consistently acquires substantial evidence-based background information relevant to clinical cases seen, and asks questions that indicate an in-depth analysis of this information and of the case. Student's scholarly project reflects original thought, including an ability to figure out next steps for research about the chosen topic. Honors: Student demonstrates all the competencies listed for a �satisfactory� grade. In addition, student's evaluations of patients include thorough, detailed, nuanced histories and accurate, descriptive mental status and cognitive and neurological examinations. Student can develop comprehensive differential diagnoses and a reasonable plan to arrive at a final diagnosis, when feasible. Student proactively finds relevant evidence-based information and shares it with the treatment team. Student communicates with patients in a nuanced, empathic way that conveys the necessary information for further patient participation in diagnostic work-up and treatment. Student's scholarly project is well organized and effectively delivered, and reflects an accurate, up to date synopsis of the evidence base for the chosen topic. Satisfactory: Student's evaluations of patients consistently include key elements of history, mental status, cognitive and neurological examinations, differential diagnosis and plan for diagnostic work-up. Student demonstrates ability to form a diagnostic work-up or treatment plan that has defined goals and/or treatment modalities and is consistent with clinically effective and cost-effective care. Student demonstrates ability to explain risks and benefits of recommended tests and/or treatments to patients and their families. Student demonstrates ability to find evidence-based information and apply it to clinical situations. Student communicates effectively with patients, family members, other clinicians and supervisors. Student performs assigned tasks, consistently exhibits professional behavior, and works effectively as part of a health care team. Student completes a scholarly project. Unsatisfactory: Student does not demonstrate one or more of the competencies listed for a �satisfactory� grade.