The Inpatient Neurology MAS (Martin A. Samuels) Consult Service handles all inpatient and emergency consults for neurology in the hospital. It is an excellent opportunity to learn about the neurological complications of medical and surgical disease but you will see bread and butter neurology problems as well. While many of the patients on an inpatient neurology service already carry a neurological diagnosis, a good portion of the patients on the consult service are called for symptoms only, allowing you the opportunity to make the neurological diagnosis based on the history and neuro-anatomical localization. It will also give you the experience of formulating a plan, communicating it to the primary service and following up with them to ensure its execution. These skills are needed for any consult service.
- The team consists of an attending, a PGY 4 resident, two PGY3 residents and 1-2 students.
- The consult team reviews the patient record, interviews and examines the patient and comes up with an impression and recommendations for the primary team.
- As a student on the service, you should see at least one new consult per day. You should accumulate all the important data and history and perform an examination of the patient. You should write out a proposed impression and recommendations and present them to your resident. They will then see the patient themselves and review and edit your recommendations as needed.
- You should produce a written note including history, exam, assessment and recommendations.. However, this note does not substitute for the resident’s note.
- You should continue to follow up these patients on you service as needed and be available to follow up on other patients on the service as well.
- Rounds with the attending will occur daily. You should be prepared to present patients that you saw on rounds and to give updates on follow ups as well.
Common problems you will be called for include:
- Mental status changes
- New headaches
- Suspected seizures
- New onset weakness or numbness
- Vertigo
- Vision changes
- Management of outpatient neurological problems (such as MS, PD) in patients admitted for medical problems.
- Neurological prognosis in ICU patients
- Coma or brain death examinations
