Introduction
This multidisciplinary rotation focuses on the outpatient diagnosis and management of cognitive impairment and the behavioral manifestations thereof. During this 1-4 week rotation, residents will participate in outpatient neurology clinics at the main UW and 20 South Park locations as well as psychiatry and geriatrics clinics at multiple UW locations and at the VA.
Goals
The goal of this rotation is for senior residents to develop skill in the outpatient evaluation and management of patients with known or suspected neurodegenerative dementia or other forms of cognitive impairment. The emphasis is on the outpatient clinical management of patients with both common and less common dementias, including the identification and management of their associated behavioral manifestations.
Objectives and Evaluation Matrix
As with all of the neurology rotations, the specific objectives are reflected in the entrustable professional activities and individual milestones listed below. These form the basis for the end-of-rotation evaluation. (Please see the section End-of-Rotation Evaluations above for the list of milestone abbreviations).
| Rotation Objectives | ||
| Upon completion of the curriculum, residents will . . . | ||
| # | Description | Milestones |
| 1 | Classify typical and atypical causes of cognitive impairment. | PC3, PC12, MK1 |
| 2 | Describe and initiate etiological workup for causes of cognitive impairment. | PC4, PC12, MK2 |
| 3 | Use neuropsychological test results to localize cerebral dysfunction and render differential diagnosis for neurocognitive disorders. | PC3, PC12, MK1, MK2 |
| 4 | Describe management of common behavioral complications of neurocognitive disorders | PC4, PC12 |
| 5 | Counsel patients and their families regarding their diagnoses, prognoses, and treatment options | SP3, SP4, PR1, IC1 |
Schedule
Below is a sample schedule for this rotation. This schedule is subject to attending availability; accordingly, this elective may not be able to be offered during weeks when multiple attendings are out of clinic (for example, national conference weeks or holidays).
The weekly schedule can, within certain parameters, be adjusted to address specific resident learning goals for the rotation. If there are specific requests for scheduling, these should be included in the elective request form and sent to Sara Nagel and Pam Adams.
| MONDAY | TUESDAY | WEDNESDAY | THURSDAY | FRIDAY | |
| AM | Clinic (Geriatric Medicine, Fitchburg Clinic) | Neuropsychological Testing (Neuropsychology, UW Clinic) | Cognitive Multidisciplinary Clinic (Dr. Mangin, 20 S. Park Clinic) | Cognitive Multidisciplinary Clinic (Dr. Seeger, UW Clinic) | Reading/Admin |
| PM | Reading/Admin | Clinic (Geriatric Medicine, Fitchburg Clinic) | Continuity Clinic | Dementia Telemedicine Clinic (Psychiatry, VA Clinic) | Reading/Admin |
| MONDAY | TUESDAY | WEDNESDAY | THURSDAY | FRIDAY | |
| AM | Clinic (Geriatric Medicine, Fitchburg Clinic) | Geriatric Psychiatry (Psychiatry, Fitchburg Clinic) | Cognitive Multidisciplinary Clinic (Dr. Mangin, 20 S. Park Clinic) | Cognitive Multidisciplinary Clinic (Dr. Seeger, UW Clinic) | Reading/Admin |
| PM | Reading/Admin | Clinic (Geratric Medicine, Fitchburg Clinic) | Reading/Admin | Continuity Clinic | Dementia Telemedicine Clinic (Psychiatry, VA Clinic) |
Work Hours
The number of work hours per week is estimated to be 40-50; there are no weekend or call duties.
Suggested References
Daroff, R. B., & Bradley, W. G. (2012). Bradley’s neurology in clinical practice. Philadelphia, Pa.: Elsevier/Saunders.
Budson A.E. & Solomon P.R. (2016). Memory Loss, Alzeimer’s Disease, and Dementia, 2nd ed. Philadelphia, Pa.: Elsevier Inc.
Patten, J. (1996). Neurological differential diagnosis. London; New York: Springer.
Freedman M, ed. CONTINUUM August 2019;25(4). doi: 10.1212/01.CON.0000579076.48859.92
Latest revision: 05-14-2021
