Department of Neurology and Neurosurgery Clinical and Clinical Research Fellowship Application Form

Transcription

1 NeurlgyResidency Prgram DepartmentfNeurlgy& Neursurgery Pstaladdress: MntrealNeurlgicalInstitute 3801UniversityStreet Mntreal,PQ,CanadaH3A2B4 Tel.:(514) Fax:(514) DepartmentfNeurlgyandNeursurgeryClinicalandClinicalResearchFellwshipApplicatinFrm TypefFellwship:Cgnitive/BehaviuralNeurlgyFellwship NameftheFellwshipSupervisrs:Dr.HwardChertkw,Dr.LesleyFellws FellwshipInfrmatin: Numberffellwshippsitinsrequested:1 Namefhspitalsinvlvedintraining:MNH,JGH,MGH(ptinal) DescriptinfFellwship:Thisisaneyearfellwshipwith thepssibilityfaneyearextensin. The fcus will be n clinical cgnitive / behaviural neurlgy training with an expsure t clinical and/rbasicscienceresearchdependingupnthetrainee spreference. Under the supervisin f the attending neurlgists, the fellw will attend varius memry and cgnitive clinics apprximately three days per week. The fellw will be respnsible fr evaluating and treating patients with dementia, with cgnitive cmplaints such as memry lss,rwithbehaviuralchangessuchasapathy. TheresearchcmpnentwillbecarriedutinDrChertkw srdr.fellws labratry,rin thatfneftheirclleagueswiththeircsupervisin. Researchactivityandpublicatinsrelatedtfellwship: (supervisrs CVsappended) Missinstatementfrfellwship: T prvide scientifically based, cmprehensive and effective diagnsis and management fr patientswithcgnitiveandbehaviuralcmplaints. T prvide basic training in clinical r basic science research methdlgy required fr furtheringtheunderstandingfhumancgnitinanddisrderstheref. Surce f funding fr fellwship: The Fellwship is cnditinal upn successfully securing peer reviewed Fellwship award funding by r fr the candidate. The supervisr/department may supplementtheseawardsdependingnspecificcircumstances. DuratinfFellwship:neyear Page 1 f 4

2 NamesftheTeachingFaculty HwardChertkw Rles:Csupervisr,ClinicalandResearch Summaryfclinicalpractice:Attendingneurlgist,JewishGeneralHspital;Directr,Blmfield Centre fr Research in Ageing, Lady Davis Research Institute; Directr, Jewish General Hspital/ McGillUniversityMemryClinic. Majr Strengths: Clinicianscientist trained in Cgnitive Neurlgy and Neurlinguistics; Clinical andresearchinterestsindementia,aphasia,anddisrdersfsemanticmemry. LesleyFellws Rles:Csupervisr,ResearchandClinical Summary f clinical practice: Attending neurlgist, Mntreal Neurlgical Hspital; Research Scientist,CgnitiveNeurscienceGrup,MntrealNeurlgicalInstitute AcademicFacilities MajrStrengths:ClinicianScientistwithinterestsincgnitiveneurscience;ExperienceasDirectr fmcgillmdphdprgram;managesthemcgillcgnitiveneurscienceregistry FacilitiesfrClinicalActivities: ThefellwwillhaveaccesstthetwiceweeklymemryclinicattheJewishGeneralHspital (S)hewillhaveaccesstDr.Fellws clinicnehalfdayperweekatthemntrealneurlgical Hspital (S)hewillhaveaccesstDr.Chertkw scgnitiveneurlgyclinicnehalfdayperweekatthe JewishGeneralHspital (S)hemayalschsetattendalliedclinicssuchas: TheMntrealNeurlgicalHspitalneurpsychiatryclinicstaffedbyDr.GhislaineSavard anddr.theklivakis; ThemnthlyMntrealGeneralHspitalneurpsychiatriclupusclinic; TheMntrealGeneralHspitaltraumaticbraininjuryclinic; ThepainclinicsattheMntrealNeurlgicalHspitalandMntrealGeneralHspital; etc. Thefellwwillprvideccasinalcnsultatinservicestinpatientswithcgnitivecmplaintsat themntrealneurlgicalhspital,andpssiblyattheryalvictriahspitalandjewishgeneral Hspital ResearchActivities: WillbecarriedutandsupervisedinthelabsfDr.FellwsandDr.Chertkw.Hwever,thefellw willhaveaccesstresearchactivitieswiththermembersftheblmfieldcentrefrresearchin Page 2 f 4

3 AgeingandthermembersftheCgnitiveNeursciencesUnitattheMNI.Thespecificresearch prject(s)willbewrkedutincllabratinwiththesupervisr. Libraryaccess,materialsrelevanttfellwshiptraining:ReadilybtainablethrughMcGill Multimedialearningmaterialsavailable:Yes Availabilityfaskillslabifapplicable:N/A FellwDutiesandRespnsibilities Callrespnsibilitiestcverservice:fellwswillnttakecall Willthefellwbesupervisingresidents:N Aretherefixedrtatinsatvariusinstitutins:N Whataretheutpatientclinicrespnsibilities:Evaluatepatients(histryandexaminatin),establisha treatmentplanalngwiththermembersfmultidisciplinaryteam(neurpsychlgist,cns,ot,pt, speechtherapist). What are the teaching respnsibilities twards residents: The fellw will participate in infrmal teachingduringclinicsandinfrmalteachingfneurlgyandthermcgillresidentsascalledupn. Outline participatin in academic activities invlving the residents: The fellw will be available t prvideccasinallecturesttheneurlgyresidentsascalledupn. Describeanysupprtstaffavailabletthefellw:N/A Prpsedmeetingstbeattendedbythefellwculdinclude:CanadianNeursciencesFederatin; CgnitiveNeurscienceSciety;AmericanAcademyfNeurlgy;ScietyfrNeurscience;Scientific MeetingfCanadianAssciatinfGerntlgy;ScientificMeetingftheGerntlgicalScietyf America;etc. What is the research prductivity/publicatins expected by the fellw: The gal is t present the researchfindingsataninternatinalrnatinalcnference,andtpublishatleastnepaperbased arund the research cmpnent f the fellwship chsen by the fellw. Review papers will als be undertaken. Curriculum What is the intended caselad fr the fellw: Clinic 3 days/week: 3 new patients, 4 fllwups per clinicday.12cnsultatinsperweek. What are the intended percentages f the varieties f cases: Dependent upn the specific clinics attendedbythefellw What regular reading materials are t be prvided: The fellw is expected t stay abreast f basic scienceandclinicaldevelpmentsinhis/herfieldbyreadingleadinghighimpactjurnals(neurlgy, Page 3 f 4

4 LancetNeurlgy,Brain,CgnitiveandBehaviralNeurlgy,etc ).Thefellwsarealsexpectedt readcgnitiveneurscience,behaviuralneurlgy,andneurpsychiatrytextbks. Outlinetheweeklycnferenceschedule:Tuesday:JGHservicerunds;Thursday:MNIservicerunds; Friday:NeurlgyGrandRunds(am);labmeetingsfrresearchsupervisrs Whatrlewillthefellwplayinattending,rganizing,andpresentingrunds/cnferences:Therehas beenalngstandingplantdevelpamnthlyreventuallyweeklymcgillcgnitiveneurscience rundswhichwuldincluderesidentteaching.thefellwwillaidinrganizingthis. Evaluatin and feedback: fellws will be evaluated at regular (i.e., quarterly) intervals n their perfrmance at bth the clinical and research levels. Satisfactry perfrmance will be required t cntinuethesecndyearfrthefellwship,ifschsenbythefellw. Clinical evaluatins and feedback will be prvided by the attending physicians invlved bth infrmallyduringtheclinicandfrmallyat3mnthintervals.frmalevaluatinsincludenen neverbalsessinsandwrittenevaluatinsbasedupnstandardizedcanmedscriteriaadaptedt thefellwshipspecificgalsandbjectives. Researchevaluatinsandfeedbackwillbeprvidedbytheresearchsupervisr(s)inthefrmf1 hurnennesessinsatleastncepermnthatwhichtimethefellwwillpresenthis/her researchprgressandresults,aswellasdiscussprblemsandfuturedirectins. Page 4 f 4

5 Page 1 f 12 NeurlgyResidency Prgram DepartmentfNeurlgy& Neursurgery Pstaladdress: MntrealNeurlgicalInstitute 3801UniversityStreet Mntreal,PQ,CanadaH3A2B4 Tel.:(514) Fax:(514) DepartmentfNeurlgyandNeursurgery Cgnitive/BehaviuralNeurlgyFellwship(GeneralandSpecificObjectives) 1.MedicalExpert/ClinicalDecisinMaker GeneralRequirements Demnstratediagnsticandtherapeuticskillsfrethicalandeffectivepatient care. Accessandapplyrelevantinfrmatintclinicalpractice. Demnstrateeffectivecnsultatinserviceswithrespecttpatientcare, educatinandlegalpinins. SpecificRequirements Prvidescientificallybased,cmprehensiveandeffectivediagnsisandmanagementfrpatients withdementiaandtherneurlgicaldisrdersaffectingbehaviurandcgnitin.refertthe Appendixfrspecificclinical,technical,andknwledgerequirementsrelevanttthemedical expertrle. 2.Cmmunicatr GeneralRequirements Establishtherapeuticrelatinshipswithpatients/families. Obtainandsynthesizerelevanthistryfrmpatients/families/cmmunities. Listeneffectively. Discussapprpriateinfrmatinwithpatients/families,thehealthcareteam, andcmmunityrganizatins. SpecificRequirements

6 Cmmunicateeffectivelywithpatients,theirfamiliesandmedicalclleagues(particularlyreferring physicians),andtherhealthcareprfessinalsinbththeinpatientandutpatientsettings.the residentwill: Cmmunicateeffectivelyandregularlywithpatientsandtheirfamilies. Becnsiderateandcmpassinateincmmunicatingwithpatientsand families,willinglyprvideaccurateinfrmatinapprpriatettheclinical situatin,withareasnableattemptatprgnsis. Learntwritecncisereprtsftheclinicalfindingswithcnclusinsand recmmendatinscmprehensibletthennspecialist. Cmmunicateeffectivelyandapprpriatelywithpsychlgists,nurses, ccupatinaltherapists,scialwrkersandtherparamedicalpersnnel. Whenrderinginvestigativeprcedures,ensuretherehasbeenadequate cmmunicatinabutthepatientwiththepersnwhwillactuallybeding and/rreprtingthediagnsticstudy. 3.Cllabratr GeneralRequirements Cnsulteffectivelywiththerphysiciansandhealthcareprfessinals. Cntributeeffectivelyttherinterdisciplinaryteamactivities. SpecificRequirements Beaneffectiveteacherftherphysicians(includingmedicalstudentsandhusefficers),ther healthcarepersnnel,andpatients.theresidentwill: Prvideinstructintmedicalstudentsandmrejunirphysiciansatalevel apprpriatettheirclinicaleducatinandprfessinalcmpetence. Willinglyshareknwledgewiththerswithwhmtheyareassciated,thus ensuringthemsteffectivedeliveryfhealthcaretpatients. 4.Manager GeneralRequirements Utilizeresurceseffectivelytbalancepatientcare,learningneeds,and utsideactivities. Allcatefinitehealthcareresurceswisely. Wrkeffectivelyandefficientlyinahealthcarerganizatin. Page 2 f 12

7 Page 3 f 12 Utilizeinfrmatintechnlgytptimizepatientcare,lifelnglearningand theractivities. SpecificRequirements Beprficientinprfessinalskillsrelatedtthediagnsisandtreatmentfdementiaandther cgnitivedisrders. Demnstratethefllwingprfessinalskillsintimemanagement: Recgnizethateffectiveuseftimedependsupnpunctuality. Recgnizethateffectiveuseftimerequiresplanning. Develpspeedaswellasaccuracyinclinicalskills. Reservetimefrreadingandkeepingcurrentwiththeneurlgicalliterature. Establishrutinesfrcarryingutregularactivitiesandadheretthem. Maintaincmpleteandaccuratemedicalrecrds: Recrdandmaintainacmpleteandaccuratemedicalrecrdfreverypatient seen;thisrecrdwillincludethepatient'shistryandthefindingsnphysical examinatin(includingtheneurlgicalexaminatin),adifferentialdiagnsis, aprvisinaldiagnsis,effectivelycrdinatethewrkfthehealthcare team. Indicate,bythetreatmentplan,thatfrtheptimaltreatmentfmany patientswithneurlgicaldisrder,ateamapprachisnecessarymembers ftheteammayincludenurses,rehabilitatinpersnnel(physitherapists, ccupatinaltherapists,speechtherapists,etc.),psychlgists,scialwrkers, etc. Identifywhereanimprtantrle(s)canbeplayedbydiseasefcusedlay grupswithregardthelpingthepatientand/rfamilyandtfacilitateits happening. Learntutilizelimitedmedicalresurcesjudiciusly: Theresidentwilldemnstratewhentbtainneurimagingandther labratrytestinginpatientswithcgnitivedisrders,andwhenntt.the residentwilldemnstratewhtminimizetheusefcstlytestswithut underminingtheabilitytbtainaprecisediagnsis. Theresidentwillremainuptdatewiththemstcurrentevidence determiningtheefficacyftreatmentsincgnitivedisrders,sast recmmendtreatmentsthatarebthclinicallyandcsteffective. 5.HealthAdvcate

8 GeneralRequirements Identifytheimprtantdeterminantsfhealthaffectingpatients. Cntributeeffectivelytimprvedhealthfpatientsandcmmunities. Recgnizeandrespndtthseissueswhereadvcacyisapprpriate. SpecificRequirements Learnabutcmmunityresurcesandrelatedpatientsupprtgrups;prvideassistancet accessprgrams(e.g.hmecare,ccupatinalandphysitherapy,drugplans,applicatinfr nursinghmesetc)andparticipateintheiractivities. Educate,beabletgenerateandaccessinfrmatin(e.g.printedmaterial,videtapeswebsites) andbeavailableasaresurcepersntcunselpatientseffectivelynneurlgicaldisrders. Cunselpatientsntheimprtanceftakingrespnsibilityfrtheirwnwellbeingandrecgnize theimprtantdeterminantspredispsingtwrseningfneurlgicalstatus Understandtherlefnatinalandinternatinalbdies(e.g.AlzheimerSciety)intheprmtin fneurlgicalhealth,andthepreventin,detectin,andtreatmentfdisrdersfbehaviurand cgnitin. Advcatefrapartnershipwithfamilyphysiciansandtherprimaryhealthcarewrkersinthe diagnsisandtreatmentfcgnitivedisrdersinthecmmunity 6.Schlar GeneralRequirements Develp,implementandmnitrapersnalcntinuingeducatinstrategy. Criticallyappraisesurcesfmedicalinfrmatin. Facilitatelearningfpatients,husestaff/studentsandtherhealthprfessinals. Cntributetdevelpmentfnewknwledge. SpecificRequirements Beabletcriticallyassesstheneurlgicalliteratureasitrelatestpatientdiagnsis,investigatin andtreatment: Develpcriteriafrevaluatingneurlgicalliterature. Criticallyassesstheneurlgicalliteratureusingthesecriteria. Befamiliarwiththedesignfexperimentalandbservatinalstudies, especiallyrandmizedcntrlledtrials. Beabletcalculateabsluteriskreductins,relativeriskreductinsand numbersneededttreatrharm. Page 4 f 12

9 Beabletparticipateinclinicalrbasicsciencestudiesasamemberfaresearchteam: Beabletdescribeprinciplesfgdresearch. Usetheabveprinciples,andbeabletjudgewhetheraresearchprjectis prperlydesigned. Bepreparedtpresentresearchfindingstpeersatlcal,natinalr internatinalcnferences. 7.Prfessinal GeneralRequirements Deliverhighestqualitycarewithintegrity,hnestyandcmpassin. Exhibitapprpriatepersnalandinterpersnalprfessinalbehaviurswithpatients/families, peerresidentsandtherhealthcareprfessinals. Practicemedicineethicallycnsistentwithbligatinsfaphysician. SpecificRequirements Demnstratepersnalandprfessinalattitudescnsistentwithacnsultingphysicianrle: Peridicallyreviewhis/herwnpersnalandprfessinalperfrmance againstnatinalstandardssetfrthespecialty. Bewillingtincludethepatientindiscussinscncerningapprpriate diagnsticandmanagementprcedures. Shwapprpriaterespectfrthepininsffellwcnsultantsandreferring physiciansinthemanagementfpatientprblemsandbewillingtprvide meanswherebydifferencesfpinincanbediscussedandreslved. Bewillingandabletappraiseaccuratelyhis/herwnprfessinalperfrmancesandshwthat he/sherecgnizeshis/herwnlimitatinswithregardtskillandknwledgebyapprpriately cnsultingtherphysiciansandparamedicalpersnnelwhencaringfrthepatient. Bewillingandabletkeephis/herpracticecurrentthrughreadingandthermdesf cntinuingmedicaleducatinanddevelpahabitfmaintainingcurrenthis/herclinicalskilland knwledgebasethrughcntinuingmedicaleducatin. Page 5 f 12

10 Appendix CntentfareastbecveredduringtheCgnitive/BehaviuralNeurlgyFellwship Adapted frm: Cre Curriculum fr the Behaviral Neurlgy & Neurpsychiatry f the United Cunsel f NeurlgicalSubspecialties( ThecrecurriculumfrCgnitive/BehaviuralNeurlgyiscmpsedffurprimarycntentareas: I.StructuralandFunctinalNeuranatmy A.TheFellwinCgnitive/BehaviuralNeurlgywilldevelpexpertisein: 1. Thestructuralandfunctinalrganizatinf:thecerebralcrtexanditsmajrdivisins;whitematter tracts; limbic and paralimbic structures; anatmic and functinal basal ganglia; diencephaln; the mesencephaln, metencephaln, and myelencephaln; and the cerebrvascular and ventricular systems. 2. Thestructuralandfunctinalrganizatinfcrticcrticalandcrticalsubcrticalcircuits. 3. Structuralandfunctinal cerebralhemisphericspecializatin,particularlyasregardslcalizatinand lateralizatinfcgnitive,emtinal,behaviural,andsensrimtrfunctins. 4. Neuranatmy,metablism,andfunctinalsignificancefthemajrneurtransmittersystems,lcal circuit and mdulatry neurtransmitters, neurpeptides, neurhrmnes, and ther endgenus neuractivesubstancesinthecentralnervussystem. B.TheFellwinCgnitive/BehaviuralNeurlgywilldevelpexpertiseinthestructuralandfunctinalbases fcgnitin,emtin,andbehaviur,including: 1. Cgnitin a. Arusal b. Perceptin c. Attentin d. Language e. Memry f. Praxis g. Recgnitin h. Visuspatialfunctin i. Executivefunctin 2. Emtin a. Md b. Affect c. Prsdy(affectivecmmunicatin) 3. Behaviur a. Mtivatin b. Cmprtment c. Persnality Page 6 f 12

11 II.CgnitiveNeurlgicalAssessment TheFellwinCgnitive/BehaviuralNeurlgywillbeprvidedwitheducatinandexperienceintheareasf clinicalassessmentlistedbelw.ntethatareacisanexceptintthisandismstapprpriatelyregarded asareainwhichacquisitinfknwledge,andntnecessarilyperfrmanceskills,isanapprpriategalf fellwshiptraining. A.NeurlgicalExaminatin 1. Elementalneurlgicalfunctin a. Cranialnerves b. Mtr c. Sensry d. Crdinatin e. Gait f. Reflexes,includingprimitivereflexes( frntalreleasesigns ) 2. Neurlgical sftsigns. 3. Theusefneurlgicalexaminatinratingscalesandtheinterpretatinfsuchdata. B.MentalStatusExaminatin 1. GeneralAssessment a. Appearanceandbehaviur b. Speech c. Thughtprcess d. Thughtcntent e. Emtin f. Cmprtment g. Persnality 2. CgnitiveExaminatin a. Arusal b. Attentin c. Language d. Memry e. Praxis f. Recgnitin g. Visuspatialfunctin h. Executivefunctin 3. Adjusting mental status examinatin cntent and prcess in a manner sensitive t the patient's abilitiesrimpairmentsinrdertfacilitateusefuldescriptinffindingsinpatientswhareunable tcperatewithanyrallpartsfafrmalcgnitiveexaminatin. 4. Interpreting mental status examinatin findings with respect t structural and functinal neuranatmiccrrelates. 5. Develping differential diagnsis based n mental status examinatin findings and their integratin withfindingsfrmtheneurlgicalexaminatin. Page 7 f 12

12 6. Indicatins fr, administratin f, and interpretatin f standardized neurpsychiatric rating scales thatsupplementtheneurpsychiatrichistryandmentalstatusexaminatin. C.NeurpsychlgicalAssessment 1. Thecntent,sensitivity,andspecificityfneurpsychlgicaltesting,including: a. Fixedassessmentbatteries. b. Flexiblebatteries. d. Prjectivetesting. a. Persnalityassessmenttls. 2. Theinfluencefage,educatin,culturalbackgrund,fatigue,drugs,sensryimpairment,andprimary psychiatricillnessesntestperfrmance. 3. The rle f and indicatins fr neurpsychlgical testing in the evaluatin and treatment planning relatedtneurbehaviuralandneurpsychiatricdisrders. 4. The relatinship between neurpsychlgical test results and bedside r fficebased screening mentalstatusexaminatins. 5. Theanatmicanddiseasecrrelatesfneurpsychlgicaltestabnrmalities. D.Neurimaging 1.Principlesandapplicatinsfstructuralandfunctinalimagingfthebrain,includingthegenerally acceptedclinicalindicatinsfrsuchstudies. 2. Crrelatin between neurimaging findings and clinical examinatin (neurlgical and/r mental status)findingsinpersnswithneurbehaviuralsyndrmes. *Nte:Thetypesfavailableneurimagingmethdsandalstheirgenerallyacceptedclinicalindicatinsarelikelychange vertime.thiselementfthecrecurriculummayrequirerevisinassuchchangesccur. E.ElectrphysilgicTesting 1.Principlesandapplicatinsfelectrphysilgicrecrdingsfthecentralnervussystem. 2.Crrelatinbetweenelectrphysilgicfindingsandclinicalexaminatin(neurlgicaland/rmental status)findingsinpersnswithneurbehaviuralrneurpsychiatricsyndrmes. *Nte:Thetypesfelectrphysilgytestingmethdsavailableaswellastheirgenerallyacceptedclinicalindicatinsare likelytchangevertime.thiselementfthecrecurriculummayrequirerevisinassuchchangesccur. F.LabratryStudies 1. Indicatins fr serum and urine studies relevant t the evaluatin f patients with neurpsychiatricandneurbehaviuralcnditins. 2. Indicatinsfrandinterpretatinfresultsfrmcerebrspinalfluidexaminatinrelevanttthe evaluatinfpatientswithneurpsychiatricandneurbehaviuralcnditins. Page 8 f 12

13 G.IntegratinandPresentatinfFindings 1. Integratinfcllateralhistricalinfrmatininttheclinicalassessment. 2. Develpmentfaneurbehaviuralandneurpsychiatricdifferentialdiagnsis. 3. Frmulatin f a neurbehaviural r neurpsychiatric diagnsis based n findings frm the clinicalassessment. 4. Develpmentftreatmentplanfrtheneurbehaviuralrneurpsychiatriccnditin. 5. Presentatin,bthverballyandinwriting,fclinicalimpressinsandrecmmendatinsderived frmthecmprehensiveclinicassessmentt: a. Thepatientandhisrherfamily b. Otherhealthcareprfessinals c. Officersfthecurt d. d.otherprivaterpublicagenciesprvidingservicestthepatient. III.Treatments TheFellwinCgnitive/BehaviuralNeurlgywilldemnstrateknwledgeabutandclinicalcmpetencyin the prescriptin and/r mnitring f smatic therapies, psychscial interventins, crisis interventin, and basicneurrehabilitatin,asspecifiedbelw: A.SmaticTherapies 1. Therapeutic uses, benefits, side effects, and risks assciated with psychtrpic and neurpharmaclgicagentscmmnlyusedinthecarefpatientswithcgnitivedisrders. 2. Drugdrug interactins related t these and ther medicatins cmmnly used in the care f patientswithcgnitivedisrders. 3. (Optinal) Knwledge f the indicatins and cntraindicatins fr the use f electrcnvulsive therapy and neursurgical prcedures (i.e., ablative prcedures, deep brain stimulatrs, vagus nervestimulatrs,etc.)andthersmatictherapies(e.g.,transcranialmagnetstimulatin)inthe treatmentfpatientswithneurbehaviuralandneurpsychiatricdisrders. B.PsychscialInterventins 1. Knwledge f and indicatins fr psychscial interventins used in the care f patients with neurbehaviuralandneurpsychiatricdisrders,including: a.supprtivetherapy,familytherapy,therpsychtherapeuticinterventinsrelevanttthecare fpersnswithneurpsychiatricandneurbehaviuraldisrders b.patientandfamilyeducatin c.envirnmentalinterventins Page 9 f 12

14 d.behaviuralmanagementstrategies e.usefandreferraltcmmunityresurces 2.Fellwsshulddemnstratetheabilitytwrkina splittherapy mdelwhenneeded;thisreferst amdelftreatmentinwhichthefellwisprvidingmedicalmanagementandantherclinicianis prvidingspecificpsychscialinterventins(eg,psychtherapy,behaviuralmanagement,etc.). IV.NeurbehaviuralSyndrmes Fellws in Cgnitive / Behaviural Neurlgy are expected t develp indepth knwledge regarding the neurpsychiatric and neurbehaviural cnsequences f many neurlgical and psychiatric cnditins. All fellwsareexpectedtbringtsubspecialtytrainingthelevelfknwledgeandclinicalcmpetencerequired bythercpsc(requivalent)frcmpletinfandbardeligibilityinneurlgy. GiventhelimitedduratinftraininginCgnitive/BehaviuralNeurlgy,smefellwsmayhavelittler ndirectexperienceevaluatingandcaringfrpatientswithsmeftheseprblemsduringtheperidf fellwshiptraining.theelementsfthecrecurriculumdescribedinsectinsiiii(abve)aredesignedt ensurethatfellwsdevelptheknwledgebaseandclinicalskillsrequiredtunderstand,evaluate,andtreat patientswithneurbehaviuralprblemsthrughmasteryftheprinciplesfbehaviuralneurlgy.inthe servicefpreparingfellwstprvidecarefrpersnswithneurbehaviuralprblemsarisinginthecntext fthebradrangefcnditinsinwhichsuchprblemsdevelp,fellwsareexpectedtbthcmplement and supplement bedsidelearning thrugh guided selfdirected learning activities and/r didactic experiences. Guided selfdirected learning activities may include reading relevant textbks, peerreviewed articles, r ther materials recmmended by training prgram faculty. Didactic experiences may include seminarsrthercursewrkprvidedbythetrainingprgramitselfrbytherprgramseitherwithinr affiliated with the institutin in which the fellwship training ccurs. Additinally, Fellws shuld be encuraged t attend lcal r natinal cnferences relevant t this aspect f training in Behaviural Neurlgy. Thrughthesemeans,itisexpectedthatthefellwwilldevelpanadvancedlevelfknwledgeregardingthe neurbehaviural aspects, epidemilgy, neurgenetics, putative neurlgical substrates, and typical neurpathlgicalfeaturesfmstfthecnditinslistedbelw,wheresuchareknwn.manycnditins listedbelwwillbeemphasizedverthersandthefellwmaynlygaincursryexpsuretsmefthe neurpsychiatricsyndrmeslistedinsectinc. A.FcalCgnitive/BehaviuralSyndrmes,includingdisrdersf: 1.Arusal(e.g.,cma,persistentvegetativestate,minimallycnsciusstate,etc.) 2.Perceptin(e.g.,illusins,hallucinatins,sensryimpairments) 3.Attentin(e.g.,delirium,cnfusin,neglect/visuspatialdisturbances) 4.Language(e.g.,theaphasias) 5.Memry(e.g.,theamnesias) 6.Praxis(e.g.,theapraxias) 7.Recgnitin(e.g.,theagnsias) Page 10 f 12

15 8.Executivefunctin(e.g.,dysexecutivesyndrme) 9. Cmprtment and scial behaviur (e.g., disinibitin, witzelsucht, parxysmal irritability and aggressin [r rganic aggressive syndrme ], KlüverBucy syndrme, etc.; see als impulse cntrldisrders,belw) 10.Mtivatin(e.g.,apathy,abulia,akineticmutism) 11.DementingDisrders B.Cgnitive,Emtinal,andBehaviuralManifestatinsfNeurlgicalDisrders 1. Agerelatedcgnitiveimpairment 2. Neurdegenerative disrders (e.g., Alzheimer s disease, frnttempral dementia, diffuse Lewy bdydisease,parkinsn sdisease,huntingtn sdisease,etc.) 3. Crtical,subcrtical,whitematter,andmixeddementias 4. Strkeandthercerebrvasculardiseases(e.g.,transientischemicattack[TIA],reversibleischemic neurlgicimpairment[rind],vasculardementias,intracranialhemrrhage,aneurysms,hypxic ischemicencephalpathy) 5. Amnestic disrders (e.g., alchl amnestic disrder [r Krsakff s psychsis], transient glbal amnesia,psttraumaticamnesia,psychgenicamnesia) 6. Epilepsy(e.g.,primaryand/rsecndarygeneralizedand/rpartialseizures,Geschwindinterictal persnalitysyndrme,nnepilepticseizures) 7. Multiplesclersis 8. Traumaticbraininjury 9. Hydrcephalus(includingnrmalpressurehydcephalus) 10. Primaryandsecndarybraintumrs 11. Central nervus system infectins (e.g., HIV, neursyphilis, Lyme disease, herpes encephalitis, prinencephalpathies) 12. Neurendcrinedisrders(e.g.,hypandhyperthyridism,diabetesmellitus,etc.) 13. Txicexpsures/ingestins 14. Metablic disrders, including slid rgan failure and transplantatin and inbrn errrs f metablism(e.g.,adrenleukdystrphy,phenylketnuria,etc.) 15. Mvementdisrders(e.g.,Parkinsn sdisease,huntingtn sdisease,wilsn sdisease,acuteand tardivemvementdisrders,psychgenic[cnversin]mvementdisrders) Page 11 f 12

16 16. Headache(e.g.,tensintype,migraines,cluster,etc.) 17. Acuteandchrnicpain 18. Cllagenvasculardiseases,includingsystemiclupuserythematsus C.NeurpsychiatricSyndrmes 1.Attentindeficitanddisruptivebehaviurdisrders 2.Learning,cmmunicatin,andmtrskilldisrders 3.Dyslexia 4.Develpmentaldisabilities,includingmentalretardatin 5.Autismandpervasivedevelpmentaldisrder 9.Substanceabuseanddependence 10.Disrdersfmd(e.g.,majrdepressivedisrder,biplardisrder,etc.) 11. Disrders f affect (e.g., pathlgical laughing and crying, affective lability, essential crying, euphria,placidity,etc.) 12.Anxietydisrders(e.g.,panicdisrder,psttraumaticstressdisrder,generalizedanxietydisrder, bsessivecmpulsivedisrder) 13.Psychticdisrders(e.g.,schizphrenia,schizaffectivedisrder,delusinaldisrders) 14.Persnalitydisrdersandpersnalitychangeduetneurlgical/medicalcnditins 15. Impulse cntrl disrders (e.g., intermittent explsive disrder, aggressin/rage due t neurlgical/medicalcnditins,hypersexuality,selfinjuriusbehaviur,etc.) 16.Smatfrmdisrders(e.g.,smatizatin,cnversindisrder,etc.) 17.Factitiusdisrders 18.Malingering 19.Sexualdisrders 20.Sleepdisrders 21.Ticdisrders,includingGillesdelaTurette ssyndrme Page 12 f 12