Neurology week 1 - finished!

My day started in the Acute Brain Injury Unit (ABIU)/Rehab ward. My doctors and I joined the "Shoulder Clinic" rounds led by an Orthopedist and a Physiotherapist. Ironically, they didn't only examine shoulders, they also examined other joints. We saw a patient with a frozen shoulder, a patient with subluxation of the shoulder, and another with limited range of motion in the knee.

Later in the morning, I attended an online seminar. The Neurosurgical Fellow leading the class presented a case and together we discussed the associated investigations, considerations, and management. It was very interactive. It was a refresher for some of the topics I studied earlier in the week and I found it was great practice for my Neurology final exam.

After lunch, I had bedside teaching. Another student and I met the doctor in front of the National Hospital for Neurology and Neurosurgery (NHNN). Once we'd all introduced ourselves, we headed upstairs to the ABIU/Rehab ward and found a place to sit in the kitchen. We talked about what we wanted to achieve over the next four weeks from this once a week teaching session. I expressed wanting to be more confident performing a full neurological physical examination, this includes the peripheral nervous system exam I explained on Wednesday as well as the cranial nerve examination. The other student agreed. The doctor decided that we would begin by talking through the steps of the physical examination before going to the ward to perform it on a patient. We began with the cranial nerve examination and he asked that we describe how to examine each cranial nerve. The other student started with the first cranial nerve, then I did the second, and we took turns until we covered all twelve. 

At the ward, the doctor found a patient who agreed to let us practice performing the exam on them. I examined all twelve cranial nerves and the other student examined the upper limbs. Comparing the left arm to the right arm each step of the way, the student checked the tone, power, reflexes, sensation, and coordination. Once the examination was complete, we thanked the patient and went into the hallway to discuss the doctor's feedback. The doctor asked me to report back the findings from my cranial nerve examination. There are several ways to do this. I could have stated the results for each of the cranial nerves, but rather I focused on the abnormal findings. The doctor was pleased with this and asked the other student to do the same for her examination. Afterwards, we set a date and time for next week's session. the day was done.  

Week one is done, and it has been amazing. Not once this week did I feel exhausted, I have learned so much, and I have had time every day to study. I look forward to what awaits me next week.

A selfie in front of the NHNN logo to end the first week.