Visiting Practitioner Program - Neurology

Faculty:
  • Thomas Schubert, DVM, DABVP, DACVIM (Service Chief)
  • Roger Clemmons, DVM, PhD
Residents/Interns:
  • William Draper, DVM
  • Rossi House, DVM
  • Sarita Miles, DVM

Visiting practitioners should meet in the Neurology Laboratory VH-20 at 9:00 a.m. Monday of the first day of the rotation for orientation with the senior or junior students so activities on the neurology service can be reviewed.

Daily Routine

Neurology Clinics are 9:30 a.m. to 2:00 p.m. Mondays and Wednesdays (bring your lunch). You will join the students as they begin each case. The front desk will page "neurology student to the front desk". Although one student will be primary, all students will try to see as many of the cases as possible. When the students have finished the history, physical and neurological examinations, location of lesions, differential diagnosis and diagnostic plan, they will beep one of the neurology clinicians on duty. The neurology clinician will discuss the student's evaluation and then examine the patient. The neurology clinician will then give the client the differential diagnosis, possible plans for evaluation and assist them to make a decision of what do. We expect the visiting practitioners to participate in the discussions and observe the clinician and client interaction.

When patients are admitted, students make sure animals are vaccinated and heartworm treatment is continued. The animal's care is the student's and neurology clinician's responsibility, 24 hours a day. Students do 8:00 p.m. treatments and sign up treatments after 10:00 p.m. on the sheet in ICU. Visiting practitioners can assist in treatments and observe, but may have no direct case responsibility. All blood tests must be submitted by 2:00 p.m.. Anesthesia requests must be submitted by 3:30 PM. Radiology and consultation requests are submitted as soon as possible.

Afternoons on Monday and Wednesday are usually spent on initial diagnostic test submission and paperwork. The student will write a first day SOAP for each case which is a brief summary of abnormal and pertinent findings. The visiting practitioner should review all first day SOAPs. The referring veterinarian will be contacted by the student and given the differential diagnosis and the plan. The clinician will usually call the veterinarian with the final diagnosis.

At 9:00 a.m. on Tuesdays and Thursdays, workups and surgery of cases begin, depending on the anesthesia schedule. All visiting practitioners should participate so they are current on all hospitalized neurology patients. Visiting practitioners may scrub in to assist in surgery, so bring your scrubs.

Afternoons on Tuesdays and Thursdays and all day Fridays are usually spent on case workups, in surgery, or study and discussions. Each visiting practitioner should utilize spare time to study the literature about the current cases. There are neurology reference texts and video case problems to study in the neurology laboratory. If you go to the reading room, please inform the neurology clinician so you can be informed of emergency cases and other activities. Neurology clinicians may be involved with other classes, committee meetings, phone calls and paperwork throughout the day. Not all learning will be in the form of structured activities, although didactic material is often presented when time allows. Visiting practitioners are expected to give one 15 minute presentation on a subject of their choice to the students and clinician on duty.

There will be an afternoon walk through rounds everyday to update and check on cases before going home. Students will call clients daily about hospitalized cases, write communications in the record and inform the neurology clinician on the case.

Miscellaneous Information About Neurology Service

All cases with a history or possibility of seizures are maintained in ICU. All ICU cases must have orders written by 8:00 AM. The students are responsible for 8:00 AM treatments only. Oral medications must be supplied. All controlled substances are kept in the lock box with only a 24 hour supply available.

There are no formal rounds on the weekend except in certain instances at the discretion of the clinician. Weekend duties may be shared among students on the neurology service or each may care for their own. SOAPs will be done daily on the weekend.

The clinician will write the discharge orders and the student and visiting practitioners will assist in the discharge of their cases. We normally do not discharge after 3:30 p.m. or on the weekend, but the clinician will decide on exceptions.

Emergency cases are seen as needed daily between 8:00 a.m. and 5:00 p.m. Evening neurological emergencies may be transferred to the Neurology Service the following morning. Visiting practitioners and students will be on emergency duty for neurosurgery.

The visiting practitioners, students, technicians and neurology clinicians must work together as an efficient, thorough and amicable team. We like to have a good time as well as practice the highest quality of medicine and surgery. The welfare of our animals and clients and a healthy learning environment are MOST IMPORTANT! Time permitting on Friday we have lunch together.

At the end of the rotation the visiting practitioner should be able to accurately collect a history, perform physical and neurological examinations, localize lesions, and formulate a differential diagnosis and diagnostic plan for common neurological complaints such as seizures, head tilt, back or neck pain, paraplegia or quadriplegia. Management of seizure disorders, intervertebral disc disease, inner ear infections, and discospondylitis should be mastered.