SU529M.3

Advanced Multidisciplinary Brain Tumor Elective

Sites: MGH
Director(s): Jean-Valery Coumans
Prerequisites: HMS Principal Clinical Experience (Core Clinical Clerkships) as well as a prior sub-internship in neurosurgery is required before this course.
Offered: Full time every month
Location: MGH - Mass. General Hospital (3)
Open to Exclerks: No (HMS only)
Description: This course is intended to be taken after completion of a subinternship in Neurosurgery. The goal is to expose fourth year students with an interest in neurosurgery, to the presentation, diagnosis and treatment of patients with brain tumors. Students round with the neurosurgery oncology team and attend brain tumor conference. Students accompany Drs. Bob Carter, William Curry, Brian Nahed and Daniel Cahill to outpatient clinics and have the opportunity to gain exposure to ongoing research efforts in their respective brain tumor laboratories. Students assist in the operating room and are introduced to the relevant surgical anatomy and principles of brain tumor surgery. Additionally, thematic reading on the topic of brain tumor surgery is assigned weekly, and there are weekly 1:1 meetings with faculty (Drs. Carter, Curry, Nahed and Cahill). At the conclusion of the rotation, the student presents on an aspect of clinical neurooncology to the department.
Incorporation of Basic Science Content and Evidence-Based Medicine:
Basic science is an integral part of this course. Exposure is gained in the brain tumor laboratory, the laboratory meeting, and with the assigned weekly reading. Evidence based medicine is the corner stone of this concentrated experience in neurooncology. The goal of the course is, in essence, to review the current treatment options for patients with brain tumors, based on the latest scientific evidence.
Grade Criteria:
Honors with Distinction:
Attends all conferences, weekly faculty meeting, rounds and clinic. Demonstrates entrustable behavior when performing a accurate, time sensitive history, accurate physical examination, generation of a thorough differential diagnosis. Entrustable with complete and accurate oral presentation of patients cared for on rounds with treatment plan. Entrustable with ability to collaborate as a member of an interdisciplinary team. Able to transition care responsibility by communicating with a consultant. Recognizes neurosurgical emergencies that arise in neurooncology patients. With direct supervision, obtains informed consent prior to neurosurgical oncology procedures (emerging to entrustable). Entrustable with interpretation of most routine neuroendocrine test results and with common neuroimaging findings in patients with intracranial tumors. Demonstrates emerging to entrustable behavior with interpretation of molecular genetic information of tumor patients and recommends treatment based on profile. In the operating room, identifies most relevant anatomy, and identifies key steps in the surgical resection of tumors. In the operating room, assists with basic surgical tasks (entrustable with universal precaution, sterile technique, prepping surgical field, basic surgical technique). At the end of the rotation, presents to the department in depth management options of a neurooncology patient seen in the course of the rotation, and contrasts the advantages and shortcomings of each treatment option. Identifies area for further scholarship as it pertains to the particular disease.

Honors:
Attends all conferences, weekly faculty meeting, rounds and clinic. Entrustable with accurate an timely history, accurate physical examination and interpretation of basic imaging. Emerging to entrustable in generating a basic differential diagnosis. Able to relate and update on patient status and treatment plan to other team members and consultants. Recognizes neurosurgical emergencies that arise in neurooncology patients. With direct supervision, emerging to entrustable in obtaining informed consent prior to neurosurgical oncology procedures. emerging to entrustable in interpreting basic neuroendocrine test results, basic neuroimaging findings in patients with intracranial tumors and molecular genetic information of tumor patients. In the operating room, identifies some relevant anatomy, and key steps in the surgical resection of tumors. In the operating room, entrustable with universal precaution and sterile technique, emerging to entrustable with application of basic surgical technique. At the end of the rotation, presents to the department a patient seen in the course of the rotation with in depth management options.

Satisfactory:
Attends all conferences, weekly faculty meeting, rounds and clinic. Presents patients cared for on rounds. pre-entrustable behavior with most relevant history and basic physical examination. Pre-entrustable behavior with generation of a basic differential diagnosis and with interpretation of basic endocrine and radiographic images. Demonstrates basic understanding of clinical neurooncology including discerning between some treatment options for various tumor types. Pre-entrustable in collaborating as a member of the team and in discerning need for urgent versus routine patient care in neuro-oncology patients. At the conclusion of the rotation, presents to the department a patient cared for while on service with overview of treatment options.

Unsatisfactory:
Fails to attend all weekly faculty meeting. Does not report to morning rounds or to clinic consistently. Does not complete assigned reading or does not demonstrate improved understanding of the care of neuroocology patients. Behavior requires corrective response and unable to correct. Unable to recognize major tumor types on imaging, and unable to discern between major treatment options for patients with brain tumors.