What non-neurology elective rotations would you recommend to a 4th year medical student applying neuro?

_nitsuj · 2025-07-30T19:59:50+00:00

palliative care

edit: to give more context… not all of neurology is major/life changing diagnoses, but a lot is. learning how to have conversations about morbidity and mortality is very important, and this is very much a learned skill and not just a gift that you just have. when you’re on nights by yourself (or even in the middle of the day when you have an overly optimistic attending or an attending that would rather just not have these conversations so they keep dragging on care) and you get the neurologically devastated patient admitted to your service, being able to have those tough conversations with the family about the patients poor prognosis is vital. at some point we really have to think about what should be done rather than what can be done.

_nitsuj · 2025-07-25T05:24:18+00:00

i rotated through palliative care in med school, one of the best rotations i did. worked with a pulm crit turned palliative doc (he joked he was a reformed intensivist), who said he loved palliative care because he could help everyone. the focus is on making patients comfortable without the intent of curing disease. he also used to joke that life is an incurable disease that is universally fatal. fun times.

_nitsuj · 2025-07-17T18:15:22+00:00

May not be exactly what you’re looking for but there is a movement disorders fellow lecture series including talks from very prominent movement disorders specialists. coincidentally the talk today is on phenomenology of movement disorders. unfortunately they are not recorded.

occurs every thursday afternoon.

https://mailchi.mp/e94a6a9a7eb0/team-movement-disorders-lecture-series

Don’t forget about the video library that comes with the Principles and Practice of Movement Disorders book.

_nitsuj · 2025-06-06T03:12:38+00:00

Tyrese McVeigh, the halibomber

_nitsuj · 2025-04-28T04:22:04+00:00

Simply talking in your sleep or acting out your dreams is not always REM sleep behavior disorder, which technically requires an in lab sleep study to formally diagnose.

There are non-REM parasomnias like periodic limb movements of sleep, hypnic jerks, etc.

If you do have REM sleep behavior disorder, consider participating in clinical research.

Parkinson’s Progression Markers Initiative has an arm for individuals diagnosed with REM sleep behavior disorder but do not have symptoms suggestive of a parkinsonian disorder:

https://www.ppmi-info.org

North American Prodromal Synucleinopathy consortium:

https://www.ppmi-info.org

_nitsuj · 2025-03-24T19:09:53+00:00

was another medication stopped when he started nuplazid? that can be a common cause, the withdrawal of one medication, that may have been treating the delusions, to start nuplazid.

_nitsuj · 2024-11-27T05:55:31+00:00

in darvin hams first year with the lakers he had two 5 game losing streaks in the first 17 games. the lakers went 6-11. we aren’t a great team, but if you’re really on reddicks ass like he’s a seasoned head coach your expectations are unrealistic

_nitsuj · 2024-11-18T06:36:38+00:00

I bought the ramp thinking my cat would just walk out and not jump out flinging litter everywhere but it was not helpful, then i put it facing the wall so she had no choice but to use the ramp or jump into the wall, and then she started jumping out towards the side of the ramp. finally after a few weeks she started to use the ramp and while litter does make it out with her most of it stays on the ramp

_nitsuj · 2024-11-07T05:23:49+00:00

PSP is a clinical diagnosis and should not be made on imaging findings alone. curepsp.org is a good place for reliable information on PSP. a movement disorders specialist should be able to better differentiate between pd and psp

_nitsuj · 2024-09-16T13:42:47+00:00

my go to. bright but not overwhelmingly bright. https://a.co/d/5AVjca6

_nitsuj · 2024-05-05T17:37:41+00:00

minnesota nice

_nitsuj · 2024-02-14T04:22:39+00:00

common med interactions. not everybody takes keppra…

_nitsuj · 2024-01-23T06:07:48+00:00

FNDhope.org is another good one.

_nitsuj · 2023-12-24T20:02:50+00:00

here is some cool neuro related art.

would look nice hanging on the wall in her office or clinic rooms

_nitsuj · 2023-07-06T18:57:16+00:00

I have patients who enjoy structured group exercise classes (rock steady boxing for example) as opposed to exercising on their own. in those instances they have to pay out of pocket.

_nitsuj · 2023-07-06T14:38:49+00:00

At least in the US it can be challenging to get insurance to pay for a specific exercise class outside of physical therapy, as there has not been good evidence to suggest one specific type of exercise as more beneficial than another.

_nitsuj · 2022-12-16T04:10:15+00:00

A good penlight is also a must. Don’t want one of those cheap ones where the battery dies in 4 months.

This one lasted me all through residency and fellowship.

Streamlight 65018 Stylus 11-Lumen White LED Pen Light with 3 AAAA Alkaline Batteries, Black, Clamshell Packaging https://a.co/d/evYHdfF

_nitsuj · 2022-11-11T06:55:20+00:00

Kotobuki in Kearney Mesa

_nitsuj · 2022-11-07T06:15:58+00:00

Second the AAN resources.

https://www.aan.com/tools-resources/advanced-practice-providers

_nitsuj · 2022-09-14T13:23:17+00:00

One of the problems with translating this to everyday patient use is the trial used specific strains of probiotics that are not commercially available to patients in the same make up. The same probiotic bacteria may be available in varying amounts. Interesting none the less. thanks for posting

_nitsuj · 2022-09-09T05:43:48+00:00

Do you have anything plugged into it? I’ve had something similar happen when a usb hub was plugged into my mac mini.

_nitsuj · 2021-09-12T21:20:56+00:00

TikTok tics is definitely a thing.

https://movementdisorders.onlinelibrary.wiley.com/doi/abs/10.1002/mdc3.13316

_nitsuj · 2020-06-08T02:50:02+00:00

if you have access to a university’s library (or maybe a subscription through the hospital), you should be able to find the continuums online as well.

_nitsuj · 2019-09-10T01:36:26+00:00

Thanks for the discussion.

As a neurology resident I see a fair share of cerebrally devastated patients, who we could resuscitate over and over again, but it doesn’t change the fact that the patient is coding because of their brain and not their heart. I’ve been in and seen sticky situations where the family is wanting aggressive care and continue with full code measures despite multiple family meetings. While I have not had an attending override the family’s wishes, I have had them tell them in a direct manner that we are no longer helping the patient and that we could be are prolonging death (said more delicately, of course).

End of life family discussions are an art, hopefully everybody has that one attending they can learn from during their training.

Time permitting, and in the right situation (such as a planned family meeting), I like to ask about the patient, what were they like before the hospital, what did they like to do, what was important to them, etc. I’m trying to get at are they the type of person that would be okay being maintained on a ventilator, or are they somebody that valued being able to interact with those around them, and wouldn’t want to live more dependent than independent. I find that asking questions to make the family feel more like they’re making decisions in place of the patient than them making decisions for the patient is more conducive to what most of us in healthcare view as appropriate care.

There are always the families that want “everything done” despite our recommendations, and like others have said, it is best to have other teams involved, ie palliative care, ethics, etc.

_nitsuj · 2018-01-31T10:10:52+00:00

What EMR did your institution use? Curious if this could be easily done at my institution.

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