Course Director: Naim Haddad, MD
Associate Course Director (Neurology): Leopold Streletz, MD
Associate Course Director (Psychiatry): Ziad Kronfol, MD
Staff Support: firstname.lastname@example.org
Brain and Mind is an integrated course that ranges from basic neuroscience and gross anatomy of the head and neck to neurological diagnosis and psychopathology. The faculty is drawn from the Departments of Neurology & Neuroscience, Pathology, Pharmacology, Physiology & Biophysics, Psychiatry, and Radiology. The course synthesizes basic science and clinical aspects of information about the central nervous system to promote both the acquisition of fundamental knowledge and the development of diagnostic skills. The teaching modalities that are utilized emphasize active student participation. Important features are the problem-based analysis of classical neurological and psychiatric disorders, and the opportunity to examine individual patients in clinic settings. Information on key topics is provided in the form of lectures, patient presentations and small-group tutorials, as well as laboratory sessions on neuroanatomy and gross anatomy of the head and neck. Acquaintance with contemporary research ideas and techniques is fostered by journal club sessions that review papers from the current literature. Computer-based educational and research tools enhance many of these activities.
Problem-Based Learning (PBL)
The backbone of the course is a series of cases embodying important clinical entities in Neurology and Psychiatry. These cases have been selected to provide the basis for an orderly development of knowledge in basic and clinical neuroscience.
Lectures and Patient Presentations
Lectures deal with key topics in both the basic science and clinical areas. Lecturers have been selected for their skill in this form of teaching as well as their expertise in particular subjects.
Laboratories and Small Group Sessions
Clinical Anatomy Dissection and Imaging Laboratory. The anatomy of the head and neck is an important component of this course, leading into a view of the brain, spinal cord, sense organs and the viscera of the Head and Neck, in relation to their surrounding structures. The laboratory sessions include dissection, examination of prosections and models, and correlations with radiological images.
Functional Neuroanatomy Laboratory. Computer-based exercises and small-group tutorials are used to convey a three-dimensional perspective of brain structure and its functional correlations.
Small Group Tutorials. These include sessions on neuropathology, neuroradiology, neuropsychology neuropharmacology, brain imaging and behavioral science. Various learning modalities are involved, including problem sets, discussion of scientific papers and computer-based exercises.
Afternoon sessions in diagnosis of neurological disease and psychopathology provide direct patient contact to enable students to develop their interview and diagnostic skills in these areas.
Psychopathology. The clinic sessions take place on Monday mornings at the Hamad Medical Center, with the class in three groups.
Physical Diagnosis of Neurological Disease. In two periods the students are instructed in the principles of neurological examination and practice the exam in the Clinical Skills Center. Two periods involve examination of patients in a clinic or the hospital at Hamad Medical Center. This series also includes patient presentations and clinical problem-solving sessions on motor, sensory and visual disorders.
Articles selected from the current literature in basic neuroscience research are discussed, with emphasis on the analysis of experimental design and technique, as well as the significance of the results. Related articles for general readers highlight the broader scientific and social significance of the Journal Club articles. Six sessions review articles identified in the course.
By the end of the BAM course, the medical student should be able to master the following course objectives:Knowledge:
- K1 Explain gross brain morphology (including the brain’s developmental configuration and its blood supply) and dynamics of CSF.
- K1, K5, K7 Identify functional properties of nervous tissue in the CNS, as a basis for understanding its normal activity (including memory, attention, cognition, emotion, and sleep) and how activity is disturbed by pathological processes (e.g., ischemia, neurodegeneration, traumatic injury, and epilepsy).
- K1, K6 Describe anatomy and function of motor and sensory pathways and their control centers in relation to the principles of neurological testing and localization of neurological lesions.
- K5, K6, K7 State the neuropathology of important clinical entities, including neoplasms, degenerative disorders, infections, vascular disease, and autoimmune disease.
- K8 Describe the pharmacology of clinically important drugs, including analgesics, anesthetics, anti- epileptics, anti-depressants, anti-psychotics, anxiolytics, drugs of abuse, and ophthalmological medications.
- K1, K6, K7 Explain the gross anatomy of the head and neck, including its implications for clinical problems, especially in relation to the nervous system.
- K6 Explain the use of brain imaging (i.e., CT, MRI, PET, SPECT, angiography) for clinical and experimental purposes.
- K4, K5, K6, K7, K8 Describe the epidemiology, etiology, clinical manifestations, diagnostic procedures, and treatment of common psychopathological syndromes, including schizophrenia, depression, bipolar disorder, suicide, anxiety, personality disorders, eating disorders, substance abuse, somatoform disorders, and childhood disorders.
- K4, K5, K6, K7, K8 Discuss the epidemiology, etiology, clinical manifestations, diagnostic procedures, and treatment of common neurological disorders, including nerve compression, dementia, aphasia, pain syndromes, Parkinson’s disease, multiple sclerosis, epilepsy, neoplasms, headache, paraplegia, Tourette’s syndrome, neuropathies, and stroke.
- K8 Relate introductory information on neurological surgery.
- K6 List basic principles of the neurological examination.
- K7, K8 Recognize various important ophthalmological diseases and their treatment.
- K10, S5, S12 Apply the essentials of history-taking and diagnosis in psychiatric and neurological patients (with particular emphasis on approach to interview skills in cognitively and psychiatrically impaired patients).
- S5 Perform a complete mental status examination in psychiatric and neurological patients.
- S5 Perform a complete neurological examination and demonstrate use of the ophthalmoscope.
- S11 Present oral and written history, physical findings, and diagnostic formulation of patients with neurological and psychiatric disorders.
- S1, S3, S8 Solve clinical problems in a team setting using critical thinking and decision-making.
- S2, S3, S10, A9, A10 Search various electronic and other databases and resources for evidence- based studies and critically evaluate their usefulness and clinical relevance to the medical problem at hand.
- S11, S12 Demonstrate enhanced communication and interpersonal skills with patients and with colleagues in a small group setting.
- A2, A3 Demonstrate sensitivity to patients’ psychiatric and neurological needs.
- A5 Respect the views, time, and participatory rights of classmates and faculty in small and large
group teaching settings.
How Learning Objectives Are Assessed
This course uses a variety of methods to assess students throughout the course that include both formative and summative evaluation. Methods for assessing student achievement of course learning objectives include weekly quizzes, practicum examination in clinical anatomy and neuroanatomy, clinical performance in psychopathology clinics and neurology physical diagnosis, patient write-ups, neurological examination of a standardized patient, Triple Jump examination, and attendance, participation, and quality of contributions in journal club and problem-based learning small group sessions. Please refer to the course syllabus for more specific details on grading.
Note: Knowledge (K), Skills (S), and Attitudes (A), with corresponding numbers in parentheses (e.g., K1, S2, A4), refer to Weill Cornell Medical College’s Educational Objectives of the program leading to the MD degree found at http://qatar-weill.cornell.edu/education/med/eduObj.html
Quizzes and Practical Exams
A 50-minute quiz each week, usually on Sunday at 8 a.m., is used for an objective assessment of the student’s comprehension of substantive information from the lectures, small group tutorial sessions, patient presentations, PBL case, Journal Club, Functional Neuroanatomy Laboratories and Clinical Anatomy Laboratories. The quizzes are generally a test of the previous week’s material. Although the quizzes include questions on the Clinical Anatomy and Functional Neuroanatomy components, the final course grades for these components are determined by practical exams of cumulative knowledge in each of these areas, given toward the end of the course.Clinical Skills Assessment
The clinical Preceptors at HMC will provide assessments of student performance, including patient write-ups. In the Psychopathology Clinics and the Neurological Physical Diagnosis sessions each student is required to produce patient write-ups, which are graded by their respective Preceptors.Triple Jump Examination
During the last two days of the course, students undergo an examination based on a case similar to those discussed in the PBL sessions, consisting of three components: a written analysis of the case, overnight independent study of the original case material plus additional information about the case, and written answers to questions on the studied material. The students use classroom computers for the written portions of the examination.Other Performance Assessments
The Preceptors in the PBL sessions and Journal Clubs will provide quantitative assessments of each student’s performance on the basis of attendance, participation in discussion and quality of contribution. These Preceptors, as well as those in the various small group activities, will also provide narrative comments about student performance where appropriate.Course Grades
This course is graded on a Pass-Fail basis. In order to pass the course, the student must have achieved a passing grade of at least 65% in each of the 8 course components, which consist of the following:
- Weekly quizzes
- Clinical Anatomy
- Functional Neuroanatomy
- Triple Jump Examination
- Analytical skills and professional attributes:
- Journal Club
- Psychopathology Clinics
- Neurology Physical Diagnosis
Failure in 1-3 of these components will result in a Marginal grade, which will require remediation of each of the individual components that were failed. The remediation will consist of further study and/or examination, as determined by the Course Directors, to be completed at a time specified in the Academic Calendar. Failure of remediation of any component will result in a grade of Failure for the course as a whole, which will require appropriate further remediation as indicated in the Guidelines for Promotion and Graduation. Likewise, failure of 4 or more of the course components will result in failure of the course as a whole.Book List
D.W. Black & Andreasen N., Introductory Textbook of Psychiatry, 5th ed. 2010. American Psychiatric Publishing, Inc.
Blumenfeld, H. Neuroanatomy through Clinical Cases. 2nd edition, Sinauer
It will be used in the course as a source of clinical examples related to neuroanatomy, and has good material related to the practice of the neurological exam. However, it does not provide complete coverage of some important topics in the course, so students may want to use one of the recommended neuroscience textbooks in addition. Note website for neurological examination link (Neuroexam.com).
Fitzgerald et al, Clinical Neuroanatomy and Neuroscience, 6th ed, 2010, Saunders. Features contributions of the WCMC faculty (Prof. E. Mtui)
Kumar, V. et al. Robbins and Cotran Pathologic Basis of Disease, 7th ed. 2005. Elsevier Saunders.
Linda Wilson, Cranial Nerves, 3rd Edition, People’s Medical Publishing House
Netter, F. H. Atlas of Human Anatomy, 5th ed. 2010. Icon Learning Systems.
Moore, K. L. and Dalley, A. Clinically Oriented Anatomy, 5th ed. 2006. Lippincott Williams