Clinical Neurology & Brain Sciences iBSc for 3rd year MBBS students at UCL

Welcome to this new and exciting Clinical Neurology & Brain Sciences iBSc option!

When medical students qualify as doctors, it is very hard to avoid neurology no matter what specialty they choose. Almost 1 in 10 of primary physician consultations, and up to 1 in 5 of acute medical admissions, feature neurological conditions^1,2. Despite  this, Neurology is a 'shortage specialty' among doctors, and the need to try and address this are well recognised in the UK and internationally^3,4.

Our new iBSc course will help to address this bigger need in medicine. Far from being an area to be intimidated by, clinical neurology can be an extremely rewarding speciality. Our iBSc is centred around the Queen Square  Institute of Neurology, a global leader in neuroscience. The UK's largest dedicated neurological and neurosurgical hospital, The National Hospital for Neurology & Neurosurgery, is also in Queen Square (pictured). Whether you are a budding neurologist yourself, or will ultimately become an expert in another area, knowledge of clinical neurology, and its underlying brain sciences, will serve you in good stead.

The programme is made up of 120 credits in total: six 15-credit modules and a 30-credit library project dissertation. All modules are compulsory and some learning on these modules will be experienced together with MSc students allowing interaction with postgraduates. Regular tutor sessions exclusively for students on our iBSc will take place. These sessions are a vital thread through the course and allow frequent opportunities to  support learning to date as well as opportunities to practice the clinical examination and see some clinical cases. Perhaps the most exciting part of this course is that it is not limited to the modules and their assessments. There is a real desire to make this a course that can help you develop with the opportunity to explore other important skills for your future career paths, including presentation skills and guidance on topics such as publications.

This course adopts a blended learning approach. This is more in some modules than others. For some modules a large portion of the lecture material is delivered online, and this gives greater flexibility for the tutor sessions, and it is hoped additional clinical experience with this. Due to the nature of the course delivery where students join MSc students for some of the teaching, please kindly note that lectures may be scheduled in Reading Weeks in both Term 1 and Term 2.

The only requirement for this iBSc is successful completion of both Years 1 & 2 of the MBBS programme. We hope students will be keen to learn more about clinical neurology and brain sciences-we are keen to teach these and look forward to an exciting and fulfilling course!

References:

1) Morrish P, The changing relationship between neurology and general practice in the UK.  British Journal of General Practice 2009; 59 (565): 599-604. DOI: 10.3399/bjgp09X45383

2) Moodley KK, Nitkunan A, Pereira AC. Acute neurology: a suggested approach. Clin Med (Lond). 2018 Oct;18(5):418-421. doi: 10.7861/clinmedicine.18-5-418.

3) Burton A. How do we fix the shortage of neurologists? Lancet Neurology 2018 Jun;17(6):502-503. doi: 10.1016/S1474-4422(18)30143-1.Epub 2018 Apr 18.

4) Jordan JT, Cahill C, Ostendorf T, et al. Attracting neurology’s next generation: a qualitative study of specialty choice and perceptions. Neurology. 2020;95(8): e1080-e1090

Programme learning outcomes

• Graduates of this degree will have demonstrated that they can:
• Critically apply and interpret clinical neurology knowledge in a range of clinical circumstances.
• Develop critical appraisal and both oral and written communication competency.
• Be able to communicate effectively orally and in writing with a variety of audiences and in different clinical contexts.
• Demonstrate collaborative teamwork focussed on clinical neurology challenges.
• Show evidence of a systematic understanding of key aspects of Clinical Neurology & Brain Sciences.
• Use of conceptual understanding to devise and sustain arguments, and/or to solve problems, using ideas and techniques, some of which are at the forefront of Clinical Neurology & Brain Sciences.
• To describe and comment upon particular aspects of current research, or equivalent advanced scholarship, in Clinical Neurology & Brain Sciences.
• Display an appreciation of the uncertainty, ambiguity and limits of knowledge
• Show ability to manage their own learning
• Demonstrate an ability to make use of scholarly reviews and primary sources (for example, research articles and/or original materials appropriate to the Field of Study).

Structure Overview of the iBSc Clinical Neurology & Brain Sciences Programme

(All are Compulsory Modules):

The Structured Case Review involves a synchronous 1 tutor :1 student review of a hypothetical neurology case. The tutor asks a series of set questions, marking the student on their responses.

More detail on the Modules making up this iBSc Clinical Neurology & Brain Sciences:

1^st Module: Introduction to Clinical Neurology

This first module covers an introduction to clinical neurology and aims right from the start to give some flexibility from the online lectures covering important fundamentals of neurology. This flexibility will allow focus on the neurology examination with tutor lead sessions. In these key aspects of history taking, examination, differentials and management plans in neurology cases will be covered and practiced.  These aspects will be covered in a formative setting during this module, allowing practice before the summative assessments of Structured Case Review and neurological examination assessment. These skills are fundamental to clinical neurology.

2^nd Module: Translational Brain Science of Dementia

This module will provide a detailed, state-of-the-art overview and analysis of common dementia diseases and syndromes: their epidemiology, clinical and neuroanatomical signatures, clinical genetics and pathology, and algorithms for diagnosis and management. Sessions will be led by senior cognitive neurologists and others at the forefront of translational research in the target diseases. The core syllabus will comprise Alzheimer’s disease and its variant phenotypes, the progressive aphasias, frontotemporal dementia, Lewy body disease and syndromes of atypical parkinsonism, vascular cognitive impairment, acute and subacute encephalopathies, and dementias of younger life. Students can gain a detailed theoretical and clinical understanding of the major neurodegenerative diseases as manifestations of underlying brain pathology and anatomical patterns of brain damage.

3^rd Module: Peripheral Nerves in Health and Disease

This module will introduce the anatomy and development of the peripheral nervous system and its physiology and function. It will give the student an overview of clinical presentation, diagnosis and treatment options as well as updates on ongoing  clinical and basic research trends in peripheral nerve diseases. Lectures are supplemented by teaching on how to utilise and interpret techniques in histopathology, electrophysiology and live imaging (MRI) for diagnosis and clinical trials. This module aims to give the student an understanding of the anatomy and function of the peripheral nervous system and to provide a comprehensive overview of the clinical and scientific aspects of diseases affecting the peripheral nerves.

4th Module: Hyperacute Treatment of Stroke

Stroke is the second commonest cause of death worldwide and a leading cause of disability. Despite this, there can be opportunities to make a real difference very early on in the management of stroke. Given its commonness and impact, such hyperacute stroke treatment is of great importance to both neurologists and medical teams around the world.

The focus of this module is to enable students to localise a stroke using clinical history, signs and imaging findings. It also contains lectures on stroke classification and risk stratification of transient ischaemia. The consequences of stroke affecting the senses are also covered: vision, hearing and the balance system . The ethics of stroke will also be considered, including the management of some of the difficult situations in stroke. 

5th Module: Motor Control in Health and Disease

The module covers the following areas: (i) Motor Control, (ii) Basal Ganglia & Movement Disorders (iii) The Autonomic system. The aim of the module is to provide students with an understanding of the basic science underpinning the study of motor control, and its clinical context, focusing on the study and treatment of movement disorders. At the end of the module students will have been introduced to the motor system, and motor control.

Topics covered include: Introduction to the motor system; Cortical control of the hand; Motor control theories; Sensory control of action; Basal ganglia-pathophysiology; Parkinson’s Disease; Pathogenesis of Parkinson’s Disease; Atypical Parkinsonism; The neuropathological basis of movement disorders; Hyperkinetic Movement Disorders; Huntington’s disease; Tics and Tourette syndrome; Cerebellar disorders; Spasticity and spastic paraplegia; Basal ganglia speech disorders; Imaging of Movement Disorders; Surgery for movement disorders; Genetics of Movement Disorders; Diagnosis & Treatment of MS; Autonomic function; Neurology of bladder control & sexual function; Pathophysiology of multiple sclerosis; Remyelination mechanisms in demyelinating disease.

This Module has a novel method of assessment with a Poster Presentation. This is a very important skill to have in many areas of neurology and in wider medicine. Especially early in one’s career, there may be opportunities to present work as posters at conferences. Whilst we cannot guarantee that such outcomes would come through this iBSc, we are happy to help guide any who are interested in exploring such a possibility. Basic groundwork for this is to prepare skills in Poster presentations. This work for this is planned to be in two parts: 1) Formative assessment: Group work in the seminar on designing and presenting posters followed by individual presentations. 2) Summative assessment: Each student would then prepare a poster in line with the module learning objectives. This would be presented over 15 minutes with 30 minutes for questions.

6th Module: Clinical Neurology specialty topics

This module, as with the module Introduction to Clinical Neurology, will be based on online lectures including multimedia content from supplemented by face-to-face tutor sessions. In this module we look at  significant areas in clinical neurology which have not yet been covered in detail. Areas such as neuroinflammation, neuro-ophthalmology, muscle disease and neuromuscular junction pathology are included. As with the first Module assessment is with a Structured Case Review. This is also good preparation for presenting cases on ward rounds or neurology meetings as it helps focus our attention on pertinent aspects of the case. The presentation helps learning to present cases and answer clinical follow up questions, as would be expected in clinical practice. These are fundamental not just to neurology but to most branches of medicine. 

7th Module: Dissertation for iBSc Clinical Neurology & Brain Sciences

This dissertation will take the form of a library project. There will be some degree of flexibility to allow students to suggest their own specific topic in addition to tutor suggested ones. The library project approach gives much more flexibility than traditional research-based project, both in terms of time commitment and choice of topics. Occasionally such dissertations may lead to the potential of trying to develop a submission for consideration of publication in a journal. Whilst we cannot guarantee this would result (and it is not a requirement for the course), any students who are interested in attempting this should let the tutor know as they can provide guidance on this for the student.

A final thought for any of you considering our iBSc Clinical Neurology & Brain Sciences course: This course was developed by an experienced neurologist who still vividly remembers the excitement and fascination that neurology can provide for a medical student. It is our strong hope that those of you who apply for and take this course will feel strongly supported in an enthusiastic atmosphere in which your knowledge of neurology will be fostered in a gratifying way.