Neurology medical education training gets revamped.Victor Sung, M.D., associate professor in the UAB Department of Neurology, can help promote the School of Medicine’s neurology medical education because he empathizes with students, even if he attended a different medical school.
“I was a neurosciences major as an undergrad, so I always liked studying the brain,” says Sung, who attended the University of Texas Southwestern Medical School in Dallas. “However, my second-year course in that area was poorly organized and poorly rated. I did not do well in the course and had to explain my performance during my neurology residency interviews. I didn’t want anyone else to experience that.”
David Standaert, M.D., Ph.D., the John N. Whitaker Chair in the Department of Neurology, wanted to change neurology medical education training, too. When he first became chair in 2011, one of his main goals was to enliven neurology medical education training.
“When I took the job, I learned that not one single fourth-year student in that year tried to match into neurology,” says Standaert. “We did a number of things to change neurosciences medical education.” They partnered with Robin Lester, Ph.D., the second-year neurosciences module director. This module comprises neurology, psychiatry (behavior), pharmacology, pathology, and anatomy components.
To help with the neurology part of the module, Standaert notes they brought in Sung in 2013, who later brought in Michael Lyerly, M.D. “By bringing in young and fresh perspectives and by making it a joint effort among numerous faculty, we helped contribute to the restructuring of the second-year neurosciences module.”
Lester says Vinita Yalamanchili, M.D., and Tobias Martinez, M.D., in psychiatry; Teresa Wilborn, Pharm.D., Ph.D., in pharmacology; Kenneth Fallon, M.D., in neuropathology; and William Brooks, Ph.D., in anatomy all had a hand in reshaping the neurosciences module.
“I believe we have integrated all aspects of the broad field of neuroscience into a well-structured 10-week course,” says Robin Lester, Ph.D., professor in the Department of Neurobiology.
Making a Change
The team replaced some lecturers, reorganized the small group lessons to align with the large group content, and made sure the lectures covered material the students would be tested on for their board certification exams.
“We found it more beneficial having a faculty member with great oratory skills lecturing about a subject that wasn’t their expertise than having an expert teaching about the subject who didn’t have those same oratory skills,” says Lyerly, associate professor in the Department of Neurology. “We carefully looked over the previous course evaluations and took a lot of the students’ feedback to heart to help guide us in redirecting the course.”
“Rebuilding the second-year neurosciences module has been both challenging and rewarding,” adds Lester. “It continues to be a dynamic process, with annual adjustments aimed at providing the preclinical medical class with an enjoyable journey through the brain and leaving them with a comprehensive understanding of the nervous system.”
Now the course routinely receives high ratings among second-year students and is the two-time reigning Argus Award winner for Best MS2 Organ Module. Moreover, Sung has been named the Best Educator in Neurosciences three years in a row. He also received the UAB President’s Award for Excellence in Teaching for the School of Medicine in 2018. These accolades are a testament to the positive changes in the course because they recognize outstanding service to medical education through course evaluations, student votes, and faculty nominations.
Growing the Pipeline
Standaert, Sung, and Lyerly say their overall goal is to get more students to enter the field of neurology. They’re doing just that.
“We were averaging one to two students a year entering into neurology residencies before we helped reorganize the second-year neurosciences module. We recently had eight students match into adult neurology and two more match into pediatric neurology in a single year,” says Sung. “There’s no other way to see it. It’s four to five times more; it’s a big jump.”
The recent group of students who matched into neurology were in the first class to take the revamped neurosciences module. The trend is continuing, as the next class to take the overhauled course has another 10 students who have declared intent to apply for a neurology residency.
Standaert says one reason for the turnaround is a simple change in the course calendar. The second-year neurosciences module previously started with the small details and worked up to the big picture. “So they turned it around,” notes Standaert. “They said, ‘Let’s start with the big picture. Let’s talk about the brain as a whole, and then let’s work down to the small details in the other direction.’”
According to a recently published article by the American Academy of Neurology (AAN), there are 180 practicing neurologists in Alabama, 55 of whom are at UAB. Based on calculations using age and population numbers, the authors of the AAN article estimate there should be 280 practicing neurologists in the state.
“We are about 100 neurologists short for the state, so we are a long way from filling the gap,” admits Standaert. “But it’s really exciting to have more students enthusiastic about neurology. We’re growing that pipeline of having people from Alabama who want to train in neurology and stay here.”
Innovative Training
Standaert says another group of faculty is focused on improving the third-year medical students’ experience with neurology. He, along with third-year clerkship director John Rinker II, M.D., assistant clerkship director Marissa Natelson Love, M.D., and other faculty members redesigned how the students were assigned on neurology rotations. Instead of putting four or five third-year medical students on one neurology rotation, the instructors spread them out so there were only one or two students on a rotation.
“They get more personal attention this way, which is great,” says Standaert. “We’re getting them excited about neurology and neurosciences. They come out of their second-year neurosciences module thinking of neurology as really fun, interesting, important, and relevant. This makes their third-year neurology experience more positive from the get-go.”
There may be another perk in restructuring neurology medical education within the UAB School of Medicine: a decrease in “neurophobia.”
“Before medical students even take a course in neurosciences, some of them have an innate fear that learning about the brain is just this complex mystery. They go into it with this pessimistic attitude about how hard it’s going to be,” explains Lyerly. “If the course is not done right, you’re going validate that neurophobia. We’re doing the opposite; we’re turning neurophobia on its head.”
By Emily Henagan