Welcome to the medical neuroscience section!

Neuroscience is an important area of study for clinicians because of its role in neurological and psychiatric disease. Furthermore, neuroscience helps us understand the link between activity in the body, and in the mind, and therefore lies at the centre of understanding patient symptoms in any medical speciality. 

On the medicine course at King's, some neuroscience is taught in the first year while neurological medicine is taught as part of the Ageing block in year 2, Cognition, Movement and Senses (CMS) block in year 3 and as part of psychiatry. Students interested in neuroscience can also do an intercalated BSc. In the CMS block King's states:

“Students will develop their clinical understanding of cognition, movement and sensation in the context in neurology and ophthalmology, with some ENT overlap. They will gain clinical experience in a wide variety of settings, learning about the acute and long term presentations, their investigations, and interaction with wider fields such as neurosurgery, neurophysiology and general medicine, multidisciplinary care and the psychosocial context of these conditions.”

Our society will run teaching on fundamental neuroscience and clinical revision sessions including OSCE prep to help you not only excel on the wards, but smash your exams! 

On this page we plan to include revision tips and advice, advice and write-ups about placements at our medical school and links to study resources on neuroscience and neurology!

2020-2021 Academic Year

We want everyone to stay safe during these strange times. Due to covid-19 restrictions, clinical placements are slightly different this year, and you will be informed by your stage head what is taking place. In stages 1 and 2 (years 1-3), a lot of learning is online with a sparse clinical experience. We recommend you make the most of the time you do have, and spend time outside of placement reviewing the basic underlying science. We know- that's boring and not as exciting as placement, but it does come in handy..! 

 

Check your KEATS dashboard more updates and announcements regarding placements. In addition, keep a close eye on your weekly stage updates from the UGME (undergraduate medical education) account.  

Student experiences on neurology placements

We encourage you to submit a reflection or summary of your neurology placements. For more guidance please mail kclneurosociety@gmail.com 

"I’m currently spending 4 weeks on a neuromuscular ward in Munich, in the role of a medical student in clinical years. A typical day involves taking an active part in the morning ward round, clerking new admissions, completing individual tasks (bloods, cannulas, lumbar punctures, etc) and following the afternoon ward round with the consultant in charge. Neuromuscular diseases form a subspecialty of neurology scarcely covered in medical school, largely because they are rare. Having said that, there are several that do make the rather arbitrary cut; myasthenia gravis, amyotrophic lateral sclerosis and Guillain-Barré syndrome being among them. 

 

One of the most memorable cases I have seen so far, a young man around my age with a severe myopathy of unknown origin, would not have made any medical school textbook. The first time we met, he was sitting up in bed with his legs contorted in a way that could not have been comfortable for anyone but him. The lordotic curvature of his spine made him look like a cuddly toy, carelessly propped up against the back of the bed. His ventilator was wheezing softly in the corner, although he wasn’t paying much attention to it- he was absolutely fixated on his laptop. When I introduced myself, he sprung out of his contortionist position and folded himself into what he must have thought was a more respectful arrangement. After rattling off a few of the more generic questions of the neurological history, I asked him how he was coping with his disability at home. He made a face before twisting himself into yet another knot of limbs- “Can you do this?” I didn’t have to try to know I couldn’t. “Who are you calling disabled then?”

 

The distinctions between ability and disability, or health and disease, crop up in every area of medicine, but are perhaps most ambiguous in neurology. In his book ‘An Anthropologist on Mars’, Oliver Sacks writes: “This sense of the brain’s remarkable plasticity, its capacity for the most striking adaptations, not least in the special (and often desperate) circumstances of neural or sensory mishap, has come to dominate my own perception of my patients and their lives. So much so, indeed, that I am sometimes moved to wonder whether it may not be necessary to redefine the very concepts of “health” and “disease,” to see these in terms of the ability of the organism to create a new organisation and order, one that fits its special, altered disposition and needs, rather than in the terms of a rigidly defined “norm.”” I thought Sacks would have liked this patient as much as I did.

 

The main advice I would give students starting their neurology placements would be to keep things very simple. Neuroscience can seem daunting at first; I still shiver at the thought of those colour-coded, overloaded neuroanatomy lecture slides from first and second year. In reality, it mostly comes down to getting a crude idea of where in the nervous system pathology lies (e.g. central or peripheral)- the rest comes with experience, or so I’m told. Let the neuroanatomy take a back seat and focus on individual patient presentations, including their abilities and adaptations as well as their disabilities and deficiencies. You can always look up the science later, but the patients’ stories are unique and ultimately more memorable."

August 2020

Angela Lochmueller - Intercalating Medical Student

Jubilent Amalendran - 4th year medical student

My rotation in neurology was in Stage 2 Year 3 of the medical course, at St Thomas' Hospital. I saw a mixture of stroke patients and geriatric patients with some motor deficits.

The neurological examination is by far one of the most elegant and informative examinations I have come across in clinical medicine. On placement, having a good understanding of each step in the examination and the underlying anatomy (including cranial nerve, upper limb and lower limb) is a great start. Practising the different examinations amongst friends consolidates understanding and prepares one well for OSCEs. 

One key question in a neurological scenario is 'where is the lesion?' and the examination discerns this, usually without the need for any imaging (in many cases imaging studies should be confirmatory rather than diagnostic). 

In terms of imaging, it is important to recognise what certain emergencies (e.g. subarachnoid haemorrhage) look like on CT/MR scans. 

August 2020

Tips and resources

Revision resources we recommend

Clinical neurology - prepare yourself for the wards

  • Oxford Handbook of Clinical Medicine - Chapter 10 (Neurology) - Oxford University Press; a great general overview and crash course through essential concepts and conditions in neurology

Neuroanatomy  - consolidate your understanding by learning neuroanatomy. (Plus, it's great procrastination!) 

Exam focus - prepare yourself for exams with these great question banks and notes

N.B. We do not recommend you use every single resource listed on here! We all have different preferences for learning content,, so we have tried to provide a range of styles. Find a few different things that work for you and stick to them, rather than hopelessly try and absorb every single book out there..! 

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