Objective:

To improve fourth year medical student (MS4) sub-internship experience and self-confidence for Neurology residency by standardizing and providing innovative opportunities for a more enriching and educational sub-internship experience.

Background:

The “sub-internship” is a rotation where fourth year medical students take on an expanded role in patient care and continue developing skills needed for the demanding experience of residency. As interest in Neurology continues to grow, it is paramount to ensure medical students pursuing Neurology are well-equipped with experiences that prepare them to excel in Neurology residency.

Design/Methods:

A baseline survey was given to MS4s who completed the Neurology sub-internship rotation in 2022-2023. Students reported deficiencies such as lack of standardized expectations, limited experience practicing procedures, and a lack of confidence managing neurological emergencies. In response, the sub-internship was modified to include a boot camp orientation, set expectations, formal evaluations, a detailed syllabus, increased clinical responsibilities, and assigned didactic presentation lectures. Starting July 2023, sub-interns have been surveyed post-rotation to assess perception and evaluation of these changes.

Results:

Compared to the 2022-2023 (n=7), current MS4 sub-interns (n=12) reported improvement in understanding expectations (100% vs 71%), having opportunities to see new patients and staffing on their own (100% vs 42.9%), to formulate own diagnosis and plans (91.7% vs 57.1%), to interpret imaging (100% vs 71.4%). Self assessments had a positive trend in performing a full neurological exam (100% vs 85.7%), localizing neurological deficits (55.6% vs 42.9%), and brainstorming differentials (44.4% vs 28.6%).

Conclusions: