OVERCOME: Overlapping Clerkship for Optimized Medical Education: A Neurology Clerkship Model Using Overlapping Rotations to Expand Capacity While Maintaining Curricular Parity
Igor Rybinnik1, Helen Han2, Marco Russo1, Brad Kamitaki3
1Rutgers Robert Wood Johnson Medical School, 2Rutgers Robert Wood Johnson University Hospital, 3Rutgers-Robert Wood Johnson Medical School
Objective:
Evaluate whether an overlapping neurology clerkship with embedded virtual weeks could expand capacity while maintaining educational comparability and alignment with AAN curriculum guidelines.
Background:

Growing shortages of training opportunities constrain clerkship capacity, while site variability undermines educational comparability and perpetuates neurophobia, weakening neurology training pipeline.

Design/Methods:

In this prospective observational study, third- and fourth-year students at a public medical school completed a 6-week overlapping neurology clerkship formed by staggering two 4-week rotations. During the overlap (weeks 3–4 of 6), two groups alternated identical active-learning didactic and clinical weeks, maintaining curricular equivalence while avoiding oversaturation of clinical services. Anonymous student pre- and post-clerkship surveys, NBME scores, residency outcomes, faculty evaluations, and coordinator feedback were analyzed qualitatively and quantitatively.

Results:

622 students completed the neurology clerkship between June 2021 and April 2025; 504 pre-surveys (81%) and 455 post-surveys (73%) were analyzed. Capacity at the primary site increased by 42.9% despite losing two clinical sites. Most respondents were third-year students (61%), female (60%), and identified as Asian (38%) or White (36%). Student perceived competence rose sharply: confidence in performing the neurologic exam increased from 27% to 93.8%, and in managing neurologic emergencies from 31.7% to 91.6%. Students expressed a a more positive perspective of neurologic outcomes (33.3% vs 48.1%) and greater interest in neurology careers (23.2% vs 31.6%), with match rates rising from 1.9/year (2010–2019) to 6.3/year (2022–2025). Faculty (18/25, 72%) reported their teaching was valued (88%), were satisfied (72%), and 94% intended to continue teaching. Faculty perceived strong student competence, and the coordinator reported manageable scheduling and positive interactions.

Conclusions:

A 6-week neurology clerkship, consisting of two staggered 4-week rotations with alternating didactic and clinical weeks during the overlap, expanded capacity, improved learner competence and satisfaction, and increased neurology match rates. This model supports comparable, guideline-based training and strengthens the neurology pipeline, particularly in resource-limited settings.

10.1212/WNL.0000000000216263
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