MUHAS Training Program
Training Program for Postgraduate Neurology Trainees MUHAS (Tanzania)
Clinical Training at CMC Vellore, India
1. Program Overview
Purpose
- To provide focused subspecialty exposure in high-volume tertiary neurology practice
- To strengthen:
- Clinical reasoning
- Neurodiagnostic skills
- Neurocritical care competencies
- Evidence-based management
Duration
- Total duration: 6 months (one semester)
-
Structure:
- Month 1 and 2 – General Neurology (Foundation)
- Months 3–6 – Subspecialty rotations:
- Neurocritical Care
- Stroke Medicine
- Clinical Neurophysiology
- Neuroimaging
Target trainees
- Postgraduate neurology residents from MUHAS
- Equivalent to mid-level neurology residency stage
2. Core Training Philosophy
The curriculum is designed around three pillars of competency development:
A. Knowledge
- Understanding pathophysiology-based clinical reasoning
- Exposure to guideline-driven management
- Familiarity with diagnostic algorithms
B. Skills
- Bedside neurological examination refinement
- Procedural competence
- Interpretation of neurodiagnostic tests
C. Professional Development
- Multidisciplinary teamwork
- Ethical decision-making
- Resource-appropriate care models relevant to LMIC settings
3. Training Structure and Rotations
MONTH 1 and 2 — GENERAL NEUROLOGY (FOUNDATION)
Objectives:
- Develop structured clinical approach to neurological disorders
- Build competency in localization and differential diagnosis
- Learn inpatient and outpatient workflow
Clinical Exposure
A. Inpatient Care
- Daily ward rounds
- Case documentation
- Management planning
B. Outpatient Clinics
- New patient evaluation
- Chronic disease management
- Follow-up strategies
Academic Activities
- Daily case presentations
- Bedside teaching rounds
- Weekly seminars
- Neuroanatomy–clinical correlation sessions
Skills training
- Neurological examination mastery
- Localization exercises
- Documentation standards
MONTH 3 — NEUROCRITICAL CARE
Objectives
- Understand neurocritical pathophysiology
- Learn acute neurological emergency management
- Develop monitoring and procedural skills
Core Competencies
A. Clinical Management
- Raised intracranial pressure syndromes
- Status epilepticus
- Neuromuscular respiratory failure
- Acute encephalopathy
- Post-operative neurosurgical care
B. Monitoring Skills
- Neuro-vital assessment
- ICP monitoring principles
- Hemodynamic optimization
- Ventilator strategies in neurological patients
C. Procedures (Observation/Assisted)
- Lumbar puncture in ICU
- Central line insertion
- Airway management principles
Academic Components
- ICU case discussions
- Mortality audits
- Evidence-based neurocritical protocols
MONTH 4 — STROKE MEDICINE
Objectives
- Develop expertise in acute stroke evaluation and management
- Understand stroke systems of care
Core Clinical Exposure
A. Acute Stroke Care
- Hyperacute stroke triage
- Thrombolysis protocols
- Mechanical thrombectomy workflow
B. Stroke Subtypes
- Ischemic stroke mechanisms
- Hemorrhagic stroke management
- Stroke in young
- Cerebral venous thrombosis
C. Secondary Prevention
- Risk factor modification
- Antithrombotic therapy
- Rehabilitation planning
Diagnostic Skills
- NIHSS scoring
- Stroke imaging interpretation
- Etiologic classification (TOAST)
Academic Components
- Stroke case conferences
- Journal clubs
- Quality improvement audits
MONTH 5 — CLINICAL NEUROPHYSIOLOGY
Objectives
- Gain competency in electrophysiological testing principles
- Develop interpretation skills
Exposure Areas
A. EEG
- Routine EEG interpretation
- ICU EEG monitoring
- Epileptiform vs non-epileptiform patterns
B. EMG & Nerve Conduction
- Peripheral neuropathy evaluation
- Neuromuscular junction disorders
- Myopathy patterns
C. Evoked Potentials
- Visual evoked potentials
- Brainstem auditory evoked potentials
- Somatosensory evoked potentials
- Autonomic function testing and interpretation
- Transcranial doppler
Skills
- Indication selection
- Basic technical understanding
- Clinical correlation
Academic Activities
- Pattern recognition sessions
- Electrophysiology case discussions
MONTH 6 — NEUROIMAGING
Objectives
- Develop structured neuroimaging interpretation skills
- Understand imaging-pathophysiology correlations
Core Areas
A. MRI Interpretation
- Stroke imaging
- Demyelinating disorders
- Neurodegeneration
- Tumors and infections
B. CT Interpretation
- Emergency neuroimaging
- Trauma patterns
- Hemorrhage classification
C. Advanced Imaging
- Perfusion imaging
- MR spectroscopy
- Functional imaging basics
Skills
- Structured reporting approach
- Imaging-clinical correlation
- Recognizing red-flag findings
Academic Components
- Daily imaging rounds
- Radiology-neurology joint conferences
4. Teaching Methods
- Bedside teaching
- Case-based learning
- Multidisciplinary rounds
- Simulation sessions
- Journal clubs
- Interactive seminars
5. Evaluation Methods
Formative Assessment
- Case presentations
- Direct observation of clinical skills
Summative Assessment
- Objective structured clinical assessment
- Logbook review
6. Expected Competency Outcomes
At completion, trainees should demonstrate:
Clinical Competence
- Structured neurological evaluation
- Emergency neurological management
Diagnostic Competence
- Interpretation of neurodiagnostic tests
- Imaging correlation skills
Professional Competence
- Team communication
- Ethical decision-making
- Systems-based practice
7. Program Supervision
- Faculty mentor assigned
- Monthly performance review
- Feedback sessions
8. Integrating into Weekly Schedule
| Activity | Frequency |
| Ward rounds | Daily |
| Outpatient Clinics | 3/week, specialty clinics on Wednesdays |
| Teaching sessions | Daily |
| Journal club | Weekly (Monday) |
| Seminar | Weekly (Tuesday) |
| Case conference | Weekly (Thursday) |
| Electrophysiology conference | Weekly (Friday) |
| Combined session with Neurosurgery Weekly | Weekly (Saturday) |
9. Certification
- Certificate issued jointly by:
- CMC Vellore
- MUHAS Neurology Program