Neurology with General Internal Medicine (GIM) CESR Portfolio Guide

• Aware of, and adheres to, the GMC professional requirements
• Aware of public health issues including population health, social determinants of health and global health perspectives
• Demonstrates effective clinical leadership
• Demonstrates promotion of an open and transparent culture
• Keeps up to date through learning and teaching
• Demonstrates engagement in career planning
• Demonstrates capabilities in dealing with complexity and uncertainty
• Aware of the role and processes for commissioning
• Aware of the need to use resources wisely

• Aware of national legislation and legal responsibilities, including safeguarding vulnerable groups
• Behaves in accordance with ethical and legal requirements
• Demonstrates ability to offer apology or explanation when appropriate
• Demonstrate ability to lead the clinical team in ensuring that ethical and legal factors are considered openly and consistently

• Communicates clearly with patients and carers in a variety of settings
• Communicates effectively with clinical and other professional colleagues
• Identifies and manages barriers to communication
• Demonstrates effective consultation skills including effective verbal and non-verbal interpersonal skills
• Shares decision making by informing the patient, prioritising the patient's goals and wishes
• Shares decision making with children and young people
• Applies management and team working skills appropriately

• Makes patient safety a priority in clinical practice
• Raises and escalates concerns where there is an issue with patient safety or quality of care
• Demonstrates commitment to learning from patient safety investigations and complaints
• Shares good practice appropriately
• Contributes to and delivers quality improvement
• Understands basic Human Factors principles and practice
• Understands the importance of non-technical skills and crisis resource management
• Recognises and works within limit of personal competence
• Avoids organising unnecessary investigations or prescribing poorly evidenced treatments

• Manages clinical information / data appropriately
• Understands principles of research and academic writing
• Demonstrates ability to carry out critical appraisal of the literature
• Understands the role of evidence in clinical practice and demonstrates shared decision making with patients
• Understands public health epidemiology and global health patterns
• Demonstrates appropriate knowledge of research methods
• Demonstrates appropriate knowledge of research principles and concepts
• Follows guidelines on ethical conduct in research and consent for research
• Recognises potential of applied informatics, genomics, stratified risk and personalised medicine

• Delivers effective teaching and training to medical students, junior doctors and other healthcare professionals
• Delivers effective feedback with action plan
• Able to supervise less experienced trainees in their clinical assessment and management of patients
• Able to supervise less experienced trainees in carrying out appropriate practical procedures
• Able to act as a clinical supervisor to doctors in earlier stages of training

• Demonstrates professional behaviour with regard to patients, carers, colleagues and others
• Delivers patient centred care including shared decision making
• Takes a relevant patient history including patient symptoms, concerns, priorities and preferences
• Performs accurate clinical examinations
• Shows appropriate clinical reasoning by analysing physical and psychological findings
• Formulates an appropriate differential diagnosis
• Formulates an appropriate diagnostic and management plan
• Explains clinical reasoning behind diagnostic and clinical management decisions
• Appropriately selects, manages and interprets investigations
• Recognises need to liaise with specialty services and refers where appropriate

• Able to manage patients who have been referred acutely to a specialised medical service
• Demonstrates professional behaviour with regard to patients, carers, colleagues and others
• Delivers patient centred care including shared decision making
• Takes a relevant patient history
• Performs accurate clinical examinations
• Shows appropriate clinical reasoning
• Formulates an appropriate differential diagnosis
• Formulates an appropriate diagnostic and management plan
• Explains clinical reasoning behind diagnostic and clinical management decisions
• Appropriately selects, manages and interprets investigations
• Demonstrates appropriate continuing management of acute medical illness in a medical specialty setting
• Refers patients appropriately to other specialties as required

• Demonstrates professional behaviour with regard to patients, carers, colleagues and others
• Delivers patient centred care including shared decision making
• Demonstrates effective consultation skills
• Formulates an appropriate diagnostic and management plan
• Explains clinical reasoning behind diagnostic and clinical management decisions
• Demonstrates appropriate continuing management of acute medical illness inpatients
• Recognises need to liaise with specialty services and refers where appropriate
• Appropriately manages comorbidities in medial inpatients
• Demonstrates awareness of the quality of patient experience

• Demonstrates professional behaviour with regard to patients, carers, colleagues and others
• Delivers patient centred care including shared decision making
• Demonstrates effective consultation skills
• Formulates an appropriate diagnostic and management plan
• Explains clinical reasoning behind diagnostic and clinical management decisions
• Appropriately manages comorbidities in outpatient clinic, ambulatory or community setting
• Demonstrates awareness of the quality of patient experience

• Demonstrates effective consultation skills (including when in challenging circumstances)
• Demonstrates management of medical problems in inpatients under the care of other specialties
• Demonstrates appropriate and timely liaison with other medical specialty services when required

• Applies management and team working skills appropriately
• Identifies appropriate discharge plan
• Ensures continuity and coordination of patient care through the appropriate transfer of information
• Effectively estimates length of stay
• Delivers patient centred care including shared decision making
• Recognises the importance of prompt and accurate information sharing with primary care team following hospital discharge

• Demonstrates prompt assessment of the acutely deteriorating patient
• Demonstrates the professional requirements and knowledge of legal processes associated with consent for resuscitation
• Participates effectively in decision making with regard to resuscitation decisions
• Demonstrates competence in carrying out resuscitation

• Identifies patients with limited reversibility of their medical condition and determines palliative and end of life care needs
• Identifies the dying patient and develops an individualised care plan
• Demonstrates effective consultation skills in challenging circumstances
• Demonstrates safe and effective use of syringe pumps in the palliative care population
• Able to manage non complex symptom control including pain
• Facilitates referrals to specialist palliative care across all settings
• Demonstrates compassionate professional behaviour and clinical judgement

• Understands the anatomy and pathophysiology of the clinical manifestations of disorders of cognition and consciousness
• Able to write a history by consulting all relevant sources
• Able to examine patients using appropriate techniques and rating scales
• Able to select, request and interpret relevant investigations
• Able to work independently and as part of a multidisciplinary team to implement appropriate treatments
• Able to anticipate, recognise and manage complications in accordance with legal principles
• Able to work with and appropriately refer to other relevant professionals

• Understands the anatomy and pathophysiology of headache and pain
• Able to write a history by consulting all relevant sources
• Able to examine patients including fundoscopy, visual fields and eyemovements
• Able to select, request and interpret investigations including imaging of the brain and spine
• Able to work independently and as part of a multidisciplinary team to implement appropriate treatments
• Able to anticipate, recognise and manage complications
• Able to work with and appropriately refer to other relevant professionals

• Understands the underlying anatomy and pathophysiology of seizures and epilepsy
• Able to write a history by consulting all relevant sources in order to distinguish epileptic seizures from syncope
• Able to examine patients presenting with transient loss of consciousness, seizures and epilepsy
• Able to select, request and interpret investigations including ECG, EEG and video EEG
• Able to work independently and as part of a multidisciplinary team to manage patients with epilepsy
• Able to anticipate, recognise and communicate appropriately the physical and psychosocial consequences of living with epilepsy
• Able to work with and appropriately refer to other relevant professionals

• Understands the underlying anatomy and pathophysiology of inflammatory and infectious diseases of the nervous system
• Able to write a history by consulting all relevant sources
• Able to examine patients using appropriate techniques and rating scales
• Able to select, request and interpret relevant investigations including serology, genetic testing, imaging
• Able to work independently and as part of a multidisciplinary team to treat and implement appropriate interventions
• Able to anticipate, recognise and manage complications of the disease process and its treatment
• Able to work with and appropriately refer to other relevant professionals

• Understands the underlying anatomy and pathophysiology of movement disorders
• Able to write a history by consulting all relevant sources for patients presenting with Parkinsonism, tremor, chorea, dystonia, tics
• Able to examine patients using appropriate rating scales
• Able to select, request and interpret relevant investigations including genetic tests and brain imaging
• Able to work independently and as part of a multidisciplinary team to manage and treat movement disorders
• Able to anticipate, recognise and manage complications including motor, cognitive and behavioural complications
• Able to work with and appropriately refer to other relevant professionals

• Understands the anatomy and pathophysiology of neuromuscular disorders
• Able to write a history by consulting all relevant sources
• Able to examine patients with neuromuscular disorders using appropriate techniques
• Able to select, request and interpret relevant investigations for neuromuscular disorders
• Able to work independently and as part of a multidisciplinary team to implement appropriate treatment
• Able to anticipate, recognise and manage complications
• Able to work with and appropriately refer to other relevant professionals

• Understands the anatomy and pathophysiology of traumatic brain injury and other causes of acquired brain injury
• Able to write a history by consulting all relevant sources
• Able to examine patients with complex neurological disability using appropriate rating scales and techniques
• Able to select, request and interpret relevant investigations
• Able to work independently and as part of a multidisciplinary team to provide informed prognoses and treatment
• Able to anticipate, recognise and manage complications
• Able to work with and appropriately refer to other relevant professionals regarding resuscitation, comorbidities, bladder and bowel function

• Understands how to identify and diagnose functional neurological disorders on positive grounds
• Able to recognise that functional disorders commonly co-exist with, or can be a precursor to, other neurological conditions
• Able to describe the elements of further management of functional neurological disorders
• Able to identify the main features of common psychiatric disorders
• Able to identify the spectrum of psychosis presenting in neurological and psychiatric conditions
• Able to initiate treatment of common psychiatric disorders and acute confusion
• Able to communicate a diagnosis of a functional neurological disorder in a manner that contributes constructively

• Demonstrates knowledge of anatomy, physiology, blood supply and pathophysiology as relevant to TIA, stroke
• Able to conduct an up-to-date hyper-acute stroke clinical assessment efficiently
• Able to demonstrate a recognition and management of complications relating to cerebral reperfusion strategies
• Able to perform a comprehensive, specialist assessment, investigate and treat patients with stroke or mimic syndromes
• Able to manage comorbidities and risk factors relevant to stroke appropriately
• Able to apply principles of early multi-professional assessment
• Able to use up-to-date knowledge of evidence, guidelines, appropriate monitoring and measurement scales
• Able to recognise and manage the deteriorating stroke patient including the introduction of palliative care

• Demonstrates knowledge of the different pathophysiological mechanisms, disease processes and causes
• Able to conduct an urgent clinical evaluation and prioritise safely
• Able to provide an accurate diagnosis and appropriate comprehensive management of patients with suspected TIA or stroke
• Able to identify conditions that mimic TIA and stroke and manage these effectively
• Able to manage comorbidities and risk factors relevant to TIA and stroke in an outpatient clinic
• Awareness of up-to-date primary and secondary prevention treatment strategies for TIA and stroke
• Able to prioritise referrals received through different mechanisms
• Able to provide appropriate driving, vocational and social advice for patients with TIA or stroke

• Understands the anatomy and pathophysiology of stroke with regard to patterns of recovery
• Demonstrates an understanding of the diverse factors that can influence outcome
• Appropriately manages common post stroke complications
• Ensures rehabilitation is individualised, patient focussed
• Able to recognise and manage the deteriorating stroke patient
• Co-ordinates the multi-disciplinary team to optimise post stroke recovery
• Demonstrates good communication and understanding with patients and families
• Demonstrates an understanding of medico-legal issues relating to clinically assisted nutrition and hydration
• Contributes to and leads effective discharge planning to support transition to the community
• Understands the impact of cultural and socioeconomic patient backgrounds on stroke prognosis and rehabilitation outcomes

Currency Window

Evidence of your recent practice will be given more weight to reflect current capabilities and we suggest that approximately 50% of your evidence for a curriculum outcome is drawn from within the last five years of clinical practice (WTE).

Evidence Volume

around 100 electronically uploaded documents