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2900 Twelfth Avenue N, Suite 402-E
Billings, MT 59101
Preceptor: Lowell Quenemoen, MD
Phone: 406-238-6670 or 800-648-6274
Administrative Contacts: Paula Maulolo, 406-247-3291 or Janese
Carstens, 406-651-6404
PAPERWORK REQUIREMENTS
Immunization records:
You'll need to bring proof of immunization, including TB.
If you do not have a copy of your immunization records, you
can request a copy from Hall Health or the Employee Health
Office in UWMC.
TRAVEL, HOUSING &
COMPUTER ACCESS
Housing: Housing is provided in a six-bedroom
house shared with other UW students. Contact Paula Maulolo
or Janese Carstens at the phone numbers listed above or via
email at bto@ycchd.org
for further information
Computer access: The house has DSL and a
desk top and wireless Internet access. It is recommended that
you bring your own laptop. There are also two computers in
the clinic that can be accessed by students, and there is
free wireless access from the clinic for laptops.
Travel: If you drive, you will receive mileage
reimbursement for one roundtrip to and from Billings. You
may also be eligible for one night's stay in a hotel during
your drive each way. Contact GOWWAMI@dommail.dom.washington.edu
for mileage reimbursement and hotel information or to make
other travel arrangements. Please be advised that there is
no vehicle available at this site. If you fly, you will need
to use public transportation once at your site. Contact Beth
at the number above for driving directions.
Parking: Student apartments are in the medical
corridor and only a few blocks away from all the medical facilities.
Parking elsewhere in the medical corridor is problematic and
on a first come-first serve basis.
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FIRST DAY & ORIENTATION
Equipment to bring: White coat and name
tag, reflex hammer, tuning fork (128Hz), stethoscope, (ophthalmoscope
recommended).
First day & site orientation: Contact
Paula Maulolo to find out when to arrive on your first day.
The morning of the first day will begin at Yellowstone Medical
Building, Suite 402-East, which is directly across the street
from St. Vincent Hospital Emergency Department. Jo Anne Sipes,
the office manager, will orient you to the office and introduce
you to the staff. Then there will be orientation at St. Vincent
Hospital with Shane Nobel, Facility Access Coordinator. A
photo ID must be worn at all times in the work places.
Clerkship orientation video: Watch the away
student orientation video on the Distance
Learning page. You will need to refer to your Pocket Syllabus
(see below) when viewing the video.
Pocket syllabus: A “pocket syllabus”
will be mailed to you. A printable (PDF) version is also available
on the Pocket Syllabus page.
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COURSE
REQUIREMENTS
Course requirements are listed below. Refer to the Distance
Learning page for due dates.
Cases: Two case write-ups are due each week.
Further information is available in the orientation video
and on the Cases page. Your
assigned case numbers are on the Distance
Learning page. Please note that your assigned case numbers
are different than for the Seattle-based students. Weekly
case answers and video lectures will be available on the Distance
Learning page on Thursdays after 1PM.
Patient log: You are required to log in
the patients you have seen each week. The log is described
in the clerkship orientation video. Additional details are
on the Patient Log page.
Clinical & Bioethical Mini-CEX exercises: You
are required to do both a clinical and a bioethical mini-CEX
for this course. See the Mini-CEX
page for details.
Presentations: Presentation requirements
are described in the orientation video and are available on
the Presentations page.
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FINAL
EXAM
Final exam: If you drive to Billings, your
final exam will be held in the Bozeman WWAMI office at Montana
State University, usually on the final day of the clerkship.
Contact Elizabeth Nicholas
the first week of your clerkship to coordinate your exam time
at 406-994-4411 or nicholas@montana.edu.
If you fly to Billings, your final exam will be in Seattle
on the final day of the clerkship. See the Final
Exam page for details about the exam.
ABOUT THE SITE
General: Our goal is to ensure that in this
brief four week clerkship medical students master the techniques
of the neurological history and exam, acquire a working knowledge
of common neurological disorders, and an understanding of
the differential diagnosis of common neurological signs and
symptoms.
Schedule: Students are expected to spend
five days per week, Monday through Friday, at the clerkship
site. Exceptions are made for holidays. Our office day typically
begins at 9AM and finishes close to 5 PM. Students are encouraged
to join us for hospital rounds and are welcome to accompany
the on-call neurologist nights, weekends and holidays. Opportunities
are also available to accompany neurologists to rural outreach
clinics. You may be invited to join us in the operating room
for insertion of deep brain or vagus nerve stimulators.
We realize that students need to be away from time-to-time
for residency interviews, vacation, etc. We encourage you
to let us know as soon as possible the dates that you will
not be available. Refer to the absentee policy.
Demeanor & attire: Patients with neurological
diseases are generally older, conservative, anxious and fearful.
Conservative and professional behavior and attire are required
from students. White lab coats are recommended.
Faculty: During the 4-weeks we plan for
you to be instructed by the entire faculty in our adult neurology
practice. We do not currently have a child neurologist.
| Neurologists |
Subspecialty
Interests |
| Arturo Echeverri, MD |
Neuromuscular disease, movement disorders and epilepsy |
| Nicholas Okon, DO |
Cerebrovascular diseases |
| Karen Porth, MD |
Cerebrovascular diseases and multiple sclerosis |
| Lowell Quenemoen, MD |
Headache and chronic pain syndromes |
| Roger Williams, MD |
Multiple sclerosis and movement disorders |
Dr. Williams currently is the clerkship site director. He
will instruct the students in the performance of the neurological
examination in the first week of the rotation and provide
feedback. Proficiency will be reevaluated at the end of the
rotation as well, to ensure mastery of the neurological examination.
Each neurologist is encouraged to give you feedback on your
performance one or more times during the rotation, and don’t
be shy about asking. We also welcome your feedback. Our goal
is to make this clerkship as informative as possible for you.
Please tell the site director if you have any specific goals
for the month so that your experience is as fulfilling as
possible. The clinical mini-CEX can be confirmed by any of
the neurologists. Jo Anne Sipes is the office coordinator
who has control of the schedules and is a good resource also.
Inpatient experience: Our neurology group
has a busy inpatient service, consisting of elective and emergency
admissions and consultations. Students will be asked to see
several inpatients per week. The student is expected to follow
their assigned patient from the time of admission or consultation
until discharge, or the resolution of the clinical issue The
student should write (but not dictate) a history and physical
examination, and discuss diagnostic and therapeutic issues
with the neurologist.
Clinic experience: A combination of three
different learning models will be employed during the clerkship.
In the “autonomous” model the student is requested
to see the patient first and then present to the preceptor.
In the “shadow” model the student will follow
the preceptor and observe different varieties of patients
and interaction styles. The third model allows the student
to evaluate the patient, but in the presence of the preceptor,
which provides the opportunity for the most thorough feedback.
Each method has its strengths and weaknesses. Other opportunities
include observing and reading EMGs, EEGs, evoked potentials,
lumbar puncture, angiography, etc. Experience with a neurosurgeon,
neuropsychologist, physiatrists, etc., can be arranged during
the month.
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