325 Ninth Avenue
Seattle, WA 98104
Site Director: Andrew Rose-Innes, MD
Office Contact: Susan Guse
Phone: 206-731-3251

• FIRST DAY & CLERKSHIP ORIENTATION
• SITE EXPECTATIONS

FIRST DAY & CLERKSHIP ORIENTATION

Before you start: Email your pager number to the clerkship coordinator at neural@u.washington.edu.

Clerkship orientation: Orientation is at the UW at 8:00AM on the first day of your clerkship. The room number is on the Didactics page. Room information may change at the end of each rotation, so be sure to check the table the weekend before you begin.

ORCA Power Chart Orientation: Complete this training before your clerkship begins. Training is available online at orcaed.washington.edu. Select the Dictating Clinicians track.

After orientation: Report to Harborview. Page the chief resident when you arrive. The clerkship coordinator will email resident names and pager numbers to you.

Equipment to bring: White coat and name tag, reflex hammer, tuning fork (128Hz), stethoscope, (Ophthalmoscope recommended).

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SITE EXPECTATIONS

General: HMC neurology has the potential to expose students to variety of patients with neurologic problems, if you take advantage of what it has to offer. Students should be proactive about clinical opportunities, whether they are hands-on or shadowing experiences. On the first day of the rotation, you should ask the neurology residents and intern what the best way is to fit in. This is also a good time to mention your own specific goals for the four weeks.

Services: Harborview Medical Center has two inpatient neurology teams named after two influential neurologists: Dr. Mark Sumi and Dr. Mike Copass. Each team is made up of an attending, senior neurology resident, junior neurology resident and two medicine interns. Besides supervising their teams, the senior residents have other duties: the Copass senior is designated chief resident and the Sumi senior is designated consult resident. A mid-level practitioner joins the post-call team to help things run smoothly.

Day-to-Day: Each weekday all four students will stay with their assigned team from 7:30 AM (8AM on Tuesdays after didactics) to the end of imaging rounds. They should also attend all team teaching rounds. At other times, each student will do as outlined below, ultimately spending 2 consecutive weeks on the wards and 2 consecutive weeks on consults. For instance, the Copass ward and consult students will switch after two weeks. Each student will have one required clinic each week, either Monday or Tuesday afternoon, and that will also change at the two-week point. A second clinic per week on Wednesday afternoon will be optional as discussed below.

You should pre-round and write a daily note on each patient you are following while on the wards, and as needed while on consults. Note writing is a practiced skill. Be advised that an intern or resident must also write a note on the same patient each day due to documentation rules, and therefore, should not be seen as a reflection of the quality of your notes.

Important -- you are not allowed to stay overnight and do not get parking in order to stay past 6PM (last shuttle to UW), but at your discretion, most of the admits and a ton of learning occurs between the hours of 5-10PM. Feel free to stay.

Copass Ward Student: This medical student will admit and follow patients on the ward along with the R1s. On days that the Copass team is admitting, the medical student will go with the Chief Resident on all calls to the ER (except if in clinic or at didactics) and see as many patients as possible, completing an admission note on no more than one patient. On the post call day, the medical student may pick up other patients to follow at the direction of the team's neurology residents and attending. Ideally, the ward medical student should be managing, writing notes, and following 2-3 patients at any one time. The student is required to attend one clinic a week on Tuesday afternoon.

Copass Consult Student: After imaging rounds, this medical student will work with the consult team consisting of a senior resident, attending, and fellow student. He or she will alternate between evaluating new consults and following up on old consults along with the Sumi Consult Student. The student is required to attend one clinic a week on Monday afternoon.

Sumi Ward Student: This medical student will admit and follow patients on the ward along with the R1s. On days that the Sumi team is admitting, the medical student will go with the Chief Resident on all calls to the ER (except if in clinic or at didactics) and see as many patients as possible, completing an admission note on no more than one patient. On the post call day, the medical student may pick up other patients to follow at the direction of the team's neurology residents and attending. Ideally, the ward medical student should be managing, writing notes, and following 2-3 patients at any one time. The student is required to attend one clinic a week on Monday afternoon.

Sumi Consult Student: After imaging rounds, this medical student will work with the consult team consisting of a senior resident, attending, and fellow student. He or she will alternate between evaluating new consults and following up on old consults along with the Copass Consult Student. The student is required to attend one clinic a week on Tuesday afternoon.

Clinic: Clinic is an important setting to learn neurology. You will most likely see diseases that rarely get admitted to the hospital. All clinics are in the afternoon. Holidays or clinic cancellations may occasionally disrupt the schedule.

Monday PM general neurology clinic starting at 12:15 is the largest and each student will attend this twice. It is required.

The other required clinic is Tuesday PM. Each student will go to a general neurology clinic with Dr. Rose-Innes for one day and go to a lumbar puncture clinic with Dr. Zunt the other day. These clinics start at 1PM.

Optional clinics can be arranged for those who desire more clinic experience. Because they are optional, the clinics have been set up as a shadowing experience and no more than 2 students can do the clinics each week (work this out as a group of 4). If you are interested check with your Attending to learn more.

Look at the “Clinic Table” and remember that you SWITCH ROLES AFTER TWO WEEKS, and therefore, switch between Monday and Tuesday clinics.

Clinic Table:

Didactics: The expectation is that you will attend all neurology lectures given at HMC and that you will always be freed up on Thursday afternoon to make it to UW on time (start at 1PM – see Didactics tab). On the 2nd and 4th Tuesdays of the month there is a clinical conference at 7AM. Once a week on Tuesday or Friday there is a lecture series for R1s that the student should attend. Also attend the mid-day Wednesday conferences.

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