Neurology 640

Billings Clinic
Billings, MT

2825 8th Avenue N.
Billings, MT 59101
Site Director: Steven Arbogast, DO

WWAMI Administrative Contact: Suzie Thomas
Phone: 406-247-3285; Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

 

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 at UWMC.

 

Travel & Housing

Housing: Housing is provided in a house shared with 2 to 6 other students. Each student has a private bedroom and shared bathrooms (2), kitchen, living area and dining area. All rooms are fully furnished with linens, blankets, clocks. Towels and basic toiletries (such as toilet paper and paper towels) are provided. A washer and dryer is available free of charge, but you will need to provide detergent. The kitchen is fully furnished with cups, plates, silverware, pots and pans, and other utensils. Contact Suzie Thomas at the phone number or email listed above for further information.

Computer access: The house has internet available via a wireless router. You will need to bring your laptop with a wireless internet card. 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 Scott Bailey at This email address is being protected from spambots. You need JavaScript enabled to view it. '; document.write(''); document.write(addy_text669); document.write('<\/a>'); //-->\n This email address is being protected from spambots. You need JavaScript enabled to view it. 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 Suzie Thomas 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.

 

Orientation, First Day & What To Bring

Clerkship orientation: You will need to view the away student orientation video on the Distance Learning page. 

First day: Ccontact the site to find out when to arrive on your first day.

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

Pocket syllabus: The “pocket syllabus” you learn about in the orientation video will be available at the site. A printable (PDF) version is also available on the Pocket Syllabus page.

 

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.

 

Final Exam

Final exam: If you drive to Billings, your final exam will be held in Billings. Please coordinate your exam time with Suzie Thomas (contact information at the top of this page). If you fly to Billings, your final exam can be taken in Seattle or in Billings on the final day of the clerkship. You can leave Billings on Thursday to get back to Seattle in time. See the Final Exam page for details about the exam. 

 

About The Site

General

The Billings Clinic has a medical foundation model with a multispecialty physician group at its core.  We have a large service area and serve as a referral center for all of Eastern Montana and Northern Wyoming. This lends itself to a very large and diverse amount of neuropathology. Students will be exposed to a variety of conditions that are both common and rare.

Students are expected to spend five days per week based upon a schedule provided on the first day.

Suzie Thomas will be in touch with all students 2-weeks before the start of the clerkship to set up computer training and to obtain an ID badge.

The best place to park is in the employee lot on the corner of 6 th Avenue North and N. Broadway Blvd.

The dress code for the site is professional.

Faculty

During the 4-weeks we hope you have exposure to the entire faculty in our neurology practice.

Name Subspecialty
Dennis O’Brien, M.D. General Neurology
Mary Gaddy, M.D. General Neurology, Neurophysiology
Ronald Murray, M.D. Multiple Sclerosis
Scott Riggins, M.D. General Neurology, Neurophysiology, Sleep, EMG
Steven Arbogast, D.O. General Neurology, Neuromuscular Medicine, EMG
Melody Murter, NP Multiple Sclerosis, Pediatric Neurology, Gen. Neurology
Larry Scharfe, PA-C General Neurology

 

Dr. Arbogast is the clerkship site director. He will observe student’s performance of the neurological examination within the first two weeks of the rotation, and provide feedback. Hopefully, this will happen in the last 2 weeks, as well, to ensure mastery of the neurological examination. The clinical mini-CEX can be performed with any of the clinic preceptors. Please tell the site director if you have any specific goals for the month so that your experience is as good as possible.

Inpatient experience

Our neurology group does have a mixed consult and inpatient service. Most students will spend one week on the rotation on this service. Students will be expected to independently evaluate patients and provide a written note into the EHR. This is meant to solidify the learning process by encouraging the students to put their ideas into a single document, which will subsequently be reviewed and critiqued by the precepting physician.

Clinic experience

The outpatient clinic will involve general neurology, multiple sclerosis clinic, muscular dystrophy clinic as well as the ability to observe botulinum toxin injections, electroencephalograms, electromyograms and potentially programming of deep brain stimulators and vagal nerve stimulators.  The student may be expected to enter written notes into the electronic health record in this setting as well. Again these are meant to be educational tools to facilitate the thought process and potentially a treatment plan. A combination of three different learning models will be employed in clinic. In the autonomous model, the student sees the patient first and then presents to the preceptor. In the shadow model, the student will follow the preceptor and observe different patient interaction styles. The final model allows the student to evaluate the patient, but in the presence of the preceptor, which definitely provides the opportunity for the most thorough feedback. Each has its strengths and weaknesses.

Multidisciplinary neuroradiology rounds will be attended every Wednesday at noon, with lunch provided. During the fourth week of the rotation students are expected to present a short clinical case to this group. This case should include a brief overview of the presenting history, pathology, imaging findings and treatment options.

Clinic typically runs from 8 AM to 5 PM. There are no weekend or night clinic responsibilities although if there is an interest that could be accommodated .

Except for the faculty call schedule and vacations, your weekly schedule may look like this.

 

Monday

Tuesday

Wednesday

Thursday

Friday

AM

Dr. Arbogast

Dr. O’Brien

Dr. O’Brien

Dr. Riggins

Dr. Gaddy

PM

Dr. Arbogast

Dr. O’Brien

Dr. O’Brien

Dr. Riggins

Dr. Gaddy