Take me to:

Neurology 657

Yakima

307 S. 12th Avenue, Suite 16
Yakima, WA 98902
Site Director: Richard Sloop, MD


Clinic Manager: Kiley Hanks 
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Phone: 509-452-1234
Fax: 509-249-5831

 

Pre-arrival Requirements

Please complete and submit the paperwork NO LATER than 4 weeks before your rotation begins.

Yakima Valley Memorial Hospital

Kandace Nash
Learning Systems Specialist
Yakima Valley Memorial Hospital
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Phone 509-249-5669

 

Travel & Housing

Travel:  You will receive mileage reimbursement for one roundtrip to and from Yakima. Contact This email address is being protected from spambots. You need JavaScript enabled to view it. to arrange for travel reimbursement.

Housing: Students to set up AirBnB.  For required clerkships Airbnb is covered up to $80 per night. Please contact This email address is being protected from spambots. You need JavaScript enabled to view it. for specifics.

 

First Day

Contact Dr. Sloop's office at least a week before your start to find out when to arrive your first day.

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

 

Course Requirements

Course requirements are listed below. Refer to the Distance Learning page for due dates.

Clerkship orientation: You will need to view the away student orientation video on the Distance Learning page. Please let the clerkship coordinator know if you have questions or any difficulties 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.

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 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: The scheduling/notification process runs through UW Testing Services and the contact email is This email address is being protected from spambots. You need JavaScript enabled to view it.. See the Final Exam page for information about the exam.

 

Site Expectations

General:  Please dress neatly and professionally.  Wearing your white coat is optional. Avoid distracting jewelry (e.g. nose rings, tongue studs, lip rings, etc.) and cover any distracting tattoos. The schedule is most commonly as follows: 8AM–4PM Monday, 12-4PM Tuesday, 8AM-3PM Wednesday and Thursday and later if we go to the hospital as these are “call” days, and 8AM-12PM on Friday.  I don’t schedule time off for lunch but you should feel free to bring a lunch and eat it between patients.

Inpatient experience:  In general, we will go to the hospital 1 or 2 days a week in the late afternoon to see any consults that may require evaluation.  Anticipate that the Wed and Thurs call days may go into the evening until ~8PM.

Clinic experience:  The majority of learning will be in the clinic setting.  You will work with me directly the first 2-3 days – then you will be seeing your own patients in your own exam room and then presenting them to me.  The time you have with the patient is 1 hour to include a detailed history and physical.  A detailed history is essential.  I like to say – “if you finish taking the history and you don’t know what is wrong with the patient – you probably never will…” That is only a slight exaggeration! Call a spouse, sibling, friend or other observer at home or at work to get more detail if necessary.  You will then present the patient “at the bedside.” (Presenting at the bedside has a way of ensuring openness and honesty. There may be very infrequent reasons not to present at the bedside. You may let me know if that seems to be the case – the most common reason being if this seems likely to be conversion disorder or of some other psychiatric cause.)  If we have finished seeing your patients for the day – but there are a couple of others left that I am seeing – please join me in my room. These are additional learning opportunities. If it is not likely to be useful – I can tell you.

Oral Case Presentation:  Your presentation should include the detailed HPI, a brief PMH, always some SH, and FH if it is pertinent. In general – spend little time presenting “pertinent negatives.” Often, these negative are a distraction in the presentation and add little that is useful to a student presentation. If the exam is entirely normal and it is expected that the exam would be normal – example a migraine patient – you may simply say that the exam is entirely normal and I can ask for any clarification if necessary.

Please include a complete list of the patient’s medications. Be certain you have reconciled any list with the patient. Do not rely on any list in the EMR without actually reviewing it with the patient. At presentation – list every medication for me – I want to write each one down. You can leave off doses of medications that are not related to the neurological diagnosis at hand. I will ask you if I need the dose. Always include the dose of any antidepressants, pain medication, sleeping medication and of course any medication which they might be taking for the neurological symptoms.

Please use patient friendly descriptions for the presentation. (E.g. I do not usually need to be told whether the patient is male or female at the bedside.) Tell me something about the patient – e.g. “This is a 36 yo. Right handed, 6th grade teacher.” (I want you to tell me in the opening line whether the patient is right or left handed. It doesn’t always add something to the diagnosis – but it should be a routine question as you start the interview on this rotation.) Also – largely avoid medical jargon during the patient presentation – especially in the HPI. This will facilitate better communication with the patient.

Please finish the presentation with a differential diagnosis – and your actual diagnosis. Committing to a specific diagnosis ensures better learning. Do not take all the information you have gathered and “dump” it in my lap for me to make the diagnosis.

Documentation:  Write up each patient you evaluate – you may handwrite the history and physical / neurologic exam or type the history and handwrite the exam (I use an “exam sheet” that I handwrite for chart documentation – it is easy to use and you may use this also if it seems easier). In either case – you should type out the diagnosis and a brief discussion and plan / recommendations. The discussion / plan should reflect what was ultimately discussed after the patient presentation.

Please email me your typed write ups after completion (This email address is being protected from spambots. You need JavaScript enabled to view it.) You must use patient initials and date at the top of each page so we will know which charts to file the write ups in. Please be sure to sign each write up – Name, MS4 University of Washington.

Independent study:  I may suggest you review the literature and educate me on something during these presentations. Make a note of it and follow through. Volunteer at the end of the day or during a break that you did look up the information and then present it (e.g. in the next couple of days). Don’t wait for me to ask about what you found.