Neurology outpatient clinic
Revised May 2009
NEUROLOGY OUTPATIENT CLINIC
I.
Purposes and Objective
The purpose and objective of the Neurology Outpatient Clinic is to provide excellent care
for patients with neurological disorders in a clinical setting conducive to learning and
teaching.
II.
Policy
A.
Clinic Attendings
Two to three faculty members are generally assigned as attendings to the clinic per halfday depending upon the number of residents assigned to clinic. These physicians staff all
residents in clinic and are responsible for clinic operations that half-day, including
assigning emergency work-ins and add-on patients, handling phone calls from physicians,
and staffing the clinic nurse for management of patient telephone calls.
B.
Continuity of Care
In general neurology clinics and in the residents' continuity of care clinics, continuity of
care is provided by the residents, i.e., the same resident sees the patient at all clinic visits
whenever possible.
The resident physician's responsibility for the care of these patients extends beyond
seeing the patient in clinic. Such responsibility includes diligent follow-up of lab tests
and diagnostic studies, handling phone calls to and from the patient, and sometimes
handling phone calls to and from referring physicians. At times it may be appropriate for
the resident to see the patient in clinic at a time when that resident is not normally
assigned to clinic, for example, if an urgent problem develops which cannot be deferred
to that resident's next available clinic opening. In such cases, arrangements must be
made through the clinic staff to ensure that an examination room is available. Residents
who are on a rotation other than a clinic rotation should also make sure there is no
scheduling conflict with the responsibilities of their current rotation. If the patient must
be seen by another physician (for example, during a vacation period), it is desirable for
the resident to contact the physician who will see the patient to brief him or her on the
case.
In specialty clinics (Ataxia, Cerebrovascular Disease, Cognitive Disorders, Epilepsy,
Movement Disorders, Multiple Sclerosis, Neurogenetics, Neuromuscular, Neurooncology, and Sleep Disorders) patients are also seen by both a resident and an attending
physician. Follow-up visits may be scheduled to the specialty clinic or, at times, to the
resident's continuity of care clinic. When the follow-up visit is to the specialty clinic, the
patient is often not seen by the same resident. Residents are encouraged to discuss with
the attending which patients are appropriate for the resident to follow in their continuity
of care clinic.
III.
Procedures for Clinic Visits
A.
Prior to Clinic Visit
1. Prior medical records can be reviewed in CareWeb prior to a patient visit. Last
minute cancellations or add-ons will be posted on the master schedule in the
staff room and on the CareWeb schedule section. Patients can be added to the
schedule anytime there is an opening. Be sure to check the master schedule
and CareWeb for any changes.
2. New patients must register at the information desk in the Taubman Center
lobby prior to the visit if a registrar has not contacted the patient by phone in
advance.
3. The patient reports to the receptionist at the main desk in the Neurology Clinic.
4. The receptionist compiles a folder for each patient with a charge form, ,
Neurology Checklist and Neurology Outpatient Note When the patient arrives,
the receptionist sends a text page to the appropriate physician. Because the
paging system is not 100% reliable, it is your responsibility to check w/the
receptionist regarding your patients' arrival. The folder with the patient's
forms is placed in a slot at the reception desk according to the exam room
number assigned to the physician. If you are running late (more than 15
minutes), please let your waiting patients know so they won't think they've
been forgotten. If you are running more than 30 minutes late, inform the clinic
attending who may rearrange your schedule.
5. The physician picks up the folder from the reception desk and announces the
patient's name, introduces him/herself to the patient, and escorts the patient
from the waiting room to the assigned exam room. Exam room assignments
are indicated on the monthly exam room schedule. An updated daily exam
room schedule is posted on the staff room door. The neurology clinic does not
have medical assistants.
B.
During Clinic Visit
1. The physician will take the history and conduct a general physical and
neurological examination. All new patients should disrobe and put on a gown
for the examination. The physician may use the curtain for patient privacy or
leave the exam room and return later. Remember to respect a patient's privacy
by pulling the curtains when leaving the room if the patient is disrobed. When
abnormal findings are present which cannot be readily observed with the
patient clothed, the patient should remain gowned for examination by the
attending.
For return visits, the resident should determine the need for the patient to
disrobe and gown. The resident does not need to perform a complete exam at
each return visit, but should perform those parts of the exam that pertain to the
patient's problem.
2. Each patient seen by a resident must be presented to a clinic attending
physician. The resident should note the attending's name on the handwritten
outpatient note and Neurology Checklist.
3. Notes in the CareWeb system by the resident should be reviewed and signed by
the attending physician noting their involvement in the history, examination
and medical decision making.
4. The patient and/or family should be instructed concerning diagnostic tests,
medications, and follow-up appointments with the referring physician or return
visits to the Neurology Outpatient Clinic.
5. The clinic nurses are available for assistance with patient management,
temperature checks, injections, lumbar puncture, and the delivery of spinal
fluid specimens to the lab. They also help educate patients, particularly MS
patients who are beginning disease modifying therapy. They are also a useful
resource regarding education materials (kept in the cabinet in the staff room)
and support groups.
6. An outpatient social worker is available by consult, phone or page for
financial, interpersonal, or placement issues.
C.
At End of Clinic Visit
1. The physician will:
a.
Complete the MSP charge form by entering a diagnosis and
indicating the attending physician and the type of service
performed.
b.
Complete the Neurology Checklist.
(i)
Check all studies being ordered and indicate whether the
studies should be done the same day or at the return visit. The
blood lab is located on Level 3 and closes at 6:00 p.m.
(ii)
Specifically indicate when and to which clinic or physician
the patient is to return for a follow-up visit.
(iii) Include the resident's and attending's name, doctor number
and the patient's diagnosis on the Neurology Checklist and be sure
to sign at the bottom. This form is also used by the blood labs as a
requisition, so it is important that the information is complete.
c.
Complete a Diagnostic Service Requisition for the radiological
studies, nuclear medicine scans, EEG, evoked potentials, EMG,
vascular studies, pulmonary function and cardiology studies.
Include the resident's name and four-digit doctor number and the
attending physician's four-digit doctor number, but not the
attending's name, on each requisition and referral. Complete an
outpatient consultation form to refer the patient to another clinic.
Forms are available in the forms rack in each examination room
and in the staff room. Please write your name clearly and include
your page number when required. Enter the location code NEU on
all requisitions. This will enable the diagnostic service to send the
report to the correct location. (Patients through the age of 19
obtain X-rays in Mott Children's Hospital and require a Mott X-ray
requisition.)
When an MRI scan is ordered for a patient who may be
claustrophobic, a sedative is often prescribed. The MRI staff
recommends Valium 10 mg; any other sedative requires a special
arrangement with the MRI nurse. It is recommended that the
patient be instructed to bring the medication to the MRI rather than
take it before arrival because the appointment may be delayed. If
the patient requires sedation for an MRI, he/she will need someone
else to drive from the appointment.
d.
When ordering any lab tests or radiological procedure, the
physician should inform the patient of the plans for follow-up of
the test result and document the plan in the test results section of
the Neurology Checklist. Doing so not only constitutes a good
practice for any physician, but also helps to relieve the clinic nurse
and clerical staff of phone calls from patients wanting their results
Please check one of the following boxes on the checklist to
indicate plans for test result follow-up:
1.
2.
3.
4.
"MD will call in ______ days."
"MD will call only if abnormal."
"Next appointment." This implies the physician will
discuss the test results at the next appointment.
"Patient call MD _____/_____ ____AM PM." This means
you have asked the patient to call you. It is best to fill in
the date test results will be available and which day/time
you are easiest to reach.
e.
We receive many calls for prescription refills that could be
avoided. Remember to check whether the patient has enough
refills on their prescriptions to last until their next appointment. In
fact, unless there is a good reason not to do so, please write for one
or two extra refills on each prescription. For example, if you
expect to see the patient in 6 months, write the prescription to last
one extra month, with 6 (not 5) refills. Write the patient's name on
all prescriptions to prevent issuance to the wrong patient.
Document in dictation the number of PRN medications given,
especially for narcotics.
Prescriptions for Schedule 2 controlled substances must be issued
on State of Michigan Schedule II prescription forms that are preprinted with the physician's name. Ritalin is a Schedule II drug
which is an exception to this. It can be written on a standard
prescription form.
Prescriptions for Medicaid patients should be printed on tamperproof paper—in accordance with state laws. The receptionist
provides this paper with the patient’s folder.
f.
If the patient requires admission, follow the Admission Procedures
described later in this manual.
g.
Insert all papers into the folder and escort the patient to the waiting
room. Insert the paperwork in the cashier's chart rack. Instruct the
patient to wait in the waiting room until the clerk calls their name.
2.
The billing representative (cashier) obtains appropriate insurance
information and accepts payment or discusses payment plans for services
rendered. An MSP form must be submitted for every patient seen. Please
do not tear or throw away any form.
3.
The appointment clerk schedules diagnostic tests, appointments in other
clinics and with Social Work, and return visits to the Neurology Clinic.
All clinic phone lines close at 5:00 p.m., but a clerk is on site until 6:00
p.m. to handle patients checking out of clinic between 5:00 and 6:00 p.m.
IV.
Admission Procedures
A.
To schedule an admission, fill out a Neurology Admission Information form and
submit to Debbie Walter, Admissions Coordinator. In Debbie's absence, the
cashier will coordinate admissions. The information to be included is:
1.
Tentative admission date
2.
3.
B.
Justification for admission
Specific treatment plan
Some procedures to be performed during hospitalization may need to be
scheduled in advance by the Admissions Coordinator. For those procedures that
require the patient to be away from the inpatient service, try to schedule
appointments the afternoon after admission so that the patient can be presented to
the attending at morning rounds.
Procedures requiring advance scheduling include:
1.
2.
3.
C.
CCTV-EEG Monitoring
Polysomnography
Plasmapheresis
Observation stay admission may be appropriate whenever a patient's care is
expected to take less than 23 hours. Observation stay admission should be used
when a patient's condition is expected to improve, but when close monitoring for
several hours is needed to decide whether to admit or release the patient.
On the neurology service, observation stay admission may be appropriate for
migraine; seizure in known epileptic; dizziness; syncope, or weakness of
undetermined etiology; migraine of unknown etiology; or head trauma without
focal neurological findings. Other medical diagnoses for which observation-stay
admission is commonly used include allergic reactions, asthma, dehydration,
epistaxis, and renal colic. Observation stay should not be used for procedures
routinely requiring hospitalization, such as arteriography, myelography, or
chemotherapy. It may be appropriate to monitor a patient with a minor
complication from a procedure where the procedure itself would not normally
require admission.
Patients admitted under observation-stay admission may be converted to regular
admission status. In contrast, patients who undergo regular admission may not be
converted to observation stay admission.
D.
For emergency (same day) admissions, the physician will:
1. Inform the clinic nurse, who will:
a. Assess and monitor the patient prior to transport. Non-medical staff (e.g.
admission coordinator or clinic clerks) should not be asked to monitor or
transport a patient.
b. Help determine disposition of the patient and whether the patient needs to
go to the Emergency Department or may wait in the admitting lounge. No
nursing care is available to patients in the admitting lounge.
c. Call nursing report to the inpatient unit.
2. Inform the Admissions Coordinator (Debbie Walter) or in her absence, the
billing representative, and complete an Admitting Physician’s Order Form.
3. Speak to Emergency Department attending if the patient needs to be sent to
the Emergency Department.
4. Contact the senior inpatient resident to advise him/her of the admission,
describe the patient’s problem, and inform him/her of the plan established
with the clinic attending.
E.
For same-day and future admissions, the physician must still complete the MSP
charge form and deliver it to the cashier. For same day admissions, the patient
needs to be directed to the cashier only if a procedure (e.g., LP) was performed.
F.
The physician should submit the dictated note with inpatient plans and scheduled
procedures to the senior inpatient resident who will be responsible during the
inpatient period. If the patient will be admitted before transcription has been
completed (approximately one week) the resident should notify the senior
inpatient resident of the patient and the proposed inpatient plans.
G.
Any overbook admission to the neurology inpatient service should be discussed
with the senior inpatient resident by the admitting physician before scheduling is
finalized. This allows for better planning by the inpatient team.
V.
Appointment Scheduling
A.
All appointments and diagnostic tests are scheduled by the neurology clinic
appointment clerks.
B.
An appointment slip for a future return visit is given to the patient at the end of
the visit. When this is not possible, the appointment notice will be mailed to the
patient.
C.
All patients are mailed a reminder notice approximately 2 weeks prior to their
scheduled appointment. In addition, a clerk telephones patients one to three days
prior to the scheduled appointment to remind them of the appointment.
D.
The appointment clerk will not overbook patients to a specific physician's
schedule without authorization from the physician or a clinic attending.
Authorization will be noted on the appointment schedule for that day.
E.
Each half day, one attending physician has a same-day-service clinic for urgent
referrals of new patients. If residents receive phone calls requesting an urgent
evaluation, they should refer the call to the clinic appointments clerk. If the
patient is too acutely ill or cannot be accommodated as a same-day clinic referral,
the patient should be directed to go to the Emergency Department.
F.
The clinic attending may reassign scheduled patients to other residents as needed
to ensure a smooth flow in clinic.
G.
EMG results are available immediately, and patients may be scheduled for return
visits the same day. Results of CT scans, MRI scans, EEG, evoked potentials,
and neuropsychological testing will not be available the same day, and Neurology
Clinic return visits should generally be arranged at an appropriate interval
following these tests.
H.
Elective arteriograms and myelograms are generally performed as outpatient
procedures. Patients are monitored by the radiologists for several hours after
these procedures. These procedures can be arranged by the appointment clerks.
If the patient is felt to be a high risk for complication, it may be appropriate to
admit the patient for the procedure.
VI.
No-show and Cancellation Policy
A.
Patients are charged $20 if they miss a scheduled appointment and fail to notify us
of the cancellation 24 hours prior to the appointment. This charge is intended to
serve as a deterrent, and patients are informed of this policy when they are sent
their appointment reminders. Patients who miss three consecutive appointments
receive a letter reminding them to give advance notice if they do not plan to come
and that we may not be willing to schedule them in the future if they miss
additional appointments.
B.
The physician will be informed when patients cancel their appointment by
notation on the Staff Room Schedule.
C.
If patients cancel or do not show up for their appointments, the physician should
review the patient's medical record and take appropriate action.
The physician may decide to call the patient. If the patient needs to be
rescheduled, the physician may transfer the call to the appointment clerk or ask
the appointment clerk to notify the patient by phone or mail of the new
appointment time. The physician may want to inquire if the patient will have
enough medication to last until their next appointment.
Document any communication or action taken in the medical record using either a
telephone message form or an outpatient note.
VII.
Physician/Patient Delays
Physicians are expected to see patients within 15 minutes of the scheduled appointment
time and are responsible for personally notifying patients of longer delays.
University of Michigan Hospitals are attempting to improve timeliness of patient
appointments. Your prompt attention to your patients will allow us to meet these
standards.
There is no defined time limit beyond which we regularly refuse to see patients. Patients
are notified that late arrival may necessitate rescheduling of their appointment, but
patients who do arrive late should be seen, if at all possible, by the scheduled physician.
One way to handle established patients is to inform the receptionist that the visit will
need to be quite brief -- seeing the patient for only a few minutes to discuss refills and
interim history, for example. Another approach is that the clinic attending can examine
the schedule for any cancellations or open slots and assign the patient to another
physician.
VIII. Radiographic Images
A.
All images at UMHS are digitally archived and available from computer terminals
in the clinic and staff rooms.
B.
When patients bring outside films they can be viewed on computers in the clinic
or staff rooms. There is a non-networked computer in the staff room where
outside imaging software can be installed to view images. There is a light box in
the staff room to review imaging studies on film.
C.
To obtain a written interpretation on radiological films from other institutions, fill
out a radiology requisition. Specify the type of films to be read, what you are
looking for, and the diagnosis. You can drop MRIs off at that reading room on
B2. Other imaging studies can be dropped off in the file room on B1. The
radiologists do not formally read outside angiograms. Radiology will charge the
patient a fee for these interpretations.
IX.
Record-keeping
A.
Dictation: Dictations are required for all Neurology Clinic visits. Dictation
system instructions are posted in the Residents' room, Staff room and exam
rooms. Most of our patients have referring or personal physicians, and the
dictation should be in the form of a letter to the physician(s). If the patient
supplies the name of an outside physician not listed on the face sheet of the chart,
enter the name and the address on the face sheet. Dictations should be
completed on the day of the clinic visit. Dictated letters and notes should NOT
contain statements such as "this patient was staffed with Dr. David Fink," but
should end with the signatures of both the resident and the attending. Dictations
should contain detailed information about drugs prescribed including the name,
dose, # dispensed, and # of refills. When possible, give some indication of future
plans and options (e.g., what you will try next if the medicine doesn't work). This
should help you at the next clinic visit and will be especially helpful if the patient
calls or returns to the clinic or Emergency Department at a time when you are not
available.
Dictated letters are usually received from Transcription 4-7 days after dictation.
If your patient is somewhat medically unstable or has an appointment to see their
referring physician sooner than 2 weeks, STAT dictation is recommended.
Dictations are made STAT by punching "6" at the end of the dictation. If your
patient is highly medically unstable or has an appointment with their referring
physician within one week, a phone call to the referring physician is
recommended.
As a result of the new Medicare rules, faculty physicians need to be present
during the key portions of the examination.
B.
Signatures: The goal is for all dictated letters to be signed by both the resident
and attending and placed in the outgoing mail within 5 days. To meet this
timetable, residents and attendings need to check their CareWeb Inboxes daily if
possible, but at least several times a week. Residents at the VAMC must check
their mailboxes frequently. After revising a dictation, save and mark it revised
and then forward to the attending for signature.
C.
Test results: Residents are responsible for following up on tests ordered on their
patients. Most results are available in CareWeb. For some tests, such as
radiological procedures, EMG, and EEG, a hard copy is delivered to the resident.
Blood and urine test results are not distributed as hard copies. One system for
reviewing these is to use receipt of the dictated letter as the cue to check lab
results. To facilitate this, it may be helpful to mention tests being ordered at the
end of the dictation. Some results require earlier follow-up, and residents need a
system for reminding themselves in such cases. When tests show important
unexpected abnormalities, you may wish to discuss these with the attending who
staffed the patient or any other faculty member. When leaving on vacation, you
may wish to ask another person (e.g., the faculty who staffed a case) to follow-up
on specific test results.
Abnormal test results, particularly for patients seen in specialty clinics, may
require the attention of the attending physician. Keep in mind that the physician's
copy of the test results is not a permanent record. To document follow-up action
taken, use a telephone message form or outpatient note.
Telephone messages regarding patient requests for test results are generally routed
directly to the physician's mailbox and are not triaged by the nurse unless it is a
repeat call.
D.
Sleep charts include clinical data, baseline polysomnograms and C-PAP titrations.
Leave charts in the staffing room. Do not place them in the medical record box.
X.
Telephone Calls
A.
Patient Calls: Phone messages will be posted in the My Inbox section of
CareWeb under the tab for Notifications. The clinic office assistants initially
answer most calls regarding patient care. If the call is a request for forms or
letters, the assistant will take a message on the “Patient Contact Management
Form” and will designate the “call type” as forms/letters. For other patient
concerns, the office assistant will ask whether the patient would prefer to leave a
message for their physician, who will return the call within one to two days, or
would rather speak to a nurse immediately. The residents are expected to check
their Notifications daily and to return patient calls within one to two days. If
difficult patient management questions arise, residents are encouraged to discuss
them with clinic attendings or the Medical Director of the Outpatient Clinic.
When a resident is on a VA or UM Inpatient rotation, all patient calls are triaged
through the clinic nurse. The nurse will either handle the problem (which may
include contacting the resident) or triage the call to the resident’s or attending’s
Notifications box designating a call type of “urgent,” “advise,” “same day,” etc.
The clinic nurses may also handle repeat patient telephone calls and may help to
facilitate contact if the patient has previously called but received no response from
his physician.
B.
Personal Calls: University of Michigan policy views the use of University phones
for long distance personal calls as a serious offense. Departmental policy is that
employees should bill personal long distance calls to their calling card. If for
some reason a personal long distance call is charged to the department,
reimbursement of the charges by the caller is expected. Please inform Mari Jo
Honeck of the date and time and telephone number called.
XI.
Prescription Refills
The goal is to have a safe, legal, and convenient way for patients to have prescriptions
refilled by the physician or clinic nurse when an appointment with a physician is not
necessary.
A.
The clinic clerk will:
Fill out a Prescription renewal request –on line form
https://ummcweb29.mcit.med.umich.edu/prmc_forms/neuro/rx.cfm.
Attach to medical record (if available) and pass on to the clinic nurse.
B.
C.
The nurse will do the following:
1.
Acquire adequate patient information regarding present health status
either from telephone conversations or patient charts.
2.
Utilize prescription refill protocols when certain criteria are met,
enabling the nurse to phone in a prescription that is later signed by
the physician. Nurses do not refill narcotics or Schedule II
prescriptions without first consulting with the M.D.
3.
Document the refill on the telephone message form, along with any
other pertinent data.
The physician should:
1.
Remember to refill prescriptions at the time of clinic visit.
2.
Write the prescriptions with enough refills to last until the next scheduled
visit, plus one to two extra months.
3.
Encourage patients to call 2 weeks before they run out of their medication,
especially if a written prescription needs to be mailed.
4.
For all prescriptions, but especially controlled substances and PRNs,
diligently record the amount prescribed and the number of refills
authorized.
XII.
HMO Patients
The proportion of patients, who belong to a health maintenance organization (HMO),
such as M-Care, Blue Care Network, and others, is growing. There are several
procedural differences to keep in mind when handling HMO patients.
A.
The primary care provider (PCP) typically states on the HMO referral form the
services authorized for the neurologist to perform. This may or may not include
diagnostic tests or return visits to Neurology. The diagnostic tests least likely to
be approved, unless explicitly authorized on the HMO referral form, are MRI and
CT scans. If you see an HMO patient who needs one of these tests to complete
the diagnostic work-up, please tell the patient to discuss their authorization with
the cashier upon check-out.
B.
Do not directly refer the patient to another specialist. If you feel a referral to
another specialist is indicated, document your recommendation in the letter to the
referring physician.
C.
Most M-Care PCPs are located in the off-site satellite locations. For the purposes
of communicating and documenting the findings of the visit to the referring
physician, assume the referring physician has no access to the medical record.
Therefore, you should document fully your findings in a letter to the referring
physician as you would do for physicians outside UMMC.
XIII. Insurance Forms
Insurance forms will be completed by the Health Record Analyst rather than the
physician. The physician, however, must complete forms for: (l) proof of disability; (2)
excuse from work for medical reasons; and (3) return to work from medical leave.
XIV. Release of Information Form
The release of information form is used to obtain medical information or X-rays
regarding a patient from another hospital or physician's office. Fill in the space on the
Neurology Checklist "Request release of information to UM" and the checkout clerk will
see that the patient completes the form. The forms are also available in each exam room
and may be completed and given to the receptionist. They must have the patient's
signature.
This form is also used when a patient requests a copy of medical information from the
UM medical record. Please direct the patient to the clinic receptionist for explanation of
the procedure. All requests of this kind are handled by the Medical Correspondence Unit.
Do not copy and distribute portions of the medical record yourself.
For patients with epilepsy or loss of consciousness, document driving restrictions by
having the patient sign a driving restriction form. These forms are available in the clinic.
XV.
Emergency Equipment
A.
A crash cart, defibrillator, drug box, and oxygen are stored in the Otolaryngology
Clinic nurse's station and the Pediatric Clinic treatment room.
B.
A mouth-to-mask breathing device and selected emergency medications are
available in the cabinet in the Neurology Clinic Staff Room.
C.
The clinic nurse is available for assistance in emergency situations.
XVI. Schedule
Neurology clinic schedule—Taubman Clinics
Monday
8:00 am - 12:00 Noon
Epilepsy/Neuromuscular/General
1:00 pm - 5:00 pm
Ataxia/General/Lumbar Puncture
Tuesday
8:00 am - 12:00 Noon
1:00 pm - 5:00 pm
Neuromuscular/General
Sleep Disorders/General
Wednesday
8:00 am - 12:00 Noon
1:00 pm - 5:00 pm
No Resident Clinic
Neuro-oncology/General
Thursday
8:00 am - 12:00 Noon
Neuromuscular/Cerebrovascular/
General
Sleep Disorders/General
1:00 pm - 5:00 pm
Friday
9:00 am - 12:00 Noon
1:00 pm - 5:00 pm
Epilepsy/General/Epi Group Home
Epilepsy/Sleep Disorders/
General/Multiple Sclerosis
Neurogenetics Clinic
Neurology Clinic Schedule – East Ann Arbor Clinic
Tuesday
8:00 am - 12:00 Noon
Movement Disorders Clinic
1:00 am - 5:00 pm
Cognitive Disorders Clinic
Resident continuity clinic schedule
UH Senior Inpatient Resident
Monday 1:15 p.m.-3:15 p.m.
UH Junior Inpatient Resident
One afternoon per week 2:00 p.m.-4:00 p.m.
Scheduled to avoid on-call and post-call days.
Senior Consult Resident
Junior Consult Resident
Tuesdays 1:15 p.m.-3:15 p.m.
Fridays 1:00 p.m.-3:00 p.m.
VAMC Junior Resident
VAMC Senior Resident
Tuesday afternoons (variable) 1:00 p.m.-4:00 p.m.
Mondays 1:00 p.m.-4:00 p.m.
Pediatric Rotation
Mondays 8:00 a.m.-12:00 noon
Elective
Tuesday morning or afternoon
EEG Rotation
Monday 8:00 a.m.-12:00 noon and
Friday 9:00 a.m.-12:00 noon, alternating General
Neurology Clinic and Epilepsy Clinic.
EMG Rotation
Neuromuscular Clinics:
Monday 8:00 a.m.-12:00 noon
Tuesday 8:00 a.m.-12:00 noon
Thursday 1:00 p.m.-5:00 p.m.
General Clinic:
Friday 1:00 p.m.-5:00 p.m.