Psychiatry Clerkship

Director: Colin Stewart, MD

Clerkship/Learning Objectives

• Conduct a thorough diagnostic interview of medical patients that includes developmental, social, psychiatric, and family histories
• Conduct a complete mental status examination, including cognitive examination
• Present gathered information both orally and in written form utilizing the agreed upon structure of the service team in a way that is organized, includes all relevant information for the development of a formulation and treatment plan. 
• Develop a psychiatric formulation that logically aligns with the patient’s clinical history, including a comprehensive differential diagnosis organized from most likely to least likely based on the history and formulation
• Develop an organized, thorough, evidence-based plan of care for common psychiatric disorders, including major depressive disorder, generalized anxiety disorder, PTSD, bipolar disorder, schizophrenia, and substance use disorders.
• Demonstrate the ability to establish a therapeutic alliance with patients of various cultural and demographic backgrounds and obtain data in an empathetic, respectful, culturally-attuned, and efficient manner.
• Recognize, screen for, and assess the signs and symptoms of major psychiatric disorders and demonstrate the ability to formulate this information into a comprehensive differential diagnosis.
• Define and describe the epidemiology, natural history, symptomatology, and treatments of psychiatric disorders commonly seen in general medical and surgical patients.
• List the medical disorders and substances that contribute to psychiatric symptomatology.
• Describe the psychological impact of medical illness on patients and their families.
• Define and describe patients’ personalities and coping styles and demonstrate understanding of how these impact medical illnesses.
• Demonstrate the ability to assess the risk of suicide in patients and propose an appropriate plan of action.
• Demonstrate the ability to identify substance use disorders and propose a treatment plan based on data obtained.
• Distinguish and describe the major categories of medications used in psychiatry, including mechanisms of action, major side effects, appropriate uses, and error prevention methods.
• Triage patients to the appropriate level of care based on their acute needs, including the consideration of voluntary vs. involuntary hospitalization. 
• Describe how and when to make a referral to a psychiatrist or other mental health professional.
• Demonstrate the ability to be a contributing member of a health-care team by developing meaningful relationships with colleagues and communicating with team members in an appropriately respectful, mature, and cooperative manner, being open to the perspectives and opinions of others, and clearly stating one’s own perspective.
• Demonstrate accountability to the team by consistently meeting obligations, taking on developmentally approriate responsibilities, and consistently identifying own limitations and seeking assistance to address them and to appreciate systems of care.
• Demonstrate skill in patient counseling techniques with regard to the above topics.

​Required Clinical Experiences

• Mental Status Examination (while observed by faculty)
• Suicide Risk Assessment
• Cultural Formulation Interview
• Anxiety Disorders
• Delirium
• Major Depressive Disorder
• Post-traumatic Stress Disorder
• Psychotic Disorders
• Bipolar Disorder
• Cluster B Personality Disorders
• Substance Use Disorders 
• Use of Antidepressant
• Use of Antipsychotic
• Use of Mood Stabilizer
• Individual or Group Psychotherapy
• Psychiatric Triage, including consideration of involuntary commitment vs voluntary hospitalization
• Midpoint Feedback

​Assessment

• Clinical Evaluations
• Class Performance/SG Participation
• Assignments
• NBME Shelf Exam