Psychiatry Clerkship

General Information

Psychiatry Clerkship Goals & Objectives

Overall Goals

I. Learn to diagnose and manage a diverse range of mental illness encountered in the inpatient and outpatient psychiatric settings (or encountered in psychiatry clinical settings)

II. Acquire interview skills necessary to successfully engage patients in discussions concerning psychosis, mood symptoms, anxiety, suicidality, and drug/alcohol abuse.

III. Learn to orally present comprehensive biopsychosocial mental health assessments.

IV. Demonstrate the ability to strategically choose multidisciplinary treatment options including somatic and non-pharmacologic treatments.

V. Demonstrate the ability to assess decisional capacity and develop an appreciation of how capacity issues impact decision making in medicine and psychiatry.

VI. Master the ability work effectively as part of a multidisciplinary mental health team.

Specific Objectives and Assessment Measures

1. Diagnose and manage a broad range psychiatric illnesses.

Curriculum: Students will participate in daily inpatient or outpatient rounds with their treatment team providing a broad exposure to mental illness. In addition, all the major psychiatric illnesses are covered in on-line clerkship materials and readings, and include: child psychiatry, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, cognitive disorders and personality disorders. What constitutes a patient exposure includes directly observing an interview of a patient; interviewing a patient, and/or completing an on-line case.

Benchmark: Students will be expected to assess and follow psychiatric patients and discuss their treatment needs with their attending and team. Key features of psychiatric illness will be taught during the didactics and can be found on the website. In addition, at least 6 on-line cases in the following illness categories need to be completed: psychotic disorder, mood disorder, anxiety disorder, substance-related disorder, cognitive disorder, and personality disorder.

Test: Your overall understanding of mental illness is assessed daily when you interact with your attending and treatment team. All students will receive mid-clerkship and end-of-clerkship feedback summarizing their performance. The student is responsible for requesting mid-clerkship feedback and it should be documented in the “Psychiatry Clerkship Experience Log” and returned to Gayle Schneider (UW Box 359911) or FAX (206) 744-8615. To demonstrate a broad exposure to mental illness you will log your patient contact on the “Psychiatry Clerkship Experience Log” which should include on-line cases, and return this form to Gayle Schneider (UW Box 359911) or FAX (206) 744-8615.

2. Engage patients in a discussion of their mental health needs.

Curriculum: Students will participate in daily inpatient or outpatient rounds with their treatment team providing a routine opportunity to develop interview skills while being observed by their attending supervisor and/or other team members.

Benchmark: Complete the CEX for psychiatry which is an observed interview of a patient and receive feedback regarding this interaction. Instructions for completion of the CEX can be found on the CEX tab on the clerkship website.

Test: This assessment/interaction will be evaluated via the CEX and needs to be repeated until a passing score is achieved. The CEX form must be returned to Gayle Schneider (UW Box 359911) or FAX (206) 744-8615. In addition, all students will receive mid-clerkship and end-of-clerkship. The student is responsible for requesting mid-clerkship feedback and it should be documented in the “Psychiatry Clerkship Experience Log” and returned to Gayle Schneider (UW Box 359911) or FAX (206) 744-8615.

3. Conduct a biopsychosocial assessment.

Curriculum: The psychiatric exam and biopsychosocial formulation will be taught by residents, physician assistants, attendings and preceptors in the hospital and clinic settings. Common elements of the oral presentation are outlined on the “Oral Presentations” tab on the clerkship website.

Benchmark: You will present two full psychiatric case presentations to your attending. Recommended format and contents of this oral presentation can be found on the Oral Presentations tab on the clerkship website.

Test: Oral presentations will be evaluated using the “Oral Presentations – Evaluation Form” found in the Forms tab on the clerkship website. Each evaluation should be completed and returned to Gayle Schneider (UW Box 359911) or FAX (206) 744-8615.

4. Describe the major indications and side effects of somatic therapies in psychiatry including ECT.

Curriculum: The major psychiatric pharmacologic categories, examples within each group, prominent side effects and indications for use are taught during the clerkship through the web-based cases, during rounds and in formal didactics.

Benchmark: Key features of each will be taught during the didactics and can be found on the website.

Test: Your knowledge is assessed on a daily basis via the interactions you have with the treatment team. In addition, psychiatry uses the National Board of Medical Examiners (NBME) subject test as a final exam and this covers a considerable scope of somatic and non-pharmacologic treatments.

5. Describe how to assess decisional capacity and discuss its impact on treatment in medicine and mental health.

Curriculum: Knowing how to evaluate decisional capacity is essential for all medical providers. Didactic material is available on the clerkship website.

Benchmark: Discuss one case where decisional capacity has been evaluated or come into question with your attending physician.

Test: Completion of this discussion and understanding of decisional capacity should be documented in the “Psychiatry Clerkship Experience Log” and returned to Gayle Schneider (UW Box 359911) or FAX (206) 744-8615.

6. Discuss a psychiatric bioethical issue encountered during the clerkship.

Curriculum: Bioethical issues arise frequently in psychiatry. You are required to identify, observe and reflect on at least one bioethical clinical scenario during the clerkship.

Benchmark: Have exposure to at least one patient in which a bioethical issue is raised either in the clinical setting or through a web-based case.

Test: On the Psychiatry Clerkship Experience form write a reflection on the clinical bioethics case you observed or on a bioethics case completed on the website. This information will be returned to Gayle Schneider.

7. Work effectively as part of a multidisciplinary team.

Curriculum: Students will participate in daily inpatient or outpatient rounds and coordinate care for their patients. They should expect to initiate consults, contact other mental health providers, gather collateral from family members and generally interact with social workers, case managers and providers from all disciplines.

Benchmark: Students will be routinely asked to update the treatment team regarding the care of their patients and will act as the primary provider for the patients they are following.

Test: Although not specifically assessed, the ability to professionally work with patients, family and staff, contributes greatly to mid-clerkship and end-of-clerkship feedback provided to the student. Mid-clerkship feedback provides the student with opportunity for improvement and students can specifically ask about team interactions. The student is responsible for requesting mid-clerkship feedback and it should be documented in the “Psychiatry Clerkship Experience Log” and returned to Gayle Schneider (UW Box 359911) or FAX (206) 744-8615.

Desired Goals            

  • Demonstrate the ability to ask in a sensitive manner about the following: suicide and suicidal ideation; homicidal ideation; abuse; drug and alcohol habits.
  • List the etiologic factors of the major psychiatric illnesses including biologic, sociocultural, intrapsychic and interpersonal.
  • Demonstrate the ability to work effectively as part of a multidisciplinary mental treatment team.
  • Identify nonpharmacologic treatments including psychotherapies, psychoeducation, social and community interventions.
  • Increase level of comfort in working with patients with psychiatric illness.

** For all documents that must be submitted to Gayle Schneider, you can e-mail to gschneid@uw.edu as electronic attachments, fax to 206-744-3236, send by Campus Mail to Box 359911, or by USPS to Gayle Schneider, Box 359911, 325 9th Avenue, Seattle, WA 98104-2499.

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