The goal of the clerkship is to teach psychiatry to the non-psychiatrist.
By the end of the clerkship, students will be able to:
- Perform and document a complete psychiatric diagnostic evaluation including a complete history, mental-status examination and appropriate physical exam.
- Demonstrate the ability to evaluate each patient for potential relationships between medical and psychiatric symptoms and illnesses; potential history of abuse or neglect; and psychiatric emergencies, including dangerousness to self or others.
- Conduct a psychiatric interview in an empathic manner that facilitates information-gathering and formation of a therapeutic alliance with patients of diverse backgrounds.
- Identify psychopathology; formulate accurate differential and working diagnoses using DSM; assess patients’ strengths and prognosis; and develop appropriate biopsychosocial evaluation (laboratory, radiologic and psychological testing) and treatment plans for psychiatric patients.
- Demonstrate knowledge of the epidemiology; clinical features; course and prognosis; diagnostic criteria; differential diagnosis; and treatment strategies for the major classes of psychiatric disorders.
- Know the clinical features of, treatment for, intoxication with and withdrawal from alcohol and drugs.
- Summarize the indications and contra-indications; basic mechanisms of action; pharmacokinetics and pharmacodynamics; efficacy and cost; common and serious side effects; toxicity; drug interactions; and issues relevant to special populations of each class of psychotropic medications and demonstrate the ability to select and use these agents to treat mental disorders.
- Discuss the appropriate use and indications, benefits and side effects of Electroconvulsive therapy (ECT); light therapy; and emerging new treatments such as vagal nerve stimulation and repetitive transcranial magnetic stimulation.
- Understand the principles, techniques and indications for effective psychotherapies and behavioral medicine interventions sufficient to explain to a patient and make a referral when indicated.
- Demonstrate the ability to monitor and document patients’ clinical progress and alter diagnostic formulation and management in response to changes.
- Discuss the indications for psychiatric hospitalization, including the presenting problem and its acuity, risk of danger to patient or others, community resources and family support.
- Discuss the structure of the mental health system, understand relevant legal issues and adhere to ethical principles in the care of psychiatric patients, including:
- Respect for patient autonomy and confidentiality
- The implications and principles of civil commitment
- The process of obtaining a voluntary or involuntary commitment
- Identify the indications, precautions and appropriate use of restraints and one-to-one sitters.
- Demonstrate the ability to appraise and assimilate scientific evidence, using relevant databases of psychiatric evidence-based medicine to improve patient care.
- Demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families and other health professionals.
Most Important: Try to become more comfortable interacting with a wide variety of patients with mental illnesses.
