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Clinical Curriculum

3rd Year Clerkship

Our goal with the psychiatry clerkship is to deliver a challenging and enjoyable learning experience that focuses on the development of clinical, interpersonal and professional competence which we believe can only be achieved by students taking an active role. We understand that not all students choose Psychiatry as a career, but we believe that the ability to recognize mental illnesses, and treat or refer patients appropriately, is a crucial skill set for all future physicians to develop. The knowledge, skills and attitudes our students acquire during this rotation will provide a critical foundation for them, no matter what field of medicine they eventually choose.

The Department of Psychiatry & Behavioral Sciences here at MUSC is a highly regarded department, and our students benefit from the enthusiasm and expertise of our impressive faculty. Student’s primary assignments allow them to work closely with the attending and resident physicians on a variety of different services. This primary assignment is paired with an ancillary experience, which provides the students an opportunity to work with psychiatrists who specialize in a variety of fields in both inpatient and outpatient settings.

Student feedback is vital to the success and growth of our rotation. Our students comments and suggestions help us to improve the rotation on a continuous basis. During our feedback lunch in the last week of the rotation, we host a casual and open discussion regarding the current students' experiences and impressions.

We also hope that our students learn something about themselves over the course of the six week rotation. This clerkship is designed to play an important role in helping MUSC students become excellent physicians.

The course concludes on the last Friday of the rotation with the NBME Shelf Exam. In addition, every student completes an Objective Standardized Clinical Examination and participates in a team based Simulation Center module as part of the 6 week clerkship.

MUSC Institute of Psychiatry (IOP)

Adult Acute Care Unit
Chris Fields, M.D.
fieldsc@musc.edu

Senior Care Unit
Rindy Fernandes, M.D.
rosri@musc.edu

Child & Adolescent Unit
Natasha Juneja, M.D.
junejan@musc.edu

Jennifer Patterson M.D.
pattersj@musc.edu

General Adult Unit
Andrew Lee, M.D.
leandrew@musc.edu

Baron Short, M.D.
shorteb@musc.edu

Andrew J. Manett, M.D.
manett@musc.edu

Ethan Ashley, M.D.
ashleyet@musc.edu

Ben Kalivas, M.D.
kalivas@musc.edu

Addictions Unit
Thomas (Edward) Lewis, M.D.
lewiset@musc.edu

Temeia Martin, M.D.
martintd@musc.edu

Consultation-Liaison Team
David Beckert, M.D.
beckertd@musc.edu

Allison Smith, M.D.
smithall@musc.edu

 

Ralph H. Johnson Veterans Affairs Medical Center (VAMC)

General Adult Unit
Paul Everman, M.D.
everman@musc.edu

Christopher Pryor, M.D.
pryorch@musc.edu

David Hiott, M.D.
hiottdw@musc.edu

Billy Beck, M.D.
beckb@musc.edu

 

Ancillary Assignments

In addition, students attend a half day ancillary/outpatient experience per week for five weeks. Ancillary experiences include:

  • Child & Adolescent Psychiatry (Inpatient, IOP)
  • Project Rex, Autism Spectrum Disorder Program
  • STAR, Child & Adolescent Psychiatry Day Treatment Program
  • MUSC Counseling & Psychological Services Clinic
  • Child & Adolescent Outpatient Clinic
  • Child & Adolescent Consultation-Liaison Psychiatry
  • Consultation-Liaison Psychiatry (MUSC)
  • Biobehavioral Medicine Clinic
  • Women’s Reproductive Behavioral Health Clinic
  • MUSC IOP Addictions Inpatient Unit
  • MUSC IOP General Adult Inpatient Unit
  • VAMC Adult Inpatient Unit
  • VAMC Posttraumatic Stress Disorder Clinic
  • VAMC Substance Treatment and Recovery Program (STAR)
  • Primary Care Psychiatry (Telehealth)

Brightspace
Primary reference for the most up to date clerkship goals & objectives, block schedules, primary/ancillary site information, lecture resources, and study resources.

Call
Each student will take 3 days of call: 1 weekday long-call, 1 weekday short-call, and 1 weekend call. Weekday call shifts are 8:00 PM – 10:00 PM (short-call) or 6:00 PM – 11:00 PM (long-call). Weekend call is 1:00 PM – 6:00 PM.

Weekend Rounding
Two weekend days of rounding with your team are required. Students assigned to the Consultation-Liaison Team do not work weekends, as clinical hours during the week are typically longer.

Mid-Point Card
To be completed by 2:00 PM on the Monday of Week 4 of the rotation.

Procedures & Diagnoses (PxDx) Log
To be completed by the fifth Saturday of the rotation.

Direct Observation Card
To be completed by 2:00 PM on the Friday of Week 4.

Senior Mentor Project
To be completed by the end of the rotation. The assigned brief clinical life review focuses on reminiscing and understanding values, beliefs, and circumstances that may influence the health and health behaviors of our students’ assigned senior mentor.

Simulation Center Activity
Learn with peers how to approach an unstable patient scenario related to psychiatry through use of high-fidelity patient simulators.

Electroconvulsive Therapy (ECT)
Students attend 1 ECT session during the clerkship on the 5th floor of the IOP North Tower.

Peer-to-Peer
While not required, peer-to-peer opportunities are available to ensure students have an opportunity to observe the depth and breadth of psychiatric conditions across different patient populations.

Personal Time
Students are allowed one half-day during the first three weeks of the rotation to handle personal needs. This would need to be requested at least 1 week in advance and discussed with the student’s primary team.

Sick Leave
If a student is sick, they must complete an absence request form through Microsoft Teams and inform Mae Laroya as well as their team’s residents and/or attending before the start of the shift.

Planned Absence
In the event you need to miss time, you must complete an absence request form through Microsoft Teams, providing at least 6 weeks’ notice for consideration.

Resources for the NBME Psychiatry Subject Examination (Shelf)
Ganti L, Kaufman MS, Blitzstein SM. First Aid for the Psychiatry Clerkship, 6th ed. McGraw Hill, 2021. ISBN: 978-1264257843.

Black DW, Andreasen NC. Introductory Textbook of Psychiatry, 7th ed. American Psychiatric Association Publishing, Inc., 2020. ISBN: 978-1-61537-312-3.

Klamen DL, Pan P. Psychiatry PreTest Self-Assessment and Review, 15th ed. McGraw Hill, 2020. ISBN: 978-1260467413.

Toy EC, Klamen DL. Case Files Psychiatry, 6th ed. McGraw Hill, 2020. ISBN: 978-1260468731.

Boland R, Verduin M. Kaplan & Sadock’s Concise Textbook of Clinical Psychiatry, 5th ed. Lippincott Williams & Wilkins, 2022. ISBN: 978-1975167486.

Nussbaum AM. The Pocket Guide to the DSM-5-TR Diagnostic Exam, 1st ed. American Psychiatric Association Publishing Inc., 2022. ISBN: 978-1615373574.

Didactics are an integral part of the clerkship and are comprised of an average of 20 contact hours, including case conferences and lectures, which cover the following topics:

  • Child & Adolescent Disorders
  • Depression
  • Forensics
  • Geriatrics
  • Inpatient Case Conference
  • Interventional Psychiatry
  • Managing Challenging Patients
  • Mental Status Exam
  • Mood Disorders
  • Psychopharmacology
  • Psychotherapy
  • Quadrant Lecture/Psychiatry Interview
  • Schizophrenia
  • Substance Abuse

Psychiatry is a six-week clerkship that introduces students to the care of psychiatric patients with the goal of helping students recognize, diagnose, and treat psychopathologies using empathetic, patient-centered care.

Psychiatry Clerkship Objectives: At the conclusion of the clerkship, students will be able to do the following:

Medical Knowledge (MK)

  • (Psych1) Describe the known pathophysiology, epidemiology, risk factors, and the course of commonly encountered psychiatric illnesses (depression, bipolar disorder, anxiety disorders, substance use disorders, childhood disorders, psychotic disorders, neurocognitive disorders, and personality disorders). (MK4)
  • (Psych2) Demonstrate the ability to formulate an accurate diagnostic assessment and treatment plan for patients with the following psychiatric illnesses: depression, bipolar disorder, anxiety disorders, substance use disorders, personality disorders. (MK6)
  • (Psych3) Describe the core features, diagnostic approach to, and acute management of a patient with delirium. (MK3)
  • (Psych4) Describe the proposed mechanism of action, indications, and clinically important side effects of the following classes of medications: all antidepressant classes and those with novel mechanisms of action, neuroleptics, mood stabilizers, medications for neurocognitive disorders, stimulants, and benzodiazepines. (MK5)
  • (Psych5) Describe the role of psychotherapy for patients with mood disorders, anxiety disorders, substance use disorders, psychotic disorders and personality disorders in an inpatient and outpatient setting. (MK8)
  • (Psych6) Describe the role of electroconvulsive therapy in the treatment of patients with psychiatric illness. (MK5)
  • (Psych7) Explain how social determinants, health behaviors and preventive measures can affect psychiatric illnesses in individuals and across larger populations. (MK7)

Patient Care (PC)

  • (Psych8) Demonstrate proper techniques for interviewing a patient to obtain an accurate psychiatric history and complete a mental status examination. (PC1)
  • (Psych9) Formulate a comprehensive and organized differential diagnosis for patients presenting with psychiatric complaints. (PC2)
  • (Psych10) Develop a plan for a diagnostic evaluation of a patient presenting with psychiatric complaints, to include laboratory and other testing. (PC3)
  • (Psych11) Demonstrate the ability to integrate laboratory and diagnostic findings when developing a differential diagnosis and treatment plan for a patient with psychiatric illness. (PC3)
  • (Psych12) Develop a treatment plan for commonly occurring psychiatric illnesses that is patient centered and evidence based. (PC3)
  • (Psych13) Demonstrate the ability to effectively assess for suicidal and homicidal ideation and develop appropriate safety planning and treatment. (PC1)
  • (Psych14) Demonstrate the ability to build a positive, healing relationship with a patient and their family. (PC5)
  • (Psych15) Describe the impact of psychosocial factors on patients’ illnesses, overall health, and coping strategies. (PC5)
  • (Psych16) Demonstrate the ability to work effectively as a member of an interprofessional healthcare team. (IP4)

Interpersonal and Communication Skills (CS)

  • (Psych17) Demonstrate effective, professional, compassionate, ethical and culturally sensitive interpersonal and communication skills in interactions with patients, families, peers, and other professionals and staff. (CS1)
  • (Psych18) Recognize transference and countertransference in the context of patient interviews and develop skills to allow optimal patient treatment when present. (CS2)
  • (Psych19) Effectively present and document in a standardized format the patient data gathered from patient interviews, examinations, laboratory & diagnostic studies, and progress notes using electronic health records. (CS5)
  • (Psych20) Demonstrate effective collaboration skills as a member of a psychiatric team, including learning teams and health care teams. (CS4)
  • (Psych21) Demonstrate the ability to interview and assess hostile and agitated patients safely. (CS3)

Professionalism (PR)

  • (Psych22) Demonstrate honesty, integrity, respect, and compassion in all interactions with patients, peers, faculty, staff, and other health care professionals in all settings. (PR1)
  • (Psych23) Demonstrate ethical, patient-centered decision making and respect for the confidentiality of psychiatric patient information in all settings (i.e., clinical, academic, electronic or web-based). (PR2)
  • (Psych24) Demonstrate sensitivity and responsiveness to the individuality of the patient, taking into account their culture, race, ethnicity, spirituality, gender, sexual orientation, age, physical characteristics, medical condition, disabilities, socioeconomic status, family-context and other aspects of personal and health beliefs, practices and decisions. (PR3)
  • (Psych25) Demonstrate accountability for academic, patient care and professional responsibilities, demeanor and dress, and a commitment to continuous professional development. (PR4)

Personal and Professional Development (PD)

  • (Psych26) Acknowledge personal limitations and mistakes openly and honestly and critically evaluate mistakes to promote professional development. (PD1)
  • (Psych27) Demonstrate a commitment to personal health and well-being and recognize and address personal attributes, attitudes, and behaviors that may adversely influence one’s effectiveness as a physician. (PD3)
  • (Psych28) Define professional impairment and describe the role and responsibility of health care professionals in addressing impairment and unprofessional behavior in colleagues and in the profession. (PD4)

Practice-Based Learning (PL)

  • (Psych29) Demonstrate the ability to access, interpret, and integrate evidence-based information into patient care decisions and treatment planning for patients with psychiatric illness. (PL3)
  • (Psych30) Engage in discussions involving feedback in a constructive and positive manner. (PL3)
  • (Psych31) Use information technology successfully to access and manage patient information. (PL2)
  • (Psych32) Acknowledge limitations in skills and gaps in knowledge base and develop a plan to continue to address these via self-study or in subsequent clinical rotations. (PL1)

Systems-Based Learning (SL)

  • (Psych33) Identify issues related to the cost-effectiveness of diagnostic evaluations and patient care. (SL2)
  • (Psych34) Describe potential barriers to treatment and means of advocating for patients with psychiatric illness. (SL4)
  • (Psych35) Describe the role of a psychiatrist in the care of a patient with psychiatric illness in an inpatient and outpatient setting. (SL3)

Interprofessional Collaboration (IP)

  • (Psych36) Demonstrate an appreciation of, and ability to collaborate with, other members of the health care team including nurses, social workers, pharmacists, psychologists, and other team members and trainees. (IP4)

Procedures & Diagnoses (PxDx) Log

Your Psychiatry Clerkship grade is based on the following components and criteria:

Components

National Board of Medical Examiners Psychiatry Subject Exam (Shelf)
Honors – 91-100%
High Pass – 88-90%
Pass – 72-87%
No Pass – 71% or lower

Objective Structured Clinical Examination (OSCE)

Honors – Pass on first attempt (raw score 70% or higher)
No Pass – No Pass (raw score 69% or lower)

Clinical Performance Evaluation

Honors – 2.8 or higher (4 out 5 “exceeds expectations” on average)
High Pass – 2.6 or higher (3 out of 5 “exceeds expectations” on average)
Pass – 2.0 or higher
No Pass – Below 2.0

Criteria

Honors
Honors on Shelf Exam
Pass OSCE
Honors on CPE

High Pass
High Pass on Shelf Exam
Pass OSCE
High Pass on CPE

Pass
Pass on Shelf Exam
Pass OSCE
Pass on CPE

No Pass
Shelf Exam failure (after two attempts) OR
OSCE failure (after two attempts) OR
2.0 or below on CPE

Clinical Performance Evaluation

  • Students will receive a Clinical Performance Evaluation from the attending physician(s) who supervise(s) them on their core clinical rotation.
  • If a student works with more than one attending on their core rotation, that student can request that each attending complete a CPE form and the grade for that portion of the rotation will be a weighted average based on the amount of time that the student worked with each attending.
  • Input from the multidisciplinary team (including the resident) will be solicited to help your attending(s) evaluate your clinical performance.

The National Board of Medical Examiners Psychiatry Subject Exam (Shelf)

  • The Psychiatry Shelf Exam will be administered on the last day of the clerkship. Cutoffs for HIGH PASS and HONORS grades on this exam are established prior to the start of each academic year. Students in each rotation are not “competing” with one another regarding the score that they will receive on the Shelf Exam.
  • There is a Shelf Exam review as part of the didactic lecture series and a very helpful on-line review course and study guide available on Brightspace.

Objective Structured Clinical Examination (OSCE)

  • Each student will be administered an OSCE during the rotation. You will be assigned a specific time to report to the Clinical Evaluation Center on the 2nd Floor of the Education Center Library (ECL) for your exam.
  • During the OSCE, you will be given twenty minutes to interview a standardized patient, during which you should perform a psychiatric “work-up”, including a mental status exam as appropriate. You need not perform a review of systems. Following the interview, you will be given 20 minutes to complete a “write-up” for the patient, including the chief complaint, history of present illness, prior medical history, family history, social history, prior psychiatric history, family psychiatric history, mental status exam, assessment, differential diagnosis, and treatment plan.
  • After you have turned in your write-up, you will have 20 minutes to review your videotaped interview and write a critique of your performance. This critique should include information about the adequacy of your interviewing techniques, and the topics covered in the interview and the mental status exam. The quality of your performance on the self-critique will be assessed as an important part of your performance on the OSCE.
  • OSCE examiners will evaluate your OSCE performance, including your use of good interviewing techniques. Your written assessment of the patient will also be evaluated for its completeness, organization, legibility, and accuracy.
  • Your OSCE performance will be evaluated using several categories: 1) History Taking (as demonstrated by the content of the interview and the write-up); 2) Mental Status Examination and Documentation of Vital Signs; 3) Write-Up Assessment and Differential Diagnosis, 4) Treatment Planning and Patient Management; 5) Communication, Interview Technique, and Interpersonal Skills demonstrated with the patient; 6) Documentation of Patient Safety Assessment; and the 7) Self Critique.

3rd Year Selectives

Selectives offer 3rd year students an opportunity to learn more about a subspeciality or more specific clinical focus than what is typically offered during the 3rd year clerkships. Selectives are either 1-week or 2-week rotations in areas of the medical student’s choosing.

Each selective has their own specific goals & objectives.

  • Introduction to Child & Adolescent Psychiatry (PSYCH 801K) – 1 week intersession selective
  • Introduction to Geriatric Psychiatry (PSYCH 802K) – 1 week intersession selective
  • Introduction to Interventional Psychiatry (PSYCH 803K) – 1 week intersession selective
  • Child & Adolescent Psychiatry (PSYCH 811J)
  • Geriatric Psychiatry (PSYCH 812J)
  • VA Psychosomatic Medicine Consults (PSYCH 817J)

3rd year selectives are graded Pass/Fail based upon the attending supervisor’s evaluation of the student’s clinical performance. There is no written examination.

4th Year Electives

Although less than 5 percent of medical students nationwide become psychiatrists, psychiatric illnesses are seen in almost all disciplines of medicine, and it is important for students to develop skills for diagnosing, treating, and referring patients who have psychiatric illnesses.

The 4th year electives build upon skills first introduced in the 3rd-year psychiatry clerkship and provide students the opportunity to work with psychiatric patients in various settings. 

Each elective has their own specific goals & objectives.

  • Geriatric Psychiatry (PSYCH 858)
  • Interventional Psychiatry (PSYCH 860)
  • Forensic Psychiatry (PSYCH 870)
  • Psychosomatic Med Consults (PSYCH 871)
  • Child and Adolescent Psychiatry Externship (PSYCH 874)
  • Adult/Inpatient Psychiatry Externship (PSYCH 877)
  • Adult/Inpatient Psychiatry at the VA Externship (PSYCH 888)

4th-year electives are graded Honors/Pass/Fail based upon the attending supervisor’s evaluation of the student’s clinical performance. There is no written examination.

Contact Us

Mae Laroya, M.D.

Psychiatry Clerkship Coordinator

2 Ehrhardt Street, HS 110F
MSC 861
Charleston, SC 29425

843-792-0343
laroya@musc.edu