4th Year Elective Rotation

Externship in Integrated Internal Medicine and Psychiatry

Course Description

Students who rotate on this elective will participate in a variety of clinical activities with attending faculty and residents trained in both Internal Medicine and Psychiatry. Students may participate on inpatient medicine and/or psychiatry teams, on consult psychiatry service, and in outpatient clinics in Rutledge Tower, at the Institute of Psychiatry, and at the VA.


Learning Goals and Objectives: At the completion of this clinical rotation students should be able to do the following:

1. Utilize the aspects of collaborative clinical medicine, practiced by physicians who have training in both internal medicine and psychiatry, to develop an appropriate assessment and treatment plan. (MK3, MK5-6, PC1-3, CS1, IP1-4)

2. Demonstrate improved ability to identify psychiatric pathology that is interfering with appropriate and/or effective medical care. (MK3, MK5-6, PC1-3, CS1, IP-4)

3. Recognize personal limits in knowledge and experience, and pursue information necessary to identify the capacity of the psychiatrist’s ability to manage medical pathology. (MK2, MK3-6, MK8, PD16, PL3, PL6)

4. Demonstrate improved understanding of how physicians with dual training practice. (MK5-6, CS4, PR2, PD3-6, IP1-4)

5. Identify and demonstrate the skills necessary to provide effective and timely care taking into account appropriate resources for patients. (MK1-8, PC1-7, CS5, PR3-4, PL6, SL1-2, SL4, IP4)

6. Identify and demonstrate the skills to stabilize psychiatric disorders in the acute medical setting. Identify patients in need of care in a psychiatric acute care setting. (MK1-8, PC1-7, CS5)

7. Practice supervisory skills by providing third-year medical students with feedback on performance, documentation, and interviewing with guidance from residents or attending. (MK6-8, PC2-3, PC5-7, CS4, PR4, PD2, PD5, IP1-3)


Instructional Methodologies and Rotation Activities: Students on this rotation will be expected to learn and achieve the educational goals and objectives through the following methodologies and activities:

1. Follow 2-4 patients, on both internal medicine and psychiatry inpatient teams, and accurately conduct and record psychiatric and medical workup of a patient.

2. Attend rounds daily, report findings, and contribute to clinical discussions.

3. Complete daily notes, assess vitals, check pertinent labs, and communicate with family/interdisciplinary providers pertinent to patient care.

4. Attend grand rounds and case conferences.

5. Complete a self-directed learning project that consists of a presentation at MedPsych Resident Meeting.

6. Attend weekly MS4 workshop series (Hearing Voices, Clinical Skills, Note Writing and Handoff Skills, Reflective Exercise).


Patient Encounters: Students will be expected to work-up patients with these specified conditions:

1. Delirium

2. Substance withdrawal with medical complications

3. Toxic ingestion

4. HIV associated neurocognitive disorders

5. Comorbid medical and psychiatric conditions with severe psychosocial stressors (e.g. homelessness)


Evaluation and Feedback Methods: Students will be evaluated using the following methods:

1. Midpoint Evaluation and end of rotation E*Value Clinical Performance Evaluation.

2. Case presentation at MedPsych Resident meeting (interpersonal and communication skills).

3. Observation of students completing an initial psychiatric examination and H & P (resident, fellow, attending).

4. Observation of student discussing in-depth history and physical examination findings, diagnosis, and treatment plan during rounds by a resident, fellow, and/or attending.

5. Participation in MS4 workshop series.

6. At the end of the rotation, students will again receive verbal feedback about their performance.


Further Information:

Application available via VSAS

Please contact course Coordinator Dr. Mae Laroya for further information:

o   Telephone 843-792-0343

o   Email laroya@musc.edu