Psychiatry Clerkship

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 personhood of the patient inclusive of 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)

Psychiatry Clerkship PxDx Log

Diagnosis: Participate in the care of patients with the following diagnoses: Output or Input
Adjustment Disorder
Alcohol Use Disorder I
Anxiety Disorder I
Bipolar Disorder I
Cocaine Use Disorder I
Depressive Disorder I
Other Substance Use Disorder I
Pain Management: Opioid Use Disorder I
Personality Disorder I
Post-Traumatic Stress Disorder I
Schizophrenia or Schizoaffective Disorder I
Procedure Output or Input
Participate in counseling a patient on risks, benefits, side effects of benzodiazepines I
Observe a process of informed consent I
Participate in counseling a patient on risks, benefits, side effects of first-generation antipsychotics I
Participate in counseling a patient on risks, benefits, side effects of lithium, divalproex, carbamazepine or other mood stabilizer I
Participate in counseling a patient on antidepressants I
Observe a electroconvulsive therapy or Transcranial Magnetic Stimulation (TMS) I
Perform an evaluation of a patient's decision-making capacity I
Perform an interview of a patient with suicidal ideation I
Perform an interview of an agitated/hostile patient I
Participate in an Interprofessional Experience: Collaborate with Social Work for Patient Discharge Planning I
Exam Output or Input
Perform a mental status exam on a patient