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.

CLERKSHIP OBJECTIVES

Professionalism (PR)

• Demonstrates honesty, integrity, respect, and compassion in all interactions with patients, peers, faculty, staff, and other health care professionals in all settings. (PR1)
• Demonstrates 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)
• Demonstrates 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)
• Recognizes transference and countertransference in the context of patient interviews and develop skills to allow optimal patient treatment when present. (PR3)
• Demonstrates 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. (PR4)
• Defines professional impairment and describe the role and responsibility of health care professionals in addressing impairment and unprofessional behavior in colleagues and in the profession. (PR4)
• Demonstrates accountability for academic, patient care and professional responsibilities, demeanor and dress, and a commitment to continuous professional development. (PR5)
• Acknowledges mistakes openly and honestly and critically evaluate mistakes to promote professional growth. (PR5)

Patient Care and Procedural Skills (PC)

• Demonstrates proper techniques for interviewing a patient to obtain an accurate psychiatric history and complete a mental status examination and cognitive screening. (PC1)
• Demonstrates the ability to effectively assess for suicidal and homicidal ideation (PC1) and develop appropriate safety planning and treatment (PC6)
• Apply knowledge of potential signs and symptoms of abuse when developing treatment plans, including when to report suspected abuse. (PC3) 
• Formulates a comprehensive and organized differential diagnosis, integrating laboratory and diagnostic findings, for patients presenting with psychiatric complaints. (PC4)
• Develops a plan for diagnostic evaluation of a patient presenting with psychiatric complaints, including laboratory testing. (PC5)
• Develops a treatment plan for commonly occurring psychiatric illnesses that is patient-centered and evidence-based. (PC6)
• Describes the impact of psychosocial factors on patients’ illnesses, overall health, and coping strategies. (PC8)
• Identifies issues related to the cost-effectiveness of diagnostic evaluations and patient care. (PC8)

Medical Knowledge (MK)

• Describes the known pathophysiology, epidemiology, risk factors, and the course of commonly encountered psychiatric illnesses. (MK1)
• Describes the proposed mechanism of action, indications, and clinically important side effects of commonly prescribed psychiatric medications. (MK1)
• Describes the role of treatment modalities (e.g., psychotherapy and electroconvulsive therapy) in the treatment of patients with psychiatric illness. (MK1)
• Describes the normal psychological development across the lifespan. (MK1)
• Describes the role of a psychiatrist in the care of a patient with psychiatric illness in an inpatient and outpatient setting. (MK1)
• Applies knowledge of psychiatric concepts, the psychiatric mental status exam and cognitive screening. (MK2)
• Applies knowledge of indications, contraindications, potential adverse reactions, and likely outcomes for a given therapeutic intervention, with attention to cost and quality. (MK2)
• Applies knowledge of psychopharmacology in diagnostic and treatment decision making. (MK2)
• Applies knowledge of the risk factors for violence when making treatment plans and demonstrates an understanding of when to alert others, including potential targets. (MK2)

Interpersonal and Communication Skills (IC)

• Demonstrates effective, professional, compassionate, timely, ethical and culturally sensitive interpersonal and communication skills in interactions with patients and families. (IC1)
• Demonstrates the ability to build a positive, healing relationship with a patient and their family. (IC1)
• Demonstrates the ability to interview and assess hostile and agitated patients safely. (IC1)
• 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. (IC2)
• Demonstrate effective collaboration skills as a member of a psychiatric health care team or learning team. (IC2)
• Demonstrate effective hand-off communications with other providers. (IC2)
• 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. (IC2)
• Provide patient education regarding prevention, diagnosis, treatment plan and health promotion, including obtaining informed consent. (IC3) 

Practice-Based Learning and Improvement (PL)

• Recognizes personal limits of knowledge and skills and actively seeks and incorporates feedback and assessment data to develop and implement learning and improvement goals. (PL1)
• Acknowledges limitations in skills and gaps in knowledge base and develops a plan to address these. (PL1)
• Engage in discussions involving feedback in a constructive and positive manner. (PL1)
• Demonstrate the ability to access, interpret, and integrate evidence-based information into patient care decisions and treatment planning for patients with psychiatric illness. (PL2)

Systems-Based Practice (SP)

• Explains how social determinants, health behaviors and preventive measures can affect psychiatric illnesses in individuals and across larger populations. (SP1)
• Demonstrates the ability to access and integrate information technology as needed in patient care. (SP2)
• Describe potential barriers to treatment and means of advocating for patients with psychiatric illness. (SP4) 

REQUIRED CLINICAL ENCOUNTERS

Diagnosis Participate in the care of patients with the following diagnoses:	Outpatient or Inpatient
Agitated/hostile Patient	I
Alcohol Use Disorder	I
Anxiety Disorder	I
Bipolar Disorder	I
Stimulant Use Disorder	I
Depressive Disorder	I
Opioid Use Disorder	I
Personality Disorder	I
Post-Traumatic Stress Disorder	I
Schizophrenia or Schizoaffective Disorder	I
Suicidal Ideation	I
Adjustment Disorder	I
Procedures and Skills	Outpatient or Inpatient
Participate in counseling a patient on risks, benefits, side effects of benzodiazepines	I
Participate in a process of informed consent	I
Participate in counseling a patient on risks, benefits, side effects of 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 an electroconvulsive therapy or Transcranial Magnetic Stimulation (TMS)	I
Perform an evaluation of a patient’s decision-making capacity	I