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Psychiatry Clerkship

Psychiatry Clerkship. PSRY 5000. Kimberly W. Curtis Clerkship Coordinator. What we expect . . . Attendance When absent, inform attending, resident(s), and clerkship coordinator Dress code Professional attire, white coats (no scrubs), GHSU ID

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Psychiatry Clerkship

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  1. Psychiatry Clerkship PSRY 5000 Kimberly W. Curtis Clerkship Coordinator

  2. What we expect . . . • Attendance • When absent, inform attending, resident(s), and • clerkship coordinator • Dress code • Professional attire, white coats (no scrubs), GHSU ID • No visible tattoos, no jeans, no sandals • Communication • Check GroupWise for announcements and information

  3. What we expect . . . • No photographing patients • Taking photos of patients using a camera • or cell phone is a violation of hospital • regulations and a serious HIPAA violation. If any photography or other recording is required, specific consent from the patient must be obtained and all such photographs or recordings must be made by the “Media Section” of the hospital to which you are assigned.

  4. Goals for the Clerkship . . . • Perform a comprehensive history & physical exam • Working knowledge of major psychiatry diagnoses • Develop comprehensive treatment plan • Gain knowledge of psychopharmacologic agents • Identify psychiatric emergencies and ways to handle them • Write clear and thorough psychiatric reports • Demonstrate professionalism (demeanor, ethics, patient confidentiality, etc.)

  5. Objectives for the Clerkship . . . • Patient Care • Perform a thorough psychiatric interview of a patient with mental illness • Perform and describe a mental status examination • Appraise the information obtained in a psychiatric interview • Formulate a psychiatric differential diagnosis including all 4 diagnostic axes • Appraise the appropriate treatment modalities for psychiatric disorders • Demonstrate the ability to educate patients and their families/support systems about diagnoses, and subsequent care or mental disorder

  6. Objectives (cont’d) . . . • Medical Knowledge • Recognize the pathophysiology, epidemiology, clinical picture, and principles of treatment for the following disorders: • Cognitive disorders (dementia, delirium) • Psychiatric aspects of medical disorders • Psychotic disorders • Mood disorders • Anxiety disorders • Personality disorders • Substance abuse/dependence disorders • Childhood and adolescent psychiatric disorders

  7. Objectives (cont’d) . . . • Appraise the indications, contraindications, and possible side effects of the following drug classes in formulating a treatment plan: • Antipsychotic • Anti-anxiety • Mood stabilizers • Antidepressants • Sedative/hypnotics • Other drug classes that display psychiatric side effects • Practice-Based Learning and Improvement • Choose and appraise medical literature that pertains to at least 1 (one) of their patient’s mental illness

  8. Objectives (cont’d) . . . • Interpersonal and Communication Skills • Give an oral presentation of a patient in a succinct and organized manner using findings from the psychiatric interview and mental status exam • Write complete histories and physicals and progress notes in succinct and organized manner using findings from the psychiatric interview and physical exam • Communicate empathically with patients with mental illness and their families or support system members • Professionalism • Demonstrate utmost respect for all with who they interact (patients and their families and support system, colleagues and team members).

  9. Suggested Reading . . . • Introductory Textbook of Psychiatry – 5th Ed. (Black, D & Andreasen, N) * • Psychiatry – 2008 (Hahn, R; Albers, L; & Reist, C) • NMS Psychiatry – 5th Ed. (Thornhill, J) * (2 copies available) • DSM-IV-TR – Diagnostic and Statistical Manual of Mental Disorders – 4th Ed. (APA) • DSM-IV Casebook (a learning companion of DSM-IV-TR (APA) • Pocket Handbook of Clinical Psychiatry – 4th Ed. (Sadock, B & Sadock, V) • Synopsis of Psychiatry Behavioral Sciences/Clinical Psychiatry – 10th Ed. (Sadock, B & Sadock, V) * • Theory and Practice of Psychiatry (Cohen, B ) * • * Available for checkout – see Clerkship Coordinator.

  10. Site Assignments . . . • On-Campus • Georgia Health Sciences Medical Center • Adult/Geriatric Inpatient Unit (3 South) • Child/Adolescent Inpatient Unit (9 North) • Consult Liaison (3 South) • East Central Regional Hospital • Eisenhower Army Medical Center, Ft. Gordon • Veterans Affairs Medical Center (Uptown Division) • Off-Campus • Brunswick – Gateway Behavioral Health Services • Cedartown – Highland Rivers Center • Columbus – The Bradley Center of St. Francis • Rome – Highland Rivers Center • Savannah – Psychiatric Medicine, PC • Thomasville – Southwestern State Hospital • Valdosta – Valdosta Psychiatric Associates, PC

  11. GHS Medical Center Inpatient Unit Orientation May 30th, 8:00 a.m. • Adult/Geriatric - 3S • Dr. Scott Van Sant (1373) • Dr. M.J. Albright (5929) • Consult/Liaison - Room 3411D • Dr. Vanessa Spearman (8326) • Child/Adolescent - 9N • Dr. Eric Lewkowiez(8783)

  12. Outpatient Experience . . . One half day per week – check your “Inpatient -Outpatient Schedule” for dates • GHS Medical Center Psychiatry Outpatient Clinic • RanjanAvasthi, MD • Bernard Davidson, PhD • Stephen Fleming, MD • Adriana Foster, MD • Ruth Graupera-Frain, MD • Christian Lemmon, PhD • Eric Lewkowiez, MD • Brian Miller, MD • Dale Peeples, MD • Lisa Sheehan, MD • Serenity Behavioral Health • Adriana Foster, MD • Augusta State Medical Prison • Nirajini Reddy, MD • Nitin Shendarker, MD • Walton Rehabilitation Hospital • Jeremy Hertza, Psy.D

  13. Lectures in Vista . . . • Tegrity lectures • Each lecture linked to a particular case study in Vista • Lectures currently available: • Anxiety Disorders (Sebastian) • Dementia, Delirium and Amnestic Disorders (Foster) • Eating Disorders Recognition, Assessment & Treatment (Lemmon) • Legal and Ethical Issues in Psychiatry (Nichita) • Mental Health Consideration in Children and Adolescents (Londino) • Mood Disorders (Shevitz) • Personality Disorders (Albritton) • Psychotherapy (Davidson) • Schizophrenia and Other Psychotic Disorders (Miller) • Substance Use Disorders (Foster)

  14. Educational Events . . . • Grand Rounds • National speakers, GHSU Faculty and Resident speakers • Thursdays from 11:30-12:30 – no Grand Rounds on the 1st or 5th (if applicable) Thursday of the month (attendance not required on the fourth week) • Weekly Case Conference/Journal Club – Dr. Brian Miller • Topics presented by residents (short notice) • Discussion of psychiatry-based journals/articles • Thursdays from 7:30 am • Attendance not required on the fourth week

  15. On-Call. . . • Weekday and Weekend Call - 5:00 p.m. until 10:00 p.m. • No new patients after 10:00 p.m. • Students based in the Emergency Department Behavioral Health Unit. (Report to Room 1469 to sign in) • Page 1st resident on-call • Must see all ER visits, floor consults, and/or direct admissions. ER VISITS TAKE PRIORITY • Switching call dates allowed – notify clerkship coordinator

  16. Access to. . . • Psychiatry Inpatient Units (3S and 9N) • ID badges activated for access to units (must be GHS Medical Center) • Psychiatry Patient Records • PowerChart (Citrix Portal) • Access from GHS Medical Center, clinics or student lounge • No access from off-campus

  17. Student Patient Encounter Log (SPEL) . . .

  18. Mid-Rotation Feedback . . . • Student responsibility: • Complete and review form with attending • Give “Patient Tracking Log” book to attending for review • Feedback form to be completed by the end of 2nd week of rotation • Return “signed” form to Clerkship Coordinator by June 13th(Fax: 706-434-6703)

  19. Psychiatry Clerkship Departmental Exam . . . • Seventeen Vignettes (A thru Q) • Vignette P - Mental Status Write-Up (see Rating Sheet) • Vignette Q - A Nervous Man (Free text answers to 10 questions similar to TBL exercise done in orientation) • Open book exam to be completed on your own time • Will prepare you for the NBME shelf exam • All vignettes to be completed by the end of the 3rd week • Each question worth from .5 to 2 points • Maximum achievable score = 15 pts.

  20. Evaluation Criteria . . .

  21. Evaluation Criteria . . .

  22. Grading . . . • Clinical Evaluation • Fifty percent (50%) • Psychiatry Clerkship Departmental Exam • Fifteen percent (15%) • National Board Subject Examination (NBME) • Thirty-five percent (35%) of converted score • Raw score converted to a GHSU clerkship grade • Students who receive a raw score of 82 or higher qualify to • receive an “A” • Raw score < 64 receives a “D” and required to retake exam

  23. Grading . . . • Honors • Students must receive a raw score of 82 or higher on their NBME and • complete the clerkship with an overall grade of an A to receive honors. • Appeals • Appeals procedure available on clerkship web site: • http://www.georgiahealth.edu/som/clerkships/Psychiatry/grade_evaluation.htm • Attendings or residents should NOT be contacted directly about grade • complaints

  24. Contact Information: Clerkship Coordinator Department of Psychiatry & Health Behavior 997 St. Sebastian Way, EG-3004 Office: (706) 721-6717 Fax: (706) 434-6703 krjohnson@georgiahealth.edu bmaddox@georgiahealth.edu

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