Clerkship

Third-Year Psychiatry Clerkship

Clerkship Director: Paula Gibbs, MD

Clerkship Coordinator(s): Lindsay Clark

The psychiatry clerkship is a required rotation experience during Phase three of the University of Utah School of Medicine curriculum for all medical students. It is a six-week clinical rotation during which time students rotate on an in-patient psychiatric unit at a variety of sites and settings. Students will have experiences dedicated to caring for ill psychiatric patients at a variety of units, including some of the following units: 5-West acute psychiatric unit at the University of Utah, psychiatric units at the Salt Lake Veterans Medical Center, in-patient units at the Huntsman Mental Health Institute (HMHI—formerly University Neuropsychiatric Institute or UNI) and consultation liaison services at both University of Utah and HMHI.

The third year medical student will become an integral member of the multidisciplinary teams that care for psychiatric patients and learn about a range of other caregiver roles, including psychologists, social workers, nursing staff, psychiatric technicians, art, recreational and music therapists, as well as the psychiatrist physicians directing the overall care of complex patients. They will gain exposure to a wide range of psychiatric illnesses that result in acute in-patient psychiatric care. Recognition of psychopathologic conditions, such as anxiety disorders, mood disorders, psychotic disorders, eating disorders and medical conditions that contribute to psychiatric problems, will be emphasized. Students will learn the terminology of mental health care, understand symptom criteria, diagnostic work-up and methodology, assessment planning and formulation in a culturally sensitive way, and treatment intervention modalities that include therapeutic techniques (group, individual and family therapy), psychopharmacological interventions and other modalities utilized to help stabilize and maintain individuals suffering from mental illness. The students have unique opportunities to see involuntary court commitment proceedings as well as more intensive treatment interventions, such as electroconvulsive therapy.

Through clinical work, students contribute on a daily basis to patient care by direct contact with patients, other medical team members and family members. They participate in gathering daily information about health and progress in treatment, documenting daily progress and meeting with family members and other treatment team members to facilitate and implement treatment and discharge planning.

Students participate in two weekly half-day sessions dedicated to formal, small group education on a variety of pertinent topics to psychiatry and the practice of medicine in general. Modes of teaching during this time include group teaching by peers, formal didactics and experiential learning sessions in which they participate. Topics range from specific psychopathologic disease states to a range of thread topics that are integrated throughout all four years of their medical school education. Topics emphasized on this rotation include systems of care issues (medical errors), medical informatics (EMR and database use for hypothesis formation and research), medical humanities, basic neuroscience and neuroanatomy of addiction and relevant basic science topics, such as neurocognitive disorder of protein misfolding.

Students take call with psychiatric residents on a time-limited basis to gain experience at assessing psychiatric emergencies and assessing level of care needs along with disposition planning. Psychiatric crisis assessment regarding suicidality and homicidiality are emphasized. Additionally, other areas of potential crisis, such as substance abuse/dependence and withdrawal, are part of the rotation.

Students are evaluated through a variety of modes, including preceptor formative and summative evaluations, end of rotation Psychiatry SHELF examination through the NBME and OSCE (observed structured clinical evaluation). Textbooks for study and review are provided during the rotation as well as specific educational time for review and preparation via senior psychiatry resident presentations.

By the end of the rotation, student doctors will have the necessary exposure to a wide range of psychiatric issues that they will encounter as future physicians (no matter what their chosen field) and will gain an appreciation for the importance and complexity that psychiatric problems play in the overall health and wellbeing of their patients. The rotation strives to give students and intense and in depth experience and gain a greater sensitivity and respect for the field of mental health.