Psychiatry Clerkship

Foundational Knowledge – Medical Knowledge

1.1

Foundational Knowledge – Medical Knowledge

1.2

Describe the determinants of health

Foundational Knowledge – Medical Knowledge

1.3

Utilize evidence in making clinical decisions

Application – Patient Care (Clinical Skills)

2.1

Conduct patient interviews and physical examinations

Application – Patient Care (Clinical Skills)

2.2

Diagnose patient health problems

Application – Patient Care (Clinical Skills)

2.3

Propose evidence-based health maintenance and therapeutic treatments

Integration – System-Based Practice

3.1

Integration – System-Based Practice

3.2

Integration – System-Based Practice

3.3

Human Dimension – Personal and Interpersonal Professional Development Goals

4.1

Human Dimension – Personal and Interpersonal Professional Development Goals

4.2

Find one’s own meaning in medicine 

Human Dimension – Personal and Interpersonal Professional Development Goals

4.3

Take care of oneself

Human Dimension – Personal and Interpersonal Professional Development Goals

4.4

Human Dimension – Personal and Interpersonal Professional Development Goals

4.5

Human Dimension – Personal and Interpersonal Professional Development Goals

4.6

Caring/Valuing – Professionalism Goals

5.3

Learning How to Learn – Practice-Based Learning

6.1

Learning How to Learn – Practice-Based Learning

6.3

LO1

Frame a patient encounter in an organized fashion, reinforcing etiology, pathophysiology, clinical manifestations, diagnostic strategies and therapeutic interventions.

1.1, 2.1

LO2

Explain disease specific treatment strategies and associated prognosis and complications.

1.1, 2.1

LO3

Evaluate patients’ presenting clinical problems, including: Major Depressive Disorder, Bipolar Disorder, Persistent Depressive Disorder, Panic Disorder, Generalized Anxiety Disorder, PTSD, OCD, Schizophrenia, Schizoaffective Disorder, Personality Disorders, Substance Use Disorders, Neurocognitive Disorders, Somatic Symptoms and Related Disorders, ADHD.

1.1, 2.1

LO4

Diagnose and manage patients with acute and chronic conditions including: list Major Depressive Disorder, Bipolar Disorder, Persistent Depressive Disorder, Panic Disorder, Generalized Anxiety Disorder, PTSD, OCD, Schizophrenia, Schizoaffective Disorder, Personality Disorders, Substance Use Disorders, Neurocognitive Disorders, Somatic Symptoms and Related Disorders, ADHD.

1.1, 2.1, 2.2, 2.3

LO5

Demonstrate the ability to recognize psychiatric emergencies among general medical patients, including: suicidal thinking, homicidal thinking, signs of mental decompensation, impulsivity, dangerously poor judgment, lethal side effects to medications (neuroleptic malignant syndrome, neurotoxic or cardiotoxic responses, overdose).

2.1, 2.2

LO6

Demonstrate knowledge about medical and medical-legal interventions (psychiatric referrals, involuntary commitment, judgments of medical capacity and competence) and recognize potential risks in general medical patients who have psychiatric disorder.

1.1, 2.3, 3.1, 3.2

LO7

Apply the fundamentals of adult care to coordinate the care of healthy adults.

1.1

LO8

Demonstrate the ability to conduct a psychiatric interview, including: establish rapport with patients by properly introducing self and defining the role the interview will have in patients' care, be empathic with patients, showing genuine concern for patients' moods, dilemmas, viewpoints, and conflicts through tone of voice, style of speaking, facial expressions and gestures, facilitate interviews with helpful blends of open and closed questions, supportive remarks, uses of silences, and therapeutic interruptions, use language that is neutral to gender, age, race, sexual orientation, culture, and religion, and conclude interviews with proper timing and respect

2.1, 4.4

LO9

Demonstrate the ability to perform a physical exam as well as a psychiatric examination, including: general appearance and activity, levels of consciousness, speech characteristics, orientation, concentration, memory, fund of knowledge, mood and affect, perceptual abilities/disturbances, hallucinations/illusions, depersonalization/derealization, thought processes, obsessions/compulsions, delusions, suicidal and homicidal thoughts, thoughts of self-harm, abstract thinking, judgment, insight, reality

2.1, 4.4

LO10

Demonstrate appropriate interpretation of labs and testing, as well as perform common screening exams for common psychiatric disorders (CAGE, MMSE).

2.2

LO11

Recognize the indications for lab data, and demonstrate the ability to: determine which laboratory tests are medically indicated based upon patients' psychiatric presentations, recognize when psychiatric laboratory data are pathological, determine when laboratory tests are indicated to check patients' compliance and responses to psychiatric medications, inform patients of risks and benefits of obtaining psychiatric laboratory tests.

2.2

LO12

Begin to formulate diagnostic reasoning, and justify therapeutic decision-making.

1.3, 2.2, 2.3

LO13

Demonstrate clear and concise oral presentations and written documentation reflecting a systematic approach to adult patients. Demonstrate the ability to develop psychiatric formulation and present plausible theories about the etiologies and courses of patients' psychiatric illnesses in regard to: biological factors, psychological factors, social factors, spiritual factors, patients' strengths, and patients' weaknesses.

2.1, 4.4

LO14

Identify the social determinants of health for a specific patient, and develop a plan to coordinate care to include community resources to try to improve the health of the individual.

1.2, 3.1, 3.2

LO15

Consider patient, physician, and system barriers to successfully negotiate treatment plans and patient adherence; and identify strategies that may be used to overcome these barriers.

1.2, 3.1, 3.2

LO16

Identify the role of each team member to the care of the patient, and call on interdisciplinary resources to provide optimal and comprehensive care.

3.3, 4.5, 4.6

LO17

Demonstrate effective skills in collaborating with family members, other health care providers, and professionals to identify the socio-cultural, familial, psychological, economic, environmental, legal, and political factors impacting the health care of the individual and the health care delivery system.

3.3, 4.5, 4.6

LO18

Establish professional relationships and effectively communicate with patients, their families, instructors, colleagues and staff.

4.1, 4.3, 4.5, 4.6

LO19

Work effectively with the broad, interdisciplinary team in patient care and appropriately incorporate their unique care skills.

4.1, 4.3, 4.5, 4.6

LO20

Demonstrate the ability to act with honesty/integrity while maintaining ethical duties to patients and others.

5.3

LO21

Demonstrate the ability to act in a manner that is dependable, dedicated and punctual.

5.3

LO22

Demonstrate the ability to act with patience, altruism and equanimity.

5.1, 4.1, 4.6

LO23

Demonstrate the ability to share advancement of knowledge with peers and other members of the health care team. Additionally, show a commitment to leadership, whether it be by taking initiative when working with families, or by taking on more challenges as the explicit leader in working with peers and in the community.

4.5, 4.6

LO24

Recognize when additional information is needed to care for the patient and demonstrate ongoing commitment to self-directed learning.

6.3

LO25

Demonstrate effective skills in navigating the medical literature to answer clinical care questions.

6.3

LO26

Demonstrate the ability to acquire and soundly manage knowledge, identify knowledge deficiencies and create a plan for knowledge gains

4.2, 6.3

LO27

Demonstrate the ability to seek out and listen to feedback on performance, accept it positively, and respond to it constructively by improving performance.

4.5, 4.3, 4.1

Neurocognitive Disorders

1

Observation

Participation in the management of a patient with altered mental status, dementia, or sequelae (eg dementia, delirium), traumatic brain injury

Psychiatric Condition

1

Full Participation

Any psychiatric diagnosis found in the DSM5

Substance abuse

2

Moderate participation

Participation in the diagnosis and/or management of a patient where substance abuse is either the primary diagnosis or is a complicating comorbid condition and/or sequelae, i.e. intoxication, withdrawal, or treatment of addiction

Anxiety Disorders and OCD

1

Moderate participation

Participation in the diagnosis and/or management of a patient where an anxiety disorder or OCD is the primary diagnosis or is a complicating comorbid condition, i.e. Generalized Anxiety Disorder, Panic Disorder, Separation Anxiety Disorder, Social Anxiety Disorder, Performance Anxiety, Specific Phobia, Anxiety unspecified, OCD, or adjustment disorder with anxiety

Mood Disorders

2

Moderate participation

Participation in the diagnosis and/or management of a patient with a mood disorders as the primary diagnosis or as a complicating comorbid condition and/or sequelae i.e. Major Depressive Disorder, Bipolar Disorder Type I or II, Cyclothymia, Persistent Depressive Disorder

Personality Disorders

1

Observation

Participation in the management of a patient with a personality disorder as the primary diagnosis or as a complicating comorbid condition and/or sequelae

Schizophrenia and Other Psychotic Disorders

1

Observation

Participation in the management of a patient with a psychotic disorders as the primary diagnosis, as a complicating comorbid condition, or as a specifier i.e. Schizophrenia, Brief Psychotic Disorder, Schizophreniform Disorder, Psychotic Disorder unspecified, or a mood disorder with a psychotic features specifier

Suicide

1

Moderate participation

Participation in the diagnosis and/or management of a patient with a history of suicidal thoughts, suicide attempt(s) and/or self-harm behaviors

Trauma and Stressor-Related Disorders

1

Moderate participation

Participation in the diagnosis and/or management of a patient with a trauma or stressor related disorder as the primary diagnosis or as a complicating comorbid condition i.e. PTSD, acute stress disorder, adjustment disorder, reactive attachment disorder, Social disengagement disorder

Adverse Childhood Event

1

Observation

Participation in the management of a patient with a history of any of the following prior to 18 years of age: emotional abuse, sexual abuse, physical abuse, intimate partner violence (parents or adults in the home, personal history), household substance abuse, household mental illness, parental separation or divorce, incarcerated household member, emotional or physical neglect

Adverse Effect of Psychiatric Medication

1

Observation

Participation in the management of a patient who experiences significant side effects to psychiatric medication i.e. Increased sedation, increased energy, decreased energy, increased appetite, sexual side effects, headaches, GI disturbance, Extra Pyramidal symptoms (akathisia, torticollis, parkinsonism), increased sweating, lab abnormalities