Goals
This course is designed to teach third year medical students the importance of assessing, diagnosing and treating, or referring for treatment, patients with mental illness. Students will learn to perform a complete psychiatric interview including the Mental Status Examination. The diagnostic criteria of the major mental illnesses contained in the DSM-5 will be reviewed and explained, and students will be able to observe and/or work with individuals experiencing a wide array of these illnesses. First line treatments for each of the classes of major mental illnesses will be reviewed and students will get the opportunity to see the effects of treatment implementation. The curriculum and clerkship experiences incorporate the biopsychosocial model as a philosophy of clinical care and as a useful clinical guide. This aids the student in understanding how suffering and illness are affected at multiple levels and is a way to understand the importance of the patient’s subjective experience in diagnosis and treatment outcome and can be useful in fostering the therapeutic alliance.
Objectives
- Engage with a patient and establish and maintain rapport including demonstrating the use of cognitive empathy, respect, sensitivity to the developmental level of the patient, cultural awareness, recognition of the social determinants of health, and seeking to understand the conceptual context of the illness.
- Conduct a psychiatric diagnostic workup in an organized prioritized manner. This should include: acquiring and organizing the psychiatric history; performing the Mental Status Examination; assessing pertinent features of the physical exam; developing a differential diagnosis; determining need for further diagnostic studies; developing an initial plan of care (including discharge planning from the time of admission); and, documenting this in a written report.
- Describe and employ DSM-5 criteria for the diagnosis of patients in the context of complex clinical presentations while taking into account the clinical history, life stressors, challenging psychosocial situations, and patient personality variables.
- Explain the range of psychiatric interventional therapeutics for various treatment options: psychopharmacologic agents, electroconvulsive therapies, psychotherapies (including fundamentals of psychodynamic, behavioral and cognitive approaches) and psychosocial interventions.
- Identify psychiatric emergencies in the clinical setting and describe appropriate interventions for same.
- Use an electronic medical record (EMR) in the care of assigned patients.
- Demonstrate the oral communication skills and the ability to work effectively with colleagues and other health professionals in clinical care settings. This includes being respectful, honest, and recognizing one’s role, expertise and personal limits as an individual provider on the team.
- Demonstrate and discuss appropriate boundaries in the physician/patient relationship.
- Demonstrate concern for patient privacy and confidentiality, identify clinical situations where confidentiality may be breached and discuss appropriate strategies to deal with these situations.
- Identify and discuss gaps in one’s own medical knowledge, clinical skills (including communication skills), and professional behavior (including personal accountability and identification of professional mistakes) and develop a plan to address these issues.
- Learn and be able to perform a search of the primary literature for best evidence utilizing Pub Med, and based on that search, deliver a student presentation on a psychiatrically oriented topic.