Psychiatry Preceptorship:

 

Goals:

1.  Provide the internal medicine resident with the knowledge base, skills, and attitudes needed to properly manage patients with common co-existing psychiatric disorders encountered in a typical Internal Medicine practice.

2. Identify which patients with underlying psychiatric problems may be managed by a general internist and which patients require emergent and non-emergent referral to a psychiatrist.

 

Objectives:

1.  Learn how to conduct an effective psychiatric interview of a physically ill patient.

2.  Compose a comprehensive formulation of a patient's problem with special attention to the life setting and special circumstances leading to the illness and request for consultation, the significance and meaning of the illness to the patient, and the psychosomatic and somato-psychic interactions.

3.  Evaluate the specific influences of a patient's personality on the manifestation of this illness and illness behavior.

4. Learn how to formulate and implement appropriate interventions using psychopharmacological, psychotherapeutic and social measures as appropriate.

5.  Gain an understanding of how to access community services to set up appropriate outpatient psychiatric care.

6.  Develop an understanding of how to deal with patient populations with specific needs - suicidal patients, incompetent patients, and elderly patients.

7.  Develop an understanding of crisis and family intervention and what is involved in committing patients to inpatient psychiatric facilities.

8.  Develop a knowledge base, diagnostic, and therapeutic approach to the following presentations - agitation, anxiety, confusion, delusions/hallucinations, depression, sleep disturbance, cognitive/memory impairment, suicidal ideation, paranoid ideation, somatization, and personality changes.

10.  Describe indications for neuro-psychological evaluation and for electroconvulsive

therapy.

11.  Perform a depression inventory and a mental status examination.

12.  Demonstrate practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice through interaction with patients, attendings and other healthcare personnel and through delivery of psychiatric care.

 

Learning Venues:

The primary site for psychiatric training of the medical resident will the Psychiatry Preceptor’s practice—office and in-patient.

 

The Psychiatry Department will provide reading references—texts and articles for the resident to review during the rotation.  Topics covered will include anxiety disorders, schizophrenia personality disorders, somatization disorders, depression/dysthymia/bipolar diseases, sleep disorders, delirium, and sexual dysfunction.

Some of these topics may be covered during the Internal Medicine Core Lecture Series.

 

Competency Assessment:

The ABIM Global Assessment Form must have all six competencies rated as satisfactory or superior. An examination might be required at the end of the rotation  and will assess medical knowledge and patient care. 

 

 Outcomes Assessment: 

The education success of the elective will be based on the following:

 

1.  Scores from the end of rotation exam demonstrating understanding.

2.  Self assessment of the value of the experience.

3.  Preceptor evaluations of the residents.

2.  Feedback from program graduates.