Chapter 1: How to Succeed in the Psychiatry Clerkship

INTRODUCTION

Your psychiatry clerkship will undoubtedly be very interesting and exciting. A key to doing well in this clerkship is finding the balance between drawing a firm boundary of professionalism with your patients while maintaining a relationship of trust and empathy.

WHY SPEND TIME ON PSYCHIATRY?

For most, your medical school psychiatry clerkship will encompass the entirety of your formal training in psychiatry during your career in medicine.

Being aware of and understanding the features of mental dysfunction in psychiatric patients will serve you well in recognizing psychiatric symptoms in your patients, regardless of your specialty choice.

While anxiety and depression can worsen the prognosis of patients’ other medical conditions, medical illnesses can cause significant psychological stress, often uncovering a previously subclinical psychiatric condition. The stress of extended hospitalizations can strain normal mental and emotional functioning beyond their adaptive reserve, resulting in transient psychiatric symptoms.

Psychotropic medications are frequently prescribed in the general population. Many of these drugs have significant medical side effects and drug interactions. You will become familiar with these during your clerkship and will encounter them in clinical practice regardless of your field of medicine.

Because of the unique opportunity to spend a great deal of time interacting with your patients, the psychiatry clerkship is an excellent time to practice your interview skills and “bedside manner.”

HOW TO BEHAVE ON THE WARDS

Respect the Patients

Always maintain professionalism and give respect to the patients. Be respectful when discussing cases with your residents and attendings.

Respect the Field of Psychiatry

• Regardless of your interest in psychiatry, take the rotation seriously.

• You may not agree with all the decisions that your residents and attendings make, but it is important for everyone to be on the same page.

• Dress in a professional manner.

• Because of the intense emotional suffering experienced by psychiatric patients, working with them can be overwhelming. Keep yourself healthy.

• Psychiatry is a multidisciplinary field. It would behoove you to continuously communicate with nurses, social workers, and psychologists.

• Address patients formally unless otherwise told.

Take Responsibility for Your Patients

Know as much as possible about your patients: their history, psychiatric and medical problems, test results, treatment plan, and prognosis. Keep your intern or resident informed of new developments that they might not be aware of, and ask them for any updates you might not be aware of. Assist the team in developing a plan; speak to consultants and family members. Never deliver bad news to patients or family members without the assistance of your supervising resident or attending.

Respect Patients’ Rights

1. All patients have the right to have their personal medical information kept ...