Overview
The Psychiatry rotation is a required, four-week preceptorial rotation taken during the third year of residency. The rotation occurs primarily at Beacon psychiatric facilities and is clinically supervised by a member of the Beacon Behavioral Health team, a board certified psychiatrist, and his/her designated colleagues at that facility. The rotation may also include experiences at Epworth Hospital, the outpatient behavioral health offices, or at Memorial Hospital with the consultation-liaison service. This rotation is supplemented by monthly noon conference didactics on Psychiatry as well as monthly small-group discussions on Behavioral Medicine.
Goals
The psychiatry rotation will provide the family practice resident:
- the opportunity to develop and expand his/her understanding of the practice of psychiatry
- experiences in multiple settings in the care of the patient with psychiatric disorders
- experiences to develop attitudes and skills, which will enable him/her to become proficient in the care of patients with psychiatric disorders
- understanding of the needs of patients with psychiatric disorders, which will facilitate appropriate referral practices
Objectives
At the completion of the rotation, the resident will have demonstrated to the satisfaction of the psychiatry preceptor:
- medical knowledge in psychiatry pertinent to the practice of family medicine, ensuring that he/she can appropriately evaluate and treat psychiatric disorders, including: (MK)
- mental status
- psychiatric disorders commonly seen in primary care, such as anxiety disorders, mood disorders, substance-related disorders, eating disorders, and personality disorders
- disorders characteristic of childhood and adolescence
- psychiatric manifestations of medical conditions such as cerebral tumor, electrolyte imbalance, trauma and drug ingestion
- delirium, dementia, amnesic and other cognitive disorders
- somatization disorders
- psychotic/thought disorders
- participation in clinical experiences pertinent to psychiatry, including: (PC)
- assessment of mental status
- screening and diagnosis of disorders commonly seen in primary care, such as anxiety disorders, major affective disorders, substance use disorders, eating disorders, attention deficit disorders
- proper use of pharmacotherapy in the treatment of psychiatric disorders commonly seen in primary care, such as anxiety disorders, major affective disorders, substance use disorders, eating disorders and attention deficit disorders
- outpatient psychiatric and addiction services, including assessment, diagnosis and treatment activities
- the ability to request and interpret appropriate data related to the patient with psychiatric disorder such as psychological testing, laboratory tests, brain imaging, and psychiatric consultation (MK, PC)
- ability to work cooperatively with other health professionals as part of a healthcare team (PC)
- ability to interpersonally engage and communicate effectively with patients with psychiatric disorders, as well as the families of those patients, regarding the diagnosis and treatment objectives (C, PROF)
- sensitivity to the social stigma associated with psychiatric disorders and demonstrate compassion, respect, integrity and responsiveness to the needs of the patients (PROF, C)
Implementation
This is a preceptorial rotation and the resident is assigned to the medical staff at Beacon Behavioral Health. The resident will accompany the assigned psychiatrist preceptor or other mental health professionals during his/her usual professional activities at applicable sites. In the course of seeing patients, the psychiatrist and mental health professionals will provide experiential learning, role-modeling and one-on-one teaching to the resident.
The resident will coordinate scheduling with the point-of-contact at Epworth, which will be provided by the residency. The resident agrees to observe all policies, regulations and procedures of applicable facilities and to notify the clinical supervisor if he/she will be late or absent due to any reason. The resident will continue to meet residency obligations to his/her Family Medicine Center population, including caring for continuity patients admitted to Memorial Hospital and rounding on nursing home patients. The resident will maintain a clinic schedule (four clinics per week) during the rotation. Upon completion of the rotation, the resident must complete the evaluation form provided in New Innovations.
Evaluation
The psychiatry preceptor(s) will complete an evaluation form at the end of the rotation assessing the resident’s success in meeting the rotation objectives as outlined in this curriculum.
Residents will specifically be evaluated on the following ACGME Milestones:
- MK-1: Demonstrates medical knowledge of sufficient breadth and depth to practice family medicine.
- PROF-2: Demonstrates professional conduct and accountability.
- PBLI-2: Demonstrates self-directed learning.
- C-2: Communicates effectively with patients, families, and the public.
- C-3: Develops relationships and effectively communicates with physicians, other health professionals, and health care teams.
