Course Director

H. Jonathan Polan, M.D.
(212)746-3682
jpolan@med.cornell.edu

Course Coordinator

Rebecca Hellman
(212)746-3231
rahellm@ med.cornell.edu

Course Goals

1. A fundamental understanding of psychiatry as a medical specialty.
2. A basic working knowledge of psychopathology, psychiatric emergencies, and treatments.
3. The ability to perform a competent basic psychiatric diagnostic interview.
4. The ability to formulate a psychiatric differential diagnosis, problem list, and initial treatment plan.
5. A current view of psychiatric practice.

Specific Objectives

1.		To understand psychiatry as a medical specialty that diagnoses and treats disorders of the brain and mind, affecting behavior, perception, emotion, thought, and judgement. Specifically, that: most psychiatric disorders result from brain dysfunction interacting with psychological stressors and the social environment account for a large proportion of morbidity in the general population and medical populations can be successfully treated by medication, psychosocial therapies, or both.
2.		To acquire a fund of basic psychiatric knowledge including: Psychopathology: Familiarity with DSM IV criteria for major adult and childhood illnesses. Principles of natural history, treatment response, and theories of etiology. Differential diagnoses of common presenting psychiatric symptoms. Knowledge of what constitutes a psychiatric emergency and the indications for psychiatric referral and/or consultation. Pharmacologic and psychotherapeutic treatments.
3.		To conduct a competent psychiatric workup, with empahsis on the psychiatric interview as the primary method of information gathering. This requires the student physician to: engage the patient with an appropriate professional stance and establish rapport take a complete psychiatric history, including relevant mental and behavioral symptoms, family history, psychosocial function, and medical history. conduct a complete mental status examination by making accurate observations of pathological behavior and mental phenomena, and inquiring into areas that may not be spontaneously revealed. appropriately probe sensitive issues such as hallucinations, delusions, suicidal and homicidal ideation, drug and alcohol use, history of abuse and sexual history manage patient’s emotional responses during the interview.
4.		To formulate a psychiatric case using: the DSM IV multiaxial system, which incorporates, the psychiatric differential diagnosis, relevant medical conditions, psychosocial stressors, and level of function. a problem-based approach based on assessments of acuteness, severity, functional impact, and potential for harm develop and help execute an initial treatment plan.
5.		To acquire, by active participation in the workup and treatment of inpatients and emergency room patients, experiential knowledge of current psychiatric practice, so as to inform career decisions.

Course Description

The psychiatry clerkship is a six-week course taken in the third or fourth year. Students are assigned to an in-patient psychiatric unit at the Payne Whitney Clinic, the Westchester Division, or Lincoln Hospital, or are assigned at the Payne Whitney Clinic to outpatient work which combines experiences in the psychiatric emergency room, the consultation-liaison service, and the Child evaluation clinic.

Student Responsibilities

1. Clinical involvement. Develop a professional rapport with your patients, know them, their histories, and mental statuses well and, under appropriate supervision, become directly involved in their care.
2. Clinical responsibility. Function as a member of the clinical team by carrying out the jobs that are delegated to you by your residents, fellows, and attendings.
3. An academic approach. In addition to the required readings in the clerkship textbooks, students are expected to read in greater depth about their patients' specific problems, and apply what they read to their cases.

Didactic Sessions

Students in the Psychiatry clerkship attend regular small group tutorials and seminars. With the house staff , they attend teaching rounds, professor's rounds, grand rounds, and house staff teaching conferences.

Evaluations and Examinations

Each student's performance is assessed by the residents and attending physicians on their assigned services, as well as by their small group attending preceptors. The written exam occurs on the last day of the clerkship and consists of multiple choice and short answer questions. The oral exam is a one hour interview, presentation, and discussion of a patient with an examiner during the last week of the rotation.

Grading

Each student's performance is determined by the weighted average of the grades submitted by their preceptors and residents, class participation, and exam grades. The clerkship director writes a composite narrative evaluation integrating all the narratives received from the preceptors, attendings, and residents. Clinical evaluations count 75% of the overall grade. The exams count 25% of the final grade.