Psychiatry at Mount Sinai Chicago

SCHEDULE:

Varies depending on your preceptor. (some start at 6:30 and end in the afternoon, some are 8-5, occasional weekends but generally M-F schedule)

You may be primarily inpatient, outpatient, or mixed 50/50. You may also find yourself for a week on consults for the inpatient floors.

Every Thursday 9a-4p is med student didactics with different lectures scheduled, all focused on important shelf exam topics. These lectures occur in the Sinai behavioral health outpatient clinic main conference room.

 

LOCATIONS:

Outpatient clinic is located on the 2nd floor of the SCI building (across the street from the main hospital parking garage). The outpatient clinic has a number of interview rooms (most of them are simple office rooms without exam tables). You’ll coordinate with your preceptor on which rooms to use. NOTE: there is occasional overlap with 

Inpatient has a few potential locations. You may be located on the 6th floor of the Kurtzon building (known to everyone as “6 East”). This is a badge-restricted area, so you’ll scan in each time you enter. You may also rotate with the crisis unit in the emergency department at Mt. Sinai. Or your preceptor may be located in the behavioral stabilization unit at Holy Cross Hospital. 

 

GENERAL: Each round of students has had a slightly different experience. This comes as a result of the site slowly increasing its volume of students. As of this writing, we are near capacity, and they are not going to further increase the number of students. 

 

The nice thing about psych at Sinai is there are no psych residents. The reason I say this is nice is because 1) you get to work directly with an attending on a team of up to 5 total students (great for more personalized evaluations) and 2) as you’ll see in psych, if there WERE residents, there wouldn’t be much for the medical students to do. As a result, you get an almost resident-level type of experience. Occasionally, you may have a Family Medicine resident join your team, but they are there to learn just as much as you. This can be intimidating for maybe the first week, but after that you’re pretty much in the swing of things. You’ll be surprised how quickly you begin to start incorporating what you’re studying directly into your daily practice.

 

THE ROUTINE: Regardless of your preceptor’s schedule, you’ll be expected to interview and document. For inpatient, you’ll do this in Word and email it to the preceptor for the EMR (MediTech). For outpatient, you’ll be typing directly into the patient’s chart (Next Gen). Follow the outline for basic psych-specific history that you’ll cover in your first lecture, and you’ll be fine.

 

LECTURES: Every Thursday is a day when med students are in lectures. The majority of the lectures are run by the program director with the occasional visiting lecturer. Early in the rotation you’ll cover the basics such as psych-specific history gathering. Later, you’ll focus more heavily on DSM-V criteria and pharmacology.

 

Everyone will be required to present a case to the class. You’ll either be paired with someone or in a group of 3, depending on the student number. You’ll be responsible for selecting a patient case you’ve seen and presenting it to the class. WORD TO THE WISE: Any time you present a case, follow the psych-specific history to the letter. Psych’s histories are pretty different from your standard medicine H&Ps. 

 

Just as with all other rotations, you’ll also be required to present on a topic as an individual. These topics get assigned by the program director and are usually about DSM-V criteria. 

 

HOW TO SUCCEED: Psych is considered the “easy” rotation, but the content can still be challenging. Do not take this rotation to be a break. Study. The majority of the questions you’ll encounter are diagnosis (based on DSM-V criteria) and pharmacology. Drill everything about these topics and you’ll be set for the shelf. 

 

To succeed in the rotation overall, you need to understand the reality within psychiatry. A lot of your patients are going to have really troubling pasts (sexual assault, abuse as a child, traumatic life events, etc.). Be prepared to deal with these in a nonjudgmental and empathetic way. You’re not expected to have answers for your patients, but you are responsible for making them feel safe. If you can do this while expressing your interest to your attending and you’ll be fine. Also, always have in the back of your mind the possibility of a person’s presentation to be related to some underlying organic source (diabetes, vitamin deficiency, thyroid disorder, infection, malignancy, some other metabolic disturbance, etc). If you start the conversation of differentials with your attending by ruling out organic causes, they’ll love you.

Good luck on your rotation!!

Brandon Byers