CLINICAL REQUIREMENTS FOR STUDENTS ON PSYCHIATRY AT SALEM
Welcome to the Salem VAMC! We hope to make your time with us as educational, yet enjoyable, as possible. Your six-week rotation with us will include a balanced combination of ambulatory care and inpatient psychiatry experience, as well as a didactic lecture series and a variety of other educational activities.
INPATIENT EXPERIENCE:
During four weeks of your rotation, you will be assigned to one of our acute inpatient psychiatric units. There you will be expected to participate in the neuropsychiatric assessment, planning, and management of patients on your service. You should be involved in the work-up of approximately three new patients per week and will be expected to participate in daily rounds, multidisciplinary team meetings, family meetings, and commitment hearings. During this portion of your clerkship rotation, we hope to provide a better understanding and appreciation for the management of patients with acute neuropsychiatric syndrome.
AMBULATORY CARE EXPERIENCE:
The remaining two weeks of your rotation will be spent rotating through a variety of ambulatory care services offered at our VA Medical Center. The services through which you will be rotating include the following:
Mental Hygiene Clinic (Salem VA based ambulatory care psychiatry clinic): During this experience you will have the opportunity to work closely with outpatient psychiatry attendings in evaluating and managing ambulatory psychiatry patients. You will be exposed to a variety of psychotherapeutic and psychopharmacologic treatments as well as participate in the continuity of care for these patients.
Psychiatric Primary Care Clinic: During this portion of your clerkship, you will have the opportunity to evaluate patients in our Psychiatric Primary Care Clinic. This clinic is designed to provide comprehensive ambulatory medical and psychiatric care for patients with chronic psychiatric illnesses. Each patient receives a thorough medical and psychiatric evaluation by a multidisciplinary treatment team with emphasis placed on preventive and maintenance healthcare. You will be responsible for aiding in the workup and evaluation of these patients. The staff in the Psychiatric Primary Care Clinic will closely supervise these evaluations.
Clozapine Clinic: The Clozapine Clinic provides follow-up care for all of our outpatients on Clozapine. These patients typically carry the diagnosis of schizophrenic and have generally been severely psychotic and refractory to other antipsychotic medications. Each patient presents to the clinic every other week for follow-up psychiatric and laboratory evaluations. You will be assigned to this clinic during your outpatient rotation and will be responsible for providing follow-up psychiatric assessments for these patients under the close supervision of Carolyn Stanley-Tilt NP.
Psychiatric Consultation Service: You will be assigned to work on our psychiatric consultation service during your two weeks of ambulatory psychiatry. Our consultation service provides psychiatric consultations to the inpatient medical and surgical services. At the assigned times, you should page Dr. Bader (pager 755) who will coordinate your activities on this service. Psychiatric consultation requests are called into the Mental Health Service Line office (X2515) that will in turn page you with the patient's name, location, and reason for consultation. You will be expected to thoroughly evaluate the patient with a full history and mental status examination. Physical examinations are not usually required. The patients will be presented to one of our consultation attendings that will see the patient and aid in the development of a complete assessment and set of recommendations for the primary physicians. You will then be expected to complete the consultation write-up and communicate the recommendations verbally to the requesting physician. Our goals are to familiarize you with the processes of consultation psychiatry as well as emphasize the complex interactions between medical and psychiatric disorders in this patient population.
Psychiatric Emergency Room: You will be assigned to the psychiatric ER for at least one afternoon during each of the six weeks of your rotation with us. Report to the VA Emergency Room at the times assigned on your schedule. You will be expected to thoroughly assess ambulatory patients who present to the Emergency Room with a complete history, mental status exam and physical exam (when appropriate). Dr. Griffeth (Pager 570) will staff each patient with you and will help develop a complete assessment and plan. In this setting, you will be exposed to a variety of neuropsychiatric emergencies, including patients who are acutely suicidal, homicidal, and/or psychotic. In addition, you will gain experience in crisis intervention.
Telemedicine: Telemedicine is a videoconference between outpatients in the Tazewell area and our facility. It meets every Tuesday morning at 9 AM in Building 11, Second Floor. Ask Mental Hygiene Clinics where the clinic is located.
Each of the above ambulatory care experiences will be explained in more detail with specific dates and times assigned on the day of orientation to our facility.
PASSPORTS:
The clinical passports are a group of forms specific for each clerkship and identify the clinical skills relevant to the particular clerkship that need to be successfully demonstrated by each student, observed and documented by a member of the faculty. It is the student's responsibility to make sure that his/her passport is completed and turned in at the end of the clerkship. The passports are not used for grading purposes but are a mechanism to document the satisfactory performance of clinical skills. Successful completion of the passport is required to satisfactorily complete a clerkship. It is recommended that you not wait until the end of the clerkship to present your passport to your attending. Rather, work through the passport skills over the 6- week period.
CONFERENCES/DIDACTICS:
Catawba Hospital Case Conference: The Catawba Hospital Case Conference takes place every Tuesday afternoon of the six-week rotation. This conference focuses on women's issues in psychiatry, but is not solely limited to this area. You will need to provide your own transportation to Catawba Hospital, which is approximately 15-20 minutes drive from the VA Psychiatry Clerkship. Have the operator, located in the lobby of Catawba Hospital; page the supervisor of medical students when you arrive on Tuesday afternoons. You will have the opportunity to interview female patients with a variety of psychiatric syndromes as well as male patients with unusual or particularly interesting findings. Your supervisor will observe the interviews and lead discussions pertaining to the patients you evaluate. Our goal is to increase your exposure to psychiatric disorders in women and help you continue to improve your interviewing skills.
In addition to the case conference, you will have an opportunity to spend a morning on rounds at the Catawba State Hospital once during your clerkship. This experience will help to diversify your overall experience with exposure to a somewhat different psychiatric population.
Tellian Case Conference: These rounds are designed specifically for student teaching and to date have been one of the most popular and informative activities offered during our clerkship. Tellian case conference begins at 3:00 PM every Wednesday. Report to Building 11, Second floor, report to Mental Hygiene Clinic clerk.
Case Conference with Dr. Spradlin: This conference takes place in Dr. Spradlin's office on 11-1, Room 104 at 10:30 am on every Thursday of the rotation. One student assigned to the inpatient service should bring a patient to each conference to be interviewed. You will have the opportunity to interview patients with Dr. Spradlin observing. Interviewing skills and the patient psychopathology will be discussed following the interview. Improving interviewing skills and understanding non-verbal forms of communication will be major focuses of the conference.
Group Psychotherapy with Patty Porterfield: These sessions will be held in Building 11, Basement Level, Room 13. You will be notified when she is able to conduct this group during the rotation. The group is reserved primarily for medical students and you will have the opportunity to discuss your own opinions, feelings, and emotions concerning the experiences you are having in this clerkship and in life in general. With this experience, we hope to further increase your understanding of group processes and your appreciation for the significance of group therapy in the management of patients with psychiatric syndromes.
Lectures: Your behavioral medicine and psychiatry clerkship at the Salem VAMC will include an extensive didactic lecture series. Lectures will be held from 12 noon to 1PM on Monday, Tuesday and Wednesday (unless noted otherwise on the lecture schedule). The lectures are intended to build upon the fundamental knowledge base obtained in the first and second years of your medical school training. We strive to make these lectures pertinent to your clinical experience.
Each of the major psychiatric disorders will be covered with appropriate handouts and audiovisual materials as needed. Each of these activities will be explained in greater detail on the day of orientation and specific dates and times will be assigned.
CALL:
You will be expected to take call for one weekend (Friday evening, Saturday and Sunday during the day) during your rotation with us. You should check the call schedule on the days you plan to work and page the resident assigned to that day. You should ask when and where to meet them on the appropriate day. You are responsible for working up new patients admitted to the acute psychiatry services as well as participating in the management of psychiatric or medical problems in patients already on the service. You will have the opportunity to present the new patients you work up to the attending psychiatrist on-call who will aid in developing a complete assessment and plan for those patients.
Revised June 2004
Welcome to the Salem VAMC! We hope to make your time with us as educational, yet enjoyable, as possible. Your six-week rotation with us will include a balanced combination of ambulatory care and inpatient psychiatry experience, as well as a didactic lecture series and a variety of other educational activities.
INPATIENT EXPERIENCE:
During four weeks of your rotation, you will be assigned to one of our acute inpatient psychiatric units. There you will be expected to participate in the neuropsychiatric assessment, planning, and management of patients on your service. You should be involved in the work-up of approximately three new patients per week and will be expected to participate in daily rounds, multidisciplinary team meetings, family meetings, and commitment hearings. During this portion of your clerkship rotation, we hope to provide a better understanding and appreciation for the management of patients with acute neuropsychiatric syndrome.
AMBULATORY CARE EXPERIENCE:
The remaining two weeks of your rotation will be spent rotating through a variety of ambulatory care services offered at our VA Medical Center. The services through which you will be rotating include the following:
Mental Hygiene Clinic (Salem VA based ambulatory care psychiatry clinic): During this experience you will have the opportunity to work closely with outpatient psychiatry attendings in evaluating and managing ambulatory psychiatry patients. You will be exposed to a variety of psychotherapeutic and psychopharmacologic treatments as well as participate in the continuity of care for these patients.
Psychiatric Primary Care Clinic: During this portion of your clerkship, you will have the opportunity to evaluate patients in our Psychiatric Primary Care Clinic. This clinic is designed to provide comprehensive ambulatory medical and psychiatric care for patients with chronic psychiatric illnesses. Each patient receives a thorough medical and psychiatric evaluation by a multidisciplinary treatment team with emphasis placed on preventive and maintenance healthcare. You will be responsible for aiding in the workup and evaluation of these patients. The staff in the Psychiatric Primary Care Clinic will closely supervise these evaluations.
Clozapine Clinic: The Clozapine Clinic provides follow-up care for all of our outpatients on Clozapine. These patients typically carry the diagnosis of schizophrenic and have generally been severely psychotic and refractory to other antipsychotic medications. Each patient presents to the clinic every other week for follow-up psychiatric and laboratory evaluations. You will be assigned to this clinic during your outpatient rotation and will be responsible for providing follow-up psychiatric assessments for these patients under the close supervision of Carolyn Stanley-Tilt NP.
Psychiatric Consultation Service: You will be assigned to work on our psychiatric consultation service during your two weeks of ambulatory psychiatry. Our consultation service provides psychiatric consultations to the inpatient medical and surgical services. At the assigned times, you should page Dr. Bader (pager 755) who will coordinate your activities on this service. Psychiatric consultation requests are called into the Mental Health Service Line office (X2515) that will in turn page you with the patient's name, location, and reason for consultation. You will be expected to thoroughly evaluate the patient with a full history and mental status examination. Physical examinations are not usually required. The patients will be presented to one of our consultation attendings that will see the patient and aid in the development of a complete assessment and set of recommendations for the primary physicians. You will then be expected to complete the consultation write-up and communicate the recommendations verbally to the requesting physician. Our goals are to familiarize you with the processes of consultation psychiatry as well as emphasize the complex interactions between medical and psychiatric disorders in this patient population.
Psychiatric Emergency Room: You will be assigned to the psychiatric ER for at least one afternoon during each of the six weeks of your rotation with us. Report to the VA Emergency Room at the times assigned on your schedule. You will be expected to thoroughly assess ambulatory patients who present to the Emergency Room with a complete history, mental status exam and physical exam (when appropriate). Dr. Griffeth (Pager 570) will staff each patient with you and will help develop a complete assessment and plan. In this setting, you will be exposed to a variety of neuropsychiatric emergencies, including patients who are acutely suicidal, homicidal, and/or psychotic. In addition, you will gain experience in crisis intervention.
Telemedicine: Telemedicine is a videoconference between outpatients in the Tazewell area and our facility. It meets every Tuesday morning at 9 AM in Building 11, Second Floor. Ask Mental Hygiene Clinics where the clinic is located.
Each of the above ambulatory care experiences will be explained in more detail with specific dates and times assigned on the day of orientation to our facility.
PASSPORTS:
The clinical passports are a group of forms specific for each clerkship and identify the clinical skills relevant to the particular clerkship that need to be successfully demonstrated by each student, observed and documented by a member of the faculty. It is the student's responsibility to make sure that his/her passport is completed and turned in at the end of the clerkship. The passports are not used for grading purposes but are a mechanism to document the satisfactory performance of clinical skills. Successful completion of the passport is required to satisfactorily complete a clerkship. It is recommended that you not wait until the end of the clerkship to present your passport to your attending. Rather, work through the passport skills over the 6- week period.
CONFERENCES/DIDACTICS:
Catawba Hospital Case Conference: The Catawba Hospital Case Conference takes place every Tuesday afternoon of the six-week rotation. This conference focuses on women's issues in psychiatry, but is not solely limited to this area. You will need to provide your own transportation to Catawba Hospital, which is approximately 15-20 minutes drive from the VA Psychiatry Clerkship. Have the operator, located in the lobby of Catawba Hospital; page the supervisor of medical students when you arrive on Tuesday afternoons. You will have the opportunity to interview female patients with a variety of psychiatric syndromes as well as male patients with unusual or particularly interesting findings. Your supervisor will observe the interviews and lead discussions pertaining to the patients you evaluate. Our goal is to increase your exposure to psychiatric disorders in women and help you continue to improve your interviewing skills.
In addition to the case conference, you will have an opportunity to spend a morning on rounds at the Catawba State Hospital once during your clerkship. This experience will help to diversify your overall experience with exposure to a somewhat different psychiatric population.
Tellian Case Conference: These rounds are designed specifically for student teaching and to date have been one of the most popular and informative activities offered during our clerkship. Tellian case conference begins at 3:00 PM every Wednesday. Report to Building 11, Second floor, report to Mental Hygiene Clinic clerk.
Case Conference with Dr. Spradlin: This conference takes place in Dr. Spradlin's office on 11-1, Room 104 at 10:30 am on every Thursday of the rotation. One student assigned to the inpatient service should bring a patient to each conference to be interviewed. You will have the opportunity to interview patients with Dr. Spradlin observing. Interviewing skills and the patient psychopathology will be discussed following the interview. Improving interviewing skills and understanding non-verbal forms of communication will be major focuses of the conference.
Group Psychotherapy with Patty Porterfield: These sessions will be held in Building 11, Basement Level, Room 13. You will be notified when she is able to conduct this group during the rotation. The group is reserved primarily for medical students and you will have the opportunity to discuss your own opinions, feelings, and emotions concerning the experiences you are having in this clerkship and in life in general. With this experience, we hope to further increase your understanding of group processes and your appreciation for the significance of group therapy in the management of patients with psychiatric syndromes.
Lectures: Your behavioral medicine and psychiatry clerkship at the Salem VAMC will include an extensive didactic lecture series. Lectures will be held from 12 noon to 1PM on Monday, Tuesday and Wednesday (unless noted otherwise on the lecture schedule). The lectures are intended to build upon the fundamental knowledge base obtained in the first and second years of your medical school training. We strive to make these lectures pertinent to your clinical experience.
Each of the major psychiatric disorders will be covered with appropriate handouts and audiovisual materials as needed. Each of these activities will be explained in greater detail on the day of orientation and specific dates and times will be assigned.
CALL:
You will be expected to take call for one weekend (Friday evening, Saturday and Sunday during the day) during your rotation with us. You should check the call schedule on the days you plan to work and page the resident assigned to that day. You should ask when and where to meet them on the appropriate day. You are responsible for working up new patients admitted to the acute psychiatry services as well as participating in the management of psychiatric or medical problems in patients already on the service. You will have the opportunity to present the new patients you work up to the attending psychiatrist on-call who will aid in developing a complete assessment and plan for those patients.
Revised June 2004