PSYCHIATRIC rOTATION


Team Structure

Schedule

Goals and Objectives

Key Readings


Neurology residents will rotate on Psychiatry Consult-Liaison for one month during their PGY-3 year of training. During your time on this service, you will see psychiatry consults along with the psychiatry team.

For details about the service, please review: Psychiatry Consult/Liaison Service Policies and Procedures

The Consult-Liaison chief should reach out shortly before your rotation to provide further information including which attending you are assigned to as well as documents e.g. interview template, info gathering and dot phrases.

On Day 1 of your rotation report at 8 AM to the Consult Liaison work room P1G25, first floor shock trauma hallway. You can also pick up a key to this room at P1H10 (located in the hallway between the shock trauma elevators and rotunda).

Team Structure

Psychiatry Attendings:

Charles Robinson, MD - Med-ICI  (preferentially covers consults from the medicine teams)

David Glovinsky, MD – General UMMC consults

Anique Forrester, MD – General UMMC consults

Samantha Latorre, MD – STC-ICI (preferentially covers consults from Shock Trauma)

Psych residents are each assigned to one attending. You will staff and see every consult you are assigned the same day, but will need to find an attending who is free (i.e. not currently staffing with a psych resident).

‍3-4 Psychiatry Residents: Typically the residents rotating on this service are PGY-2's, and thus are the same class of residents the PGY-3 neurology residents worked with on the Stroke, General, and VA services. Sometimes there are other rotating residents from family medicine or internal medicine and possible CL fellows.

‍3-4 Medical Students

Schedule

You should arrive by 8 AM daily (P1G25 - in the corridor leading to the Shock Trauma auditorium) for sign-out. Consults are assigned in bulk in the morning and again at 1 PM. Sign out with the on-call psychiatry resident occurs at 4 PM.

Rotation Calendar

  • The neurology resident should function as a member of the psychiatry consult liaison team. Patient care and didactics take priority over any other activities.

  • With the exception of once-a-week Continuity Clinic, the neurology residents will follow the same schedule as the psychiatry residents while on the rotation.

    • Taking consults in turn with other team members

    • Psychiatry didactics (daily didactics and grand rounds)

      • CL Service Case of the Day (Typically Tues, Wed) CL Work Room at 12 PM

      • Friday Seminars (Typically Friday) CL Work Room at 12 PM

      • Didactics (Every Thursday morning) Virtual or at 701 W. Pratt, 4th floor

    • If the C-L service is not busy, neurology residents can attend neurology grand rounds and neurology midday didactics, but neurology didactic sessions are NOT required when residents are on the psychiatry rotation.

  • The neurology resident has no night or weekend call for the psychiatry service.

consults

Consults are called in and fielded by an administrative assistant who records general information (patient demographics, primary team, reason for consult, etc.). This information is then passed on to the residents on a rotating basis. While consults are called in all day, they are dispatched out to the residents twice a day: once in the morning and once in the afternoon.

*You will be assigned 1-3 consults per half day and the residents or attendings will give you the contact information for the primary team.

Resident Responsibilities:

Residents will evaluate psychiatry consult patients and present the patient to the psychiatry attending and team.  Under the guidance of psychiatry attendings, residents will formulate a differential diagnosis and treatment plan.  The neurology resident will take responsibility for new consultation patients in rotation with the other residents on the service. The resident will own their consult patients and should continue to follow/write follow up notes as appropriate.

Evaluation

Evaluations of the resident performance will be sent to all Psych attendings in MedHub.

GOALS AND OBJECTIVES

The following Goals and Objectives are linked to the core competencies of “Patient Care” and “Medical Knowledge”.

  • Become proficient in obtaining an appropriate psychiatric history

  • Learn to recognize when a patient may have a psychiatric disorder

  • Learn indications for medications commonly used in psychiatry

  • Learn about complications of medications used in psychiatry

  • Learn about psychological aspects of patient-physician relationship

  • Learn about importance of personal, social, and cultural factors in disease processes and their clinical expression

  • Learn to identify and diagnose common psychiatric disorders

Key READINGs

Role of Antipsychotics in Delirium Management

Comparative Efficacy Study of Haloperidol, Olanzapine, and Risperidone in Delirium

Assessment of Patients’ Competence to Consent to Treatment

QTc Prolongation by Psychotropic Drugs and the Risk of Torsade de Pointes






OTHER REFERENCE MATERIAL

These additional references are available in both the C-L office and our own Resident Library:

  • The American Psychiatric Association Publishing Textbook of Psychosomatic Medicine and Consultation-liaison Psychiatry Revised Edition

  • Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 5th Edition






Last Updated: August 12, 2024