Psychiatry & Human Behavior (PSYH)

This core clinical experience prepares future physicians to accurately assess, recognize, and plan treatment for a variety psychiatric disorders. Additionally, students will gain confidence and comfortability in treating patients with mental illness. The six week clerkship is divided into two three-week clinical placements to provide exposure to psychiatric care in a variety of settings. Students are considered an integral part of the treatment team and will evaluate and follow patients under faculty supervision, observing and participating in all aspects of patient care. Through exposure and guidance, students will learn skills in developing therapeutic relationships with patients while establishing appropriate treatment boundaries. Case based learning and didactic seminars are scheduled for a half-day per week and attended by all students. Site placements include possible experiences in consultation liaison psychiatry, adult & geriatric inpatient psychiatry, addiction psychiatry, and child & adolescent psychiatry. Offered at Thomas Jefferson University Hospital and affiliate locations. (6 week clerkship)

The student is assigned to an adult inpatient unit to function as a sub-intern in this setting. The assignment is a continuation of the inpatient work of the junior clerkship, but at a higher level of responsibility. Broad exposure to serious psychiatric disorders is provided. The inpatient service also has beds dedicated to medical/surgical patients with prominent psychiatric co-morbidity. The sub-intern will be afforded the opportunity to function as a house officer and will have primary responsibility for his or her patients. The unit embraces the entire bio-psychosocial model as well as the multidisciplinary treatment team approach. Students participate in a weekly faculty-led patient interview and case conference. Students will thereby enhance their diagnostic and treatment skills as well as their abilities to assume a leadership role. Students are evaluated by attending psychiatrists, residents, and treatment team members through direct observation of interactions with patients and families, assessment of sophistication of chart entries, and competence obtaining and presenting patient histories, formulating cases, and carrying out basic treatment planning.

This is one of two outpatient sub-internships that meet the senior student’s ambulatory requirement (see also PSYH 408). Students engage in all aspects of clinical work in the Sleep Disorders Center, an outpatient program for the evaluation and management of sleep disorders. The program encompasses a Sleep Laboratory, inpatient consults at Jefferson Hospital Gibbon Building and outpatient clinic at the Sleep Disorders Center in Center City, as well as our satellite locations at the Navy Yard and 700 Walnut. Students are expected to observe the evaluation and management of patients and, after training, to gather an initial database, formulate a differential diagnosis, and develop recommendations for further workup and management. Students are directly supervised by attending physicians most of the time, and, to a lesser degree, house staff including residents in psychiatry, fellows in pulmonary and critical care medicine, and fellows in sleep medicine. Students observe polysomnographic studies and become familiar with sleep monitoring and scoring techniques. They are involved in performing consultations for inpatients. Reading material is provided as reference. Students are encouraged to complete an academic project by the end of the rotation, which can take many forms, including detailed case reports, topical presentations, and literature reviews. Evaluation is accomplished through direct observation of student interactions with patients by faculty and house staff as well as assessment of sophistication of chart entries and competence presenting patient information and assigned projects.

This sub-internship is designed to help the fourth year medical student develop the advanced skills needed to be a competent intern. The skills developed during this rotation will be equally relevant to students planning to pursue psychiatry residency and students planning careers in other specialties. This rotation is primarily based at the outpatient addictions clinic, but the training focus includes substance use disorders and the broad range of ambulatory psychiatric disorders affecting this population, including mood, anxiety, and personality disorders. During this rotation students develop their skills in the following areas: interviewing a patient and presenting a comprehensive history and mental status exam, developing a differential diagnosis, and planning treatment. In recognition of the ubiquitous nature of substance use disorders, students will be expected to develop an understanding of the signs and symptoms of intoxication and withdrawal from various substances of abuse and the full spectrum available in pharmacologic, behavioral, and psychotherapeutic treatment options. In addition the sub-intern student will be expected to act as a “supervisor” to the third year medical students who are rotating on the service. This experience will help prepare the sub-intern to assume the teaching responsibilities of a first-year intern. This rotation provides the unique opportunity for students to gain experience in the management of outpatients in a psychiatric clinic. Students are encouraged to follow patients, as frequently as once a week, throughout their rotation. Students will also have the opportunity to observe senior attending physicians’ with different subspecialty expertise (e.g. psychoanalysis, psychopharmacology, mood disorders) evaluate new patients. Students will also participate in case conferences in the general adult outpatient service.

Join a full-model (comprehensive) DBT team for a month. Attend DBT-related didactics, participate in DBT Consultation Team, observe DBT skills group taught by a DBT-Certified Clinician (Dr. O’Hayer), observe and participate in a DBT skills group run by two clinicians, observe and participate in a DBT graduate group. Observe and participate in a mindfulness meditation group aimed at Accessing Wise Mind. Complete a DBT behavioral Case Formulation focused on one of the patients whose treatment you have observed in this elective.

Departmental research is scheduled after consultation with the department and approval of a research project. Students may complete up to 12 credits (or 8 weeks) of research in Phase 3. Students wishing to count their research project towards the SI requirement in Phase 3, must receive permission from the SI Director and complete a capstone project.

During this elective the student (1) develops skill in the evaluation and treatment of psychiatric illness in the medical setting, (2) develops an appreciation for the interface between psychological/social factors and medical illness, and (3) learns about the variety of consultation services provided by a psychiatrist in the general hospital. The student functions as an integral clinical member of the Consultation-Liaison Service. He or she is responsible for performing initial consultations and follow-up as indicated. Because the C-L service receives requests for consults from virtually all clinical services at Thomas Jefferson University Hospital, a student has the opportunity to gain experience with the management of a wide range of clinical issues. The student is supervised by the Attendings and Resident(s) assigned to the service and fellow(s) in psychosomatic medicine. Students participate in daily teaching rounds. There is a formal didactic meeting each week and weekly grand rounds.