4th year electives

[reca]

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We're picking our 4th year electives and have considerable flexibility. Our moonlighting is pretty restricted so I figured I'd make the most of my 4th year by choosing unique electives that will help me the most down the road. I've got a clozapine clinic, transplant psychiatry rotation, and administrative psychiatry rotation decided on. Are there any recommendations that people have that they did their 4th year or would have liked to have done?

 

[splik]

I don't have specific electives per se but I would strongly recommend trying to get the full spectrum of foundational aspects of psychiatry as possible including eating disorders, autism/intellectual disabilities, ADHD, TBI, dementia (particularly early onset dementia), sexual dysfunction, sex offenders, and try to get a strong foundation in psychopharmacology including using clozapine (which seems like you will get), TCAs, and MAOIs. If you have the option of getting training in family and/or couples therapy go for it. Some things are somewhat faddish and it will be possible to easily learn on the job (e.g. TMS, ketamine, esketamine) and I would not recommend prioritizing unless you plan on working in brain stimulation out the gate. ECT on the other hand may be a more tangible skill and will also give you opportunity to see complex refractory cases.

You will continue learning a ton following training if you keep yourself switched on and active. However some things are much easier to learn later, and somethings, if you don't learn in residency, you may never get comfortable with. I would also consider what things are particular strengths of your institution that would want to take away while you can.

 

[st2205]

I did two weeks of a movement disorders rotation and found that fairly applicable to every day psychiatry.

 

[adiradirim]

If you're interested in any other field of medicine that is tangentially related, now's the time: sleep, neuroradiology, pain, headache, rheum, maybe endocrine. Other options if you have them would be any LGBT health or specific transgender clinics in addition to the ones mentioned above. Try to make your experiences as well rounded as possible while you still have the chance!

In medical school I did a forensic pathology rotation and honestly that may have been the most influential medical school rotation in terms of learning about death/dying. Probably 60% of the autopsies were psychiatric related (suicide, OD, sudden death while on psych meds). YMMV

 

[clausewitz2]

If you're interested in any other field of medicine that is tangentially related, now's the time: sleep, neuroradiology, pain, headache, rheum, maybe endocrine. Other options if you have them would be any LGBT health or specific transgender clinics in addition to the ones mentioned above. Try to make your experiences as well rounded as possible while you still have the chance!

In medical school I did a forensic pathology rotation and honestly that may have been the most influential medical school rotation in terms of learning about death/dying. Probably 60% of the autopsies were psychiatric related (suicide, OD, sudden death while on psych meds). YMMV

Pretty sure OP is talking about residency electives, not med school.

Echoing @st2205 , I did three months in an epilepsy clinic that was super helpful. Also a sleep medicine rotation, ideally with someone psychiatry trained.

 

[psyguru]

a forensic rotation may help you with a diagnosis. You have hours to interview an examinee and then (paid) time to review boxes of records. Then you have hours to tease out the minutia of what the diagnosis is and explain it clearly to the fact finder in the form of a report or testimony. also you will be able see and smell malingering more so. I learned more about the dsm5 in my fellowship than during my residency. I also agree with looking into niches you will not otherwise never see such as eating disorders, sleep, etc.