Advice: 3rd year Psychiatry Rotation?

[Hawk22]

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Hi all,

Just writing to get opinions from residents and upper level medical students, looking for advice for the 3rd year clearkship in psychiatry. Nothing specific, just general advice on what it takes to do well, learn as much as possible, and get a decent/good grade in the end (other than working hard, being organized, and reading about your patients, which is a given of course). What seperates the "good" from the "great" medical student on this rotation? What are the things you wished someone would have told you BEFORE the rotation that you didn't hear? Any special study tips or ward advice?

For studying, I'm basically planning to use First Aid for Psychiatry Clerkship and maybe BRS Psychiatry. For questions, it seems like most people like Pretest Psychiatry, so I'll most likely use that as well. For more of a reference and in-depth reading, I have the Introductory Textbook of Psychiatry by Andreasen....but I'm thinking about picking up the Current Concepts in Psychiatry instead. Any other recommendations? Anyone use the Kaplan & Sadock's Study Guide and Self-Examination Review? I looked at it today....over 500 pages and 1600 questions seems like a bit of overkill to me for 6 weeks (but if anyone has experience otherwise, feel free to chime in).

I did a few searches, but didn't find a whole lot...so I decided to start a new thread. Any words of wisdom would be much appreciated. Thanks in advance! 🙂

 

[DrMom]

Are you in an inpatient, outpatient, or combo setting?

In my rotation, I would get to the ward early so that I could talk to all of the patients & chart before the Dr got there. I'd give him a report when he got there. It was important for me to remember not only to ask them about depression, anxiety, A/V hallucinations, suicidal/homicidal ideation, etc, but also things like how well they were sleeping. I also learned to verify as much as I could (esp with things like sleeping, participation in activities) with the staff as sometimes I'd get inaccurate reports from the patients (sometimes because they were delusional & sometimes because they were manipulative). I found it very helpful to review the chart of any new admit before talking to them so that I could as the most appropriate questions. Most of the time I'd ask the patients the same basic set of questions, but sometimes their situation leads to some additional (and sometimes interesting) things to ask. ie: I had a patient who insisted that everything was fine and didn't seem the least bit delusional, but if you asked her about her family, she'd go off on how her MIL was trying to kill her and was clearly delusional.

Spend time talking to the patients & observing the group & individual activities they have. Find out what the rest of the staff's roles are. I learned a lot from the nurses, social workers, and psych techs. Read up on the psych drugs.

I solely used Kaplan & Sadock's Study Guide as my school's exam came from it. It's not a bad resource, but I don't know how worth-while it is if it isn't what your test is based on.

I spent 1/2 of my time on the locked ward and 1/2 in an outpatient setting. I didn't get nearly as much out of sitting in the office listening to the Dr talk to the patients, although I did get to see follow-up on some of the ones that had been in-pt with me.

Hope that helps a little bit 🙂

 

[Hawk22]

Are you in an inpatient, outpatient, or combo setting?

In my rotation, I would get to the ward early so that I could talk to all of the patients & chart before the Dr got there. I'd give him a report when he got there. It was important for me to remember not only to ask them about depression, anxiety, A/V hallucinations, suicidal/homicidal ideation, etc, but also things like how well they were sleeping. I also learned to verify as much as I could (esp with things like sleeping, participation in activities) with the staff as sometimes I'd get inaccurate reports from the patients (sometimes because they were delusional & sometimes because they were manipulative). I found it very helpful to review the chart of any new admit before talking to them so that I could as the most appropriate questions. Most of the time I'd ask the patients the same basic set of questions, but sometimes their situation leads to some additional (and sometimes interesting) things to ask. ie: I had a patient who insisted that everything was fine and didn't seem the least bit delusional, but if you asked her about her family, she'd go off on how her MIL was trying to kill her and was clearly delusional.

Spend time talking to the patients & observing the group & individual activities they have. Find out what the rest of the staff's roles are. I learned a lot from the nurses, social workers, and psych techs. Read up on the psych drugs.

I solely used Kaplan & Sadock's Study Guide as my school's exam came from it. It's not a bad resource, but I don't know how worth-while it is if it isn't what your test is based on.

I spent 1/2 of my time on the locked ward and 1/2 in an outpatient setting. I didn't get nearly as much out of sitting in the office listening to the Dr talk to the patients, although I did get to see follow-up on some of the ones that had been in-pt with me.

Hope that helps a little bit 🙂

Thanks Dr.Mom
As far as I know, the vast majority of our psych rotation is inpatient and I haven't really heard anyone mention much about outpatient yet. We may have a day or two outside the hospital, but I think we have to wait until 4th year to get much outpatient work.

As far as the Kaplan & Sadock book, did you find the questions helpful? Did you do most of them or just hit the major topics? 1600 questiosn seems like alot... Did you just use the review/question book or did you read one of the "watered down versions" as well? Our only "test" is the psych shelf and I have no idea if it is based on K&S or not.

 

[DrMom]

Our test had word-for-word questions from that review book (we were assigned around 1000 of the questions...50 of which were on our exam), so it was helpful for me. I went through the questions 4 times and I didn't refer to any text or review book. I'm afraid I have no idea how good it is for the shelf. Hopefully someone who does know will come along soon. 🙂

 

[Hawk22]

Thanks, that helps. I thought the K&S questions looked pretty good, so maybe I'll pick it up (I've found I learn alot just by doing questions). I'm sure someone will chime in about the shelf, but I did a searcn and didn't see the K&S book mentioned much for shelf preperation. Again, thanks so much for the advice 😉

 

[Hawk22]

Bump....

Surely someone has some advice other than Dr. Mom?? Anyone?

 

[Back34]

I read Andreasen & Black's textbook for the rotation. It goes about 700 pages, but it's a pretty easy/quick/thorough read. It's probably not as comprehensive as Kaplan and Sadoch (sp?), but who wants to spend the day reading a thousand pages of 2 point font. That being said, I felt it really prepared me well for the rotation.

As far as the shelf exam goes, I used Pretest and BRS Psychiatry (highly recommend this book). Passing for our school was 62% and I wound up with an 84% and just found out I "honored" the rotation. Hope this helps.

 

[Hawk22]

Thanks for the info Back, it is much appreciated.

I've gotten the Current Clinical Stratigies in Psychiatry book for a primary text and BRS for review. The "Current" book is very good, but pretty detailed and takes a little while for me to get through. I'll probably just read the "big picture topics" in that and focus on BRS for the rest. For questions, I've got pretest and borrowed A&L from a friend. Also borrowed the "Case Files: Psychiatry" book that looks pretty good, but I"m not sure I'll have time to get through it.

 

[kcrd]

I used the big K+S synopsis for reference (and we had assigned readings from it), during the rotation I read St Francis Guide to Psychiatry. I read blueprints and UCV a few days before the test.