WhoisJohnGalt

NYC Psychiatrist
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I am about to start my inpatient psych sub-i. This is probably a silly question, but do I need to identify to the attending and residents that it should be treated as a sub-i? I don't know why else anyone would do an inpatient psych rotation fourth year, but I just don't know anything about the whole sub-i thing. Also, what makes the sub-i different from the 3rd year clerkship? Do you just have more patients? I'm just curious how it's typically different in psych. TIA for answering my neurotic questions :)
 

CaMD

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When they find out you're a 4th year they will probably assume you're doing a sub-I. (As you said, that's pretty much the only reason a 4th year would be around.) But if not, doesn't hurt to mention it.

What makes it different from 3rd year? Level of responsibility, number of patients.

As a sub-I you prioritize patient care work over classes/didactics type stuff. aka, as a 3rd year, if you had class, you left for class no matter what work wasn't done. Whereas as a sub-I, your job is to finish up that discharge summary, and you can go to class if there happens to be nothing else going on.
 

diosa428

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They'll probably tell you on your first day what is expected of you, and if you're not sure you should ask. I carried about 4-5 patients (as opposed to 1-2 on my clerkship), and overall carried more responsibility. I feel like on my clerkship there was more emphasis placed how to diagnose a patient and how to do a MSE, but as a 4th year you're expected to know that, and also have a plan for treatment, be able to assess for side effects of medications, etc. I was also more expected to be able to do medical management for any patients with comorbid medical problems. I had much longer hours as a 4th year, since our interns have to stay until a certain time and are responsible for admitting all patients that come in before that time, so even if there was nothing to do, leaving to "go study" was not an option. And I worked on weekends, which students on the clerkship did not.