What should I know for my first psych sub-I?

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uhmocksuhsillen

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Start my first psychiatry sub-i at a university program in a week. Definitely set on applying to psychiatry next year and really want to use this month to get a good letter from a big program.

I'm reading through a general psychiatry book right now, but what am I going to be expected to do from day 1? I feel like my ability to conduct a smooth patient interview could be much improved. I received mostly honors in third year and am able to converse well with people, but the psychiatric interview is still a work in progress.

Is there going to be a big step up in what was expected from my third year rotation (I realize this is hard to answer, but in general) to my first sub-i?

Any other bits that could help me do well and/or get a good letter? Any specific pocket guides or apps to carry with me? Thanks so much.

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is this inpatient? or consults? Our great sub-is aren't the ones that know the most or are the most polished and skilled in their interview skills at the beginning of the rotation. They are the ones that are enthusiastic, teachable, work hard, want to learn as much as possible and see as many patients are they can, can adapt to change and learn how to function in a new environment quickly, actively solicit and respond non-defensively to feedback at the right time, are proactive, can be trusted to complete assigned tasks, are easy to work with and get along with, ask for help when they feel stuck, take the opportunity to be involved in additional projects (e.g. writing up an interesting case for publication or as poster presentation) and most importantly, don't irritate the hell out of everyone. This is the most important skills to survive as a medical student, especially on away rotations. Annoy the wrong person and you will not be ranked at all. As I say, it's not what you know, it's who you don't annoy.

BTW, it is perfectly legit (and sensible) to ask your attending, "what do I need to do to do well on this rotation and get a strong LoR from you?"

1. you should be the first person to arrive and the last one to leave.
2. never make the residents look bad.
3. you should know about all your patients and read their charts thoroughly so you know their history inside out and keep abreast of overnight events
4. you should gather collateral including from family, outpatient therapists/psychiatrists and fax record requests etc
5. you should read up on the problems your patients have etc.
6. you should, once a week, bring in a paper relevant to patient care and do a very brief presentation etc on this. The key word here is relevant.
7. Don't be intrusive, pushy, or ask for feedback etc when things are busy or other things are going on. Instead ask "when might be a good time for us to discuss x..."
8. don't try to0 hard. nobody likes desperation.
9. remember away rotations are more a chance for you to answer "is this somewhere I would like to be" than for the program to decide whether they want you. free yourself from having to feel that
10. be respectful to everyone.
11. if you can bake, bring some baked treats in. otherwise, store bought is fine.
 
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is this inpatient? or consults? Our great sub-is aren't the ones that know the most or are the most polished and skilled in their interview skills at the beginning of the rotation. They are the ones that are enthusiastic, teachable, work hard, want to learn as much as possible and see as many patients are they can, can adapt to change and learn how to function in a new environment quickly, actively solicit and respond non-defensively to feedback at the right time, are proactive, can be trusted to complete assigned tasks, are easy to work with and get along with, ask for help when they feel stuck, take the opportunity to be involved in additional projects (e.g. writing up an interesting case for publication or as poster presentation) and most importantly, don't irritate the hell out of everyone. This is the most important skills to survive as a medical student, especially on away rotations. Annoy the wrong person and you will not be ranked at all. As I say, it's not what you know, it's who you don't annoy.

BTW, it is perfectly legit (and sensible) to ask your attending, "what do I need to do to do well on this rotation and get a strong LoR from you?"

1. you should be the first person to arrive and the last one to leave.
2. never make the residents look bad.
3. you should know about all your patients and read their charts thoroughly so you know their history inside out and keep abreast of overnight events
4. you should gather collateral including from family, outpatient therapists/psychiatrists and fax record requests etc
5. you should read up on the problems your patients have etc.
6. you should, once a week, bring in a paper relevant to patient care and do a very brief presentation etc on this. The key word here is relevant.
7. Don't be intrusive, pushy, or ask for feedback etc when things are busy or other things are going on. Instead ask "when might be a good time for us to discuss x..."
8. don't try to0 hard. nobody likes desperation.
9. remember away rotations are more a chance for you to answer "is this somewhere I would like to be" than for the program to decide whether they want you. free yourself from having to feel that
10. be respectful to everyone.
11. if you can bake, bring some baked treats in. otherwise, store bought is fine.

Thanks so much for that write-up...your contributions here are always much appreciated.

This will be a consult+liaison sub-internship for reference.
 
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8. don't try to0 hard. nobody likes desperation.

11. if you can bake, bring some baked treats in. otherwise, store bought is fine.
While I had to laugh at this juxtaposition, it is sadly true. Such is the unfortunate reality of the Ice Cream Cone of the medical hierarchy.
 
I agree with the suggestions offered, and often medical students (including myself at the time) do not realize how important attitude is to residents and attendings.
But I would also add that your knowledge level is important as a fourth year. You should be able to see a patient and be able to come up with an appropriate differential and be on the right track in choosing a medication if one would be helpful. When I was a PGY3 we had a sub-I who did not know what fluoxetine or alprazolam were. His knowledge base was so weak that when asked what the most efficacious mood stabilizer is for children, he guessed escitalopram. He definitely would not have needed to get it correct, but guessing a medication in a completely different class is worrisome. That particular student did not match into psychiatry for at least two cycles that I know of and then I lost touch with him.
 
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