Psychiatry

Department Chairman: James A. Greene, M.D.
Director of Medical Student Education: Renate Rosenthal, Ph.D.
Office: 448-4553 (direct line); 448-6400 (Terika Miller)
Contact: Terika Miller

E-mail is by far the preferred mode of communication for this clerkship. Any requests for placements must be directed via e-mail to Dr. Renate Rosenthal, NOT to the contact person. Telephone requests will NOT be accepted. Requests for specific Attendings will NOT be accepted, but requests for locations (MMHI, VA, St Francis Hospital, or the MED) will be considered, as space is available. Please note this is not "first come-first serve.” If there are more requests than spots for any given location, assignments will be made by random drawing.

Since this is a required clerkship, students should not expect to schedule interviews or be given time off for personal reasons.

The 4-week Psychiatry Clerkship is presented in the junior year. It is offered in Memphis year-round and in Chattanooga four times a year. Please contact Ms. Ruby Bland in the Office of Medical Education for dates and availability. The Chattanooga clerkship experience is comparable to the Memphis clerkship. Full description will follow the Memphis course description.

Memphis:

Students in Memphis will have their home base in one of four hospitals (see above). All students attend lectures, teaching conferences, and Grand Rounds downtown. Attendance is required. All clinical services are run by full time (not rotating) Attendings. Students work closely with Attendings, Residents, Psychologists, and other team members.

The bulk of patients will be adults, with considerable exposure to the geriatric population. All students will witness ECT (Electroconvulsive treatment) at St. Francis Hospital. In addition, each student will visit an inpatient unit for children and adolescents for a half day. Interested students can ask for additional exposure to child and adolescent psychiatry.

Students' final grades reflect exam performance (National Board Subject Exam), clinical evaluations by preceptors and residents, lecture and conference attendance, and professional conduct. Attendance and participation in conferences and other learning opportunities will also weigh heavily in determination of the final grade.

Prerequisites: Students are strongly encouraged to hold on to their M-2 lecture notes in Psychopharmacology and Psychopathology, and to refresh their memory in these subjects within the first 36 hours of the clerkship. This prior knowledge is expected from the very first day.

Course Objectives:

At the conclusion of the clerkship, students are expected to

  • Recognize and properly diagnose psychiatric problems commonly seen in medical practice, including those of the chronically and persistently mentally ill.
  • Use the framework of the bio-psycho-social model to gather patient information and make clinical decisions
  • Demonstrate good interviewing technique
  • Display basic knowledge of treatment and referral options, and know when to refer

Night Call:

There is no student overnight call requirement; however, attendance at weekend/holiday rounds is expected, on a rotating basis, and admissions duty (observation/participation) is offered. Established duty hour rules for students will be followed.

For complete information, please refer to the Psychiatry Clerkship web site on Blackboard (PSY-3001-0406). There you will find a detailed list of goals, objectives, and expectations, as well as orientation instructions.

Chattanooga

Clerkship Director: Terry Holmes, MD, MPH, and TM (email: Terry.Holmes@tn.gov)
Administrative Contact: Joyce Poke (email: joyce.poke@erlanger.org),
Crystal Champion (at Moccasin Bend) (email: crystal.h.champion@tn.gov),
and Gary Malakoff, MD (email: gary.malakoff@erlanger.org) Department of Medicine Phone: (423) 778-2998.

The Psychiatry Clerkship at a 4-week clerkship is located in Chattanooga at Moccasin Bend Mental Health Institute, a 150 bed hospital managed under the auspices of the Tennessee Department of Mental Health and Developmental Disability. The Clerkship can accommodate up to 4 students and is offered four times each year. All students will attend educational activities published by the office of the Clinical Director in association with the Department of Psychiatry at the UT COM Memphis. Most didactics will be video conferenced from Memphis to Chattanooga. Students will be exposed to a broad spectrum of psychiatric disorders presenting for admission from a 23 county catchment area. Attendance at lectures and teaching conferences is required. Clinical wards are run by a treatment team headed by an attending psychiatrist and a nurse practitioner. Treatment teams in addition include a coordinator, a team of social workers and activity therapists, nurses and psychiatric technicians. Psychology services are readily available and available on a consultation basis.

Students' final grade will be a reflection of examination performance (NBME Psychiatry shelf exam), clinical proficiency at psychiatric evaluation and mental status examination.

Attendance and participation in conferences and other learning opportunities will also weigh heavily in determination of the final grade.

Prerequisites: Students are strongly encouraged to hold on to their M2- lecture notes in Psychopharmacology and Psychopathology, and to refresh their memory in this domain within the first 36 hours of the clerkship. This prior knowledge is expected from the very first day.

Course objective: To develop skills in:

  1. Psychiatric evaluation. The student will be able to observe/participate in assessment of patients presenting to admission for possible admission.
  2. Develop an understanding of psychiatry and the law. Exposure to forensic psychiatry on a weekly basis is offered. Legal requirements for involuntary admission and treatment will be emphasized.
  3. Develop a working knowledge of psychopharmacology to include indications, mechanism of action, risks and benefits. An emphasis on cost-effective evidence based treatment will be a focus of learning.
  4. Evaluation and treatment of outpatients presenting to a psychiatric clinic, with exposure to issues of administration and insurance benefit.
  5. Case examples/vignettes incorporating differential diagnostic process will be reviewed locally and on-line with the course directors at UT Memphis.
  6. Develop knowledge of medical entities masquerading as psychiatric illness with an emphasis on diagnosis and management of delirium.
  7. Recognition and suspicion of substance abuse in clinical practice.

By the end of the clerkship, the student should be able to recognize and be able to formulate a differential diagnosis; including the possibility of comorbid or co-occurring diagnoses. Students should know commitment criteria and be able to complete a certificate of need for involuntary hospitalization, and have a working knowledge of the mechanics of hospitalization. Students should be able to develop an understanding of when and where to refer patients for further evaluation and treatment.

Student will be assigned to a 25 bed acute or sub-acute ward and will participate with the treatment team in development of a comprehensive treatment plan. Each student will have some responsibility for 6-8 patients in the 25-bed acute or sub-acute ward at Moccasin Bend on a daily basis. They will also have a similar number of patients in the Geri-Psych inpatient and outpatient services at Erlanger North. Each student will also have exposure to a half-day with a Pediatric Psychiatrist during the rotation as a well as another day with a local psychiatrist who provides electroconvulsive therapy (ECT).

Ultimate responsibility for patient care rests with the attending psychiatrist who leads the treatment team. Medical students will have limited responsibility but will be allowed to conduct supervised interviews with patients, and in accordance with hospital bylaws, all responsibilities for inpatient chart documentation rests with the treatment team. Students will have ample opportunity to present written and sample chart notes as part of their learning experience.

Moccasin Bend faculty and treatment team professionals will supervise students directly (physicians, psychologists, nurses, nurse practitioners, psychiatric technicians responsibilities for inpatient chart documentation rests with the treatment team. Students will have ample opportunity to present written reports and sample chart notes as part of their learning experience. Students will service in an observing role during the pediatric psychiatry and ECT portions of the clerkship.

Moccasin Bend faculty and treatment team professionals will supervise students directly (physicians, psychologists, nurses, nurse practitioners, psychiatric technicians. Erlanger North faculty will directly supervise students at that site.

Students will attend training sessions conducted by the course supervisor and other assigned professional staff. They will be expected to attend the regularly scheduled Nurse practitioner training scheduled twice monthly. They will have at least two or three formal didactic lectures each week, including several that will be available via videoconference from the UT Memphis Psychiatry Clerkship. Students will attend weekly Internal Medicine Grand Rounds at Erlanger Medical Center. They should attend any ad hoc case conference and sit in and participate in treatment Review Committees conducted in accordance with Tennessee Law. Students will also rotate through the on-site Medical Clinical to help treat psychiatric patients with acute and chronic medical problems.

There is no student overnight call requirement; however, attendance at weekend/holiday rounds and admissions duty (observation/participation) is offered. Established duty hour rules for students will be followed.

For more information about the Chattanooga Clerkships (including housing, meals, etc.), go to www.utcomchatt.org/medicalstudents.

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Contact Us

UTHSC College of Medicine

Phone:901-448-5529
Fax: 901-448-7683

Executive Dean:
David M. Stern, M.D.