Psychiatry Rotation
Assessment
Mid-Rotation Assessment
Mid-Rotation Assessment
Domains assessed: Fund of Knowledge, Knowledge Integration, History taking, Clinical Examination, Clinical Management, Learning Skills, Communication Skills, Professional Responsibility and Integrity, Pursuit of Excellence and Insight, Personal Interactions. Essential Clinical Encounters review.
Curriculum Block
Clerkship / Psychiatry Rotation
- Indicates most relevant
Objectives
Clerkship Objectives
- Assess the appropriateness for and recommend ECT and TMS: indications for use, side effects.
- Assess capacity.
- Propose a preliminary understanding of a patient in a biopsychosocial model including being able to: Reach reasonable hypotheses about a patient's pre-morbid personality, coping styles, and their link to the present predicament. Specify relevant medical considerations, including substance and medication misuse. Recognize relevant environmental and social stresses. Describe the level of everyday functioning and realistic goals for improvement.
- Assess a sexual and trauma history.
- Assess sleep history and provide counselling.
- Assess child and family functioning.
- Assessment of cognitive deficits (and use of screening instruments e.g. MMSE, MOCA, etc.).
- Assess and manage acute psychosis.
- Assess the appropriate use of psychotherapy
- Recommend medication management, monitoring and counselling, including: Classes of psychiatric medications and their indications. Medication counselling: indications, choice, side effects, etc. Pre-medication work-up. Medication monitoring and work-up. Side effects (blood tests and physical e.g. AIMS). Metabolic syndromes and monitoring. Special populations (pediatric, geriatric, pregnancy). Acute syndromes/reactions (NMS, dystonia, serotonin syndrome, toxicity).
- Assess self-care.
- Demonstrate psychoeducation skills with respect to diagnoses, medications, prognosis, family education.
- Demonstrate proficiency in documentation and communication in psychiatry.
- Practice non-stigmatizing attitude and advocacy towards those experiencing mental illness in demonstrating:
- Knowledge of indications for referral to psychiatry.
- Knowledge of legal issues, the Mental Health Act and when to invoke it: risk to self and others, obligatory reporting; Use of Legal Certification Forms under the Mental Health Act; duty to warn, exceptions to requirement for consent; role of Community Treatment Orders (CTO); capacity and informed consent, right to refuse treatment, exceptions to requirement for consent.
- Knowledge of the determinants of health and outcomes in mental illness (e.g. poverty, immigration, cultural factors).
- Knowledge of social interventions and resources: Demonstrate understanding of the health care provider's role in patient advocacy; Finding and working with social agencies (CAS, food banks, CFS, Good Shepherd, AY, etc.); Understanding indications for OW and ODSP.
- Knowledge of the impact of stigma of mental illness upon patients, and society, and the role of advocacy.
- Propose a preliminary understanding of a patient in a biopsychosocial model including being able to: reach reasonable hypotheses about a patient's pre-morbid personality, coping styles, and their link to the present predicament. Specify relevant medical considerations, including substance and medication misuse. Recognize relevant environmental and social stresses. Describe the level of everyday functioning and realistic goals for improvement.
- Trauma- and stressor-related disorders
- Psychotic Disorders
- Mood Disorders (including in post-partum, seasonal, GMC)
- Anxiety Disorders
- Personality Disorders
- Substance Use Disorders (including concurrent disorders, and screening assessment tools e.g. CAGE, AUDIT, MAST)
- Geriatric and Cognitive Disorders: geriatric age-related mood, psychosis, anxiety disorders; Delirium and Dementia
- Child and Adolescent Psych (pediatric manifestation of common disorders, pediatric tx issues and their controversies): Neurodevelopmental disorders: intellectual disabilities, autism spectrum disorder, genetic syndromes ( e.g. Down, Fragile X, Fetal Alcohol), learning and communication disorders, AD/HD and treatments. Disruptive behaviour disorders (ODD, CD) Mood and anxiety disorders (incl. separation and school anxiety, and DMDD), use of SSRI in pediatric population Eating disorders. Key points in assessment of child and family functioning.
- Somatoform disorders
- Medical Psychiatry
- Demonstrate knowledge of the clinical features, epidemiology, etiology, diagnosis, differential (including medical), and assessment/management of:
- Other: Impulse control disorders, Factitious Disorder and Malingering
- Amnestic and Dissociative disorders
- Employ procedures and clinical skills so as to be able to:
- Conduct a general interview: learn specific skills that convey empathy. Take a psychiatric history in an empathic manner that enables the assessment of relevant psychological, medical and social factors. Adapt their interview techniques to deal with common sorts of "special" situations/patients (e.g., children, the elderly, those who don't speak English, those with communication or cognitive problems, use of interpreters, family members for collateral, etc.). Adapt their interview techniques to deal with common sorts of "challenging" styles (e.g., silent, over-talkative, angry, seductive, suspicious, passive, dependent, defensive, evasive patients, or those who deny they need help).
- Perform a mental status examination of a patient with psychiatric illness.
- Conduct a suicide risk assessment and management.
- Assess and manage violence/agitation/homicidality
- Assess (including relevant physical exam) and manage substance use.
- Assess and manage other psychiatric emergencies/crises and acute presentations: toxidromes and withdrawal; overdoses: (e.g. TCA, acetaminophen); severe drug reactions: NMS, sertonin syndrome, dystonia; medical conditions with possible psychiatric presentation (e.g. catatonia, delirium)
Tags
Curriculum Block
Clerkship
Psychiatry Rotation
Discipline
Psychiatry
McMaster Program Competencies
3.1 Solicit and respond to feedback from peers, teachers, supervisors, patients, families, and members of health care teams regarding one’s knowledge, skills, attitudes and professional behaviours
3.2 Integrate feedback, external measures of performance and reflective practices to identify strengths, deficiencies, and limits in one’s knowledge, skills, attitudes and professional behaviours
3.3 Set learning and improvement goals
8.2 Practice flexibility and maturity in adjusting to change with the capacity to alter one’s behaviour
8.3 Develop the ability to use self-awareness of knowledge, skills, and emotional limitation to seek help appropriately
8.4 Demonstrate awareness and acceptance of different points of view
MeSH
Clinical Clerkship [I02.358.399.450.110]
Psychiatry [F04.096.544]
