Advanced Clinical Psychiatry

Sites: MCLH
Director(s): John Roseman
Prerequisites: HMS Principal Clinical Experience (Core Clinical Clerkships) or equivalent
Offered: Full time every month
Location: MCLH - McLean Hospital (10)
Open to Exclerks: Yes (may be restricted for international students)
Description: The advanced clerkship at McLean is designed for students who have completed the Core Clerkship in Psychiatry. It provides an opportunity for intense clinical experience and in-depth exploration of a particular area of interest. Any of the numerous services afforded by the hospital may be elected as the area of concentration. These include: Clinical Evaluation Center, substance abuse unit, behavioral neurology service, partial hospitalization program, and geriatric psychiatry service. Individual supervision is provided for all clinical assignments. Advanced seminars on psychopathology and pychopharmacology will be offered to students. Interviewing techniques are emphasized if requested. Biomedical aspects of psychotic disorders may be elected as an area of concentration. The geriatric psychiatry elective will include inpatient, outpatient and long term care consulting opportunities.
Incorporation of Basic Science Content and Evidence-Based Medicine:
All students will be expected to review the evidence based medical approaches to diagnosis and treatment of psychiatric disorders in a specialty mental health program. In addition, the pathophysiology, and scientific understanding, of psychiatric disorders will be discussed and reviewed with faculty and residents.
Grade Criteria:
Honors with Distinction: More often than not, the student has performed at levels that exceed the expected level for training. While not necessarily unique, he/she has consistently demonstrated excellent to outstanding clinical skills, presentations and oral exam performance, write-ups and fund of knowledge, is highly motivated, reliable and well attuned to patients, families and staff, reads widely, and shows a consistent interest in seeking out and incorporating feedback, extending skills and knowledge, and contributing to the team. The student has demonstrated performance that would typically merit enthusiastic recommendation to a leading residency training program. Honors: Student's work is consistently solid in all respects; in at least several areas, the student's work has been very good to outstanding. Although not truly exceptional, the student is consistently motivated, reliable, and organized, and works well with patients, staff and faculty. By the end of the rotation, he/she can be trusted to perform and present a thorough, reasonably efficient evaluation on a complex patient and generate an appropriate differential diagnosis and treatment plan. He/she has completed all expected tasks during the rotation and has sometimes sought out additional opportunities for learning and contributing during the rotation. Satisfactory: Student has generally demonstrated proficiency with the basic material and skills expected of a student at this level of training but has shown limited motivation to learn during the rotation and has demonstrated one or two areas which though not frankly deficient would benefit continued improvement. Examples include occasionally superficial or disorganized write-ups or presentations, occasional notable omissions or errors in a history or MSE, some gaps in knowledge of basic psychopathology or therapeutics, occasional difficulty in interactions with patients, family or staff. Any significant deficits that raise serious concern about the student's ability to function appropriately in a clinical setting warrant a grade of Unsatisfactory rather than Satisfactory. On the other hand, reliable, motivated students who have demonstrated at least adequate proficiency in all areas of assessment and notably superior performance in some areas of assessment should generally receive Honors. Unsatisfactory: Student has shown significant deficits in any one of the major areas of assessment including obtaining and documenting clinical information, generating adequate differential diagnoses and treatment plans, exhibiting an adequate fund of knowledge about psychopathology and psychiatric treatment modalities, communicating and interacting appropriately with patients, family and staff, demonstrating reliability, integrity, collegiality and cultural sensitivity, and showing motivation to learn and to improve. The deficit(s) observed cause serious concern about the student's ability to deliver appropriate evaluation or care to patients with psychiatric disorders and/or to conduct themselves with the professionalism expected of third year medical students.