Advanced Clerkship in Diagnosis & Treatment of Major Psychoses

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: Advanced Psychiatry Clerks spend one month on an inpatient component of the Schizophrenia & Bipolar Disorder Program directed by Dost Ongur, M.D., Ph.D. Advanced clerks work closely as a member of a psychiatric team, participate in daily rounds, meet regularly with the Psychiatrist-in-Charge of the inpatient team and discuss cases with other psychiatrists and residents in a variety of settings including seminars, and case conferences. Advanced Clerks work closely with professional colleagues in psychology, social work, and psychiatric nursing to learn their approaches to the assessment and treatment of severely mentally ill patients. Advanced Clerks are exposed to the rich environment of the facilities at McLean Hospital, including elective participation in a weekly Research Seminar, Academic Grand Rounds, and a conference on psychiatric interviewing. The clerk is expected to prepare a detailed written summary of one of their clinical cases to be handed in to their attending psychiatrist. In addition, the clerk will give a brief oral academic presentation on a topic relevant to the clinical work of the program at the end of the rotation.
Incorporation of Basic Science Content and Evidence-Based Medicine:
In the lecture series as well as in the daily care of patients.
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.
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.
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.
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.