reflections on rotations: psychiatry

As a little something for myself, and hopefully to help others, I thought I would take the time to reflect back on rotations once they are done, to review my feelings overall and share what helped me the most. Since I’m starting halfway through my third year, over the next few weeks I’ll catch up by adding rotations I’ve already completed. I JUST finished this one, though, so here we go!

Psychiatry: My school refers to this rotation as “Psychation”. Which it was, to an extent.

The people: It’s a vacation from rude residents and harsh overbearing attendings. Everyone in our department was very kind (although everyone had their quirks). I enjoyed working with these teams infinitely more than other departments.

The patients: This was hard for me to handle. I did not do a very good job of leaving my work day “at work”, as they say. On days where we interviewed a lot of patients with really tough stories and lives, I would go home and just feel sad. It’s crushing sometimes that we can help these people so little.

The workload: Much, much better than any other rotation, INCLUDING outpatient Family Medicine. I loved this part of it. (But hey, maybe I’m too lazy for my own good.)

The Shelf: Rumored to be the easiest of all standardized shelf exams, I only studied for this one for two weeks. Whether or not it bit me in the ass, I’m not sure yet — I’ll let you know when we get our scores back! What I found helpful in studying was…

  • First Aid for the Psychiatry Clerkship — it still goes by DSM IV, but there were no differences that were TOO drastic. As far as I know, the shelves this year are not messing with you when it comes to the differences between DSM IV and DSM V.
  • UT Shelf Review Video — I probably rewatched three times the week before the shelf.
  • MedEd Psychiatry Videos — especially the pharmacology and pediatric videos.
  • USMLEWorld Qbank — these questions are ridiculously easier than the actual shelf, which ticked me off. Damn you, qbank!!
  • Practice shelf exams

 

Would I do this when I grow up? Nah. While I enjoyed seeing something completely different everyday, and the niceness of the teams… I didn’t enjoy interacting with the patients all that much. Histories are a pain in the butt to get, non-compliance is sky high, and there’s only so much you can do for these patients. It broke my heart every day, which I don’t think I could handle.

Have you done a psychiatry clerkship at your school recently? What were your experiences like?

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invaluable shelf review videos

If you’re in your third year of medical school, you know that preparing for shelf exams can sometimes be daunting. Through my experiences thus far (can’t believe I’m halfway through third year already) there is one video series in particular that is AMAZING for shelf review. (Ie, night before, mid-panic attack.) They are only two hours and pretty much cover everything you need to know in a nice question answer format so you can quiz yourself. Just try not to let it bother you that this girl is a fourth year and has infinitely more knowledge than I dreamed of… We all have those kids in our classes. Hope this helps!

 

UT Shelf Review Videos

the time i went to jail… sort of

This past Thursday I had the amazing and unique opportunity to spend a day in jail (technically prison I think?). As part of my third year medical school psychiatry rotation we got to have a first hand look at “forensic” psychiatry — which is, basically, the treatment of prisoners. Going in to this I really had no idea what to expect.. basically just what I had learned from watching Orange is the New Black. Similarly to the show, the mental health unit was a place you were sent off to for quite some time with no contact with the rest of the population.. Our patients spent 23 hours a day in a jail cell, and during their hour only interacted with other prisoners in the mental illness block. My heart broke for these patients, their poor quality of life, and their poor quality of mental health care. Patients are seen once every three or four weeks for about 5 minutes at a time.

I’m really hoping a lot more went on behind the scenes when I wasn’t there in order to help people return to their baseline, in order to eventually take care of themselves on release from prison.

It also highlighted the importance of finding a career you love. Never do I want to be like the doctor I watched, who treated patients like a number in a line, and didn’t even bother looking them in the eyes. I could imagine working in a prison could lead to a lot of burn out, but… To me, they still have basic rights. Especially those in for things like being drunk in public or leaving threatening messages on government voicemails. Very very interesting experience indeed!