Psychiatry

The purpose of this elective is to provide 4th year medical students interested in child and

adolescent psychiatry and/or adolescent medicine an experience in working with adolescents

presenting with acute psychiatric illness. This elective will be based on the adolescent

inpatient unit at Yale-New Haven Psychiatric Hospital; a short-term 15-bed unit serving

patients aged 12-18. Students will gain exposure to a diverse patient population with severe

mood, psychotic, behavioral, and/or substance use disorders, as well as begin to understand

the intricacies of working with families and systems providing care for adolescents with

significant emotional and/or behavioral disturbances. Teaching activities include daily

rounds and weekly case conferences.

Length of Rotation: 4 weeks (maximum -1 student)

Scheduling Restriction: Not offered 08/11/14–09/05/14; departmental approval required prior to scheduling

Student's Class Level: 4th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: yes 

Learning Objectives:

  1. History skills. Gather the important information that is needed for the adolescent’s psychiatric history and complete a history in the medical record for at least 5 patients.
  2. Physical examination skills. Complete a mental status exam on at least 5 patients. The student should demonstrate the ability to perform the mental status examination while being observed by at least one attending or resident.
  3. Knowledge/diagnostic and treatment skills: Know about common adolescent psychiatric conditions.
  4. Attitude: Demonstrate professional responsibility in working as a team member with other members of the adolescent inpatient team, patients and families.
  5. Career/context: Know the training/career pathway for child and adolescent psychiatry.
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This elective offers senior medical students the opportunity to work closely with a variety of patients who are hospitalized during their participation and treatment in research protocols. The Clinical Neuroscience Research Unit (CNRU) is a thirteen-bed inpatient ward with associated outpatient clinics and basic science laboratories on the third floor of the Connecticut Mental Health Center (CMHC). Supervised implementation of novel psychopharmacology, exposure to multiple aspects of clinical and basic science research, and in-depth experience with individual and group psychotherapies are educational aspects of this elective. Patients’ diagnostic categories include depression, obsessive-compulsive disorder, schizophrenia, cocaine abuse and substance abuse and psychiatric genetics.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction: Not offered 08/11/14–09/05/14; departmental approval required prior to scheduling

Student's Class Level: 4th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students:

yes 


Learning Objectives:

  1. History skills. Gather the important information that is needed for a psychiatric inpatient admission HPI and document this in the chart for at least 6 patients.
  2. Know about common psychiatric conditions and their presenting symptoms, including mood disorders (depression and mania), psychotic disorders, anxiety disorders, and substance misuse disorders.
  3. Describe the current first line therapy for each of these conditions.
  4. Know about the research avenues that are being pursued in each disorder and the pathophysiologic rationale for such research.
  5. Attitude: Demonstrate professional responsibility in working as a team member with other members of the CNRU, patients and families.
  6. Career/context: Know the training/career pathway for psychiatric inpatient career and psychiatric research.
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STEP (Specialized Treatment Early in Psychosis) is a multi-disciplinary team-based treatment for individuals presenting early in the course of a psychotic illness. This clinic offers unique opportunities in the assessment and treatment of a population that is difficult to access in other clinical settings. Trainees will have the opportunity to observe structured research assessments and interpretation of these scales in light of careful clinical follow-up. Given the diagnostic and prognostic heterogeneity of illnesses presenting with psychosis, this experience provides the opportunity to develop clinical expertise in diagnosis and management of a range of mental health issues. The enriched treatment includes cognitive-behavioral group therapy, family psycho-education groups and cognitive remediation in addition to vocational support with a focus on rapidly reintegrating patients back to age appropriate social, educational and employment goals. Students will have the opportunity to observe or participate in any of these treatments. The multi-disciplinary and pluralistic nature of the intervention presents a rich opportunity to participate in collaborative care with other mental health disciplines. Trainees will also be able to participate in regular seminars sponsored by the STEP and PRIME (Prevention through Risk Identification, Management & Education) clinics. The latter is a research clinic focused on prodromal psychosis. Positions: 1-2. Site: Connecticut Mental Health Center (CMHC). Scholarship: STEP is designed as a service delivery model with a built in observational cohort and experimental pragmatic randomized controlled trial. Trainees will be invited to take an active role in the various domains of scholarship including community and clinician education efforts publication and learning about clinical research design.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction: Not offered 08/11/14–09/05/14; departmental approval required prior to scheduling.  This experience must be paired with a main placement at one of the available elective inpatient services.

Student's Class Level: 4th year

Prerequisite: Psychiatry 106; departmental approval required prior to scheduling

Accept Visiting Students: yes

Learning Objectives:

  1. History skills. Gather the important information that is needed for the evaluation of a new presentation of a psychotic illness.
  2. Physical examination skills. Complete a pertinent physical examination for the evaluation of common side effects of antipsychotic medications.
  3. Knowledge/diagnostic and treatment skills: Know about the evaluation, initial management and prognosis of psychotic disorders.
  4. Attitude: Demonstrate professional responsibility in working with other members of the multi-disciplinary STEP team, patients and families.
  5. Career/context: Know the training/career pathway for academic psychiatry.
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This elective includes intensive work with inpatients who suffer from major psychiatric disorders with or without substance abuse. Emphasis is on assessment, acute treatment, and arrangement of continuing care in the community. The subintern functions as an integral member of a multidisciplinary treatment team. Clinical research participation is encouraged. Opportunities are available to explore special areas of interest (e.g., forensics, psychopharmacology, administrative) with CMHC faculty and scheduled during regular clerkship rotations.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction: Not offered 08/11/14–09/05/14; departmental approval required prior to scheduling

Student's Class Level: 4th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: yes

Learning Objectives:

  1. History skills. Gather the important information that is needed for the Inpatient psychiatric admission history and complete a history in the medical record for at least 2 patients.
  2. Mental Status examination skills. Complete a pertinent mental status examination for the evaluation of acute and chronic psychiatric condition on at least 2 patients. The student should demonstrate the ability to perform this pertinent mental status examination while being observed by at least one attending or resident.
  3. Knowledge/diagnostic and treatment skills: Know about common acute and chronic conditions.
  4. Procedural skills. Perform the Mini Mental Status Examination on at least 2 inpatients.
  5. Attitude: Demonstrate professional responsibility in working as a team member with other members of the mutidisciplinary care team, patients and families.
  6. Career/context: Know the training/career pathway for Adult General Psychiatry
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This elective includes intensive work with patients who suffer from major psychiatric disorders, and range in age from college students to middle age. Emphasis is on assessment, acute treatment and arrangement of post-discharge follow-up care in the community. The subintern is an advanced clerk functioning as a member of the multidisciplinary treatment team, taking on primary clinician and psychiatric/medical responsibilities for patients under the supervision of senior clinicians. The elective is given on the inpatient service at the Yale Psychiatric Hospital; clinical research and outpatient involvement may be options.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction: Not offered 08/11/14–09/05/14; departmental approval required prior to scheduling

Student's Class Level: 4th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: yes

Learning Objectives:

  1. History skills. Gather the important information that is needed for the inpatient psychiatry history and complete a history in the medical record for at least 10 patients.
  2. Mental Status Examination. The student should know how to perform and score a routine mental status exam and interpret the different elements of the mental status exam.
  3. Treatment Planning. The student should know the elements of a multidisciplinary treatment plan, how to individualize it and how to implement it.
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Intensive work with patients who suffer from major psychiatric disorders and range in age from college students to middle age. Most patients have access to healthcare insurance or have Medicare and/or Title XIX.  Emphasis is on assessment, acute treatment, and arrangement of post-discharge follow-up care in the community.  The sub-intern is an advanced clerk functioning as a member of the multidisciplinary treatment team, taking on primary clinician and psychiatric/medical responsibilities for patients under the supervision of senior clinicians.  The sub-internship occurs on the general adult inpatient service at the Yale Psychiatric Hospital.  Currently, the Sub-I is scheduled during the months of May through October during regular clerkship rotations for a minimum of four weeks.

Length of Rotation: 4 weeks (maximum -1 student)

Scheduling Restriction: May through October ONLY

Student's Class Level: 4th, 5th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: yes

Learning Objectives:

  1. History skills.  The student should name all the routine questions that are involved in taking a history of the acutely ill adult psychiatric patient and why they are being asked.
  2. Mental Status Examination.  Complete a pertinent mental status examination for the evaluation of acute and chronic psychiatric condition on at least 4 patients while being observed by at least one attending or resident.  The student should also know how to differentiate mood disorder versus anxiety disorder versus psychotic disorder versus comorbid personality disorder and comorbid substance abuse disorder, and be able to explain each part of the mental status examination of the psychiatric patient, why it is being performed, and what abnormalities are being sought.
  3. Knowledge.  Know the 3 most likely causes of major depressive disorder, bipolar disorder, schizophrenia, delirium, and dementia, and the mechanism for each.  Name at least 3 diagnostic tests to evaluate each of these conditions, and describe the various types of therapy for each of these conditions.
  4. Procedural skills.  Perform the Mini Mental Status Examination on at least 4 inpatients.  The student should know the key indications for the procedure, be observed and get feedback on the performance of the procedure on at least one occasion.
  5. Attitude.  Demonstrate professional responsibility in working as a team member with other members of the mutidisciplinary care team, patients and families.  The student should exhibit sensitivity to the particular psychosocial issues faced by hospitalized psychiatric patients and their families, and exhibit honesty, accuracy and integrity in all interactions with patients, families, colleagues and others.
  6. Career/context: Know the training/career pathway for Adult General Psychiatry, the 3 aspects of career satisfaction in this specialty, and key roles that the specialty plays in the health care system.
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Intensive work with inpatients who suffer from major psychiatric disorders with or without substance abuse and who have significant social challenges often including lack of access to stable housing, work, and healthcare insurance.  Emphasis is on assessment, acute treatment, and arrangement of continuing care in the community.  The sub-intern functions as an integral member of a multidisciplinary treatment team and serves as the primary clinician for 4-5 patients.  The sub-internship occurs on the inpatient service (4th floor) of the Connecticut Mental Health Center (CMHC).   Currently the Sub-I is scheduled during the months of May through October during regular clerkship rotations for a minimum of four weeks.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction: May through October ONLY

Student's Class Level: 4th, 5th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: yes

Learning Objectives:

  1. History skills.  The student should name all the routine questions that are involved in taking a history of the acutely ill adult psychiatric patient and why they are being asked.
  2. Mental Status Examination.  Complete a pertinent mental status examination for the evaluation of acute and chronic psychiatric condition on at least 4 patients while being observed by at least one attending or resident.  The student should also know how to differentiate mood disorder versus anxiety disorder versus psychotic disorder versus comorbid personality disorder and comorbid substance abuse disorder, and be able to explain each part of the mental status examination of the psychiatric patient, why it is being performed, and what abnormalities are being sought.
  3. Knowledge.  Know the 3 most likely causes of major depressive disorder, bipolar disorder, schizophrenia, delirium, and dementia, and the mechanism for each.  Name at least 3 diagnostic tests to evaluate each of these conditions, and describe the various types of therapy for each of these conditions.  The student will take on the role of a resident in implementing the treatment plan under the supervision of the attending physician. 
  4. Procedural skills.  Perform the Mini Mental Status Examination on at least 4 inpatients.  The student should know the key indications for the procedure, be observed and get feedback on the performance of the procedure on at least one occasion.
  5. Attitude.  Demonstrate professional responsibility in working as a team member with other members of the mutidisciplinary care team, patients and families.  The student should exhibit sensitivity to the particular psychosocial issues faced by hospitalized psychiatric patients and their families, and exhibit honesty, accuracy and integrity in all interactions with patients, families, colleagues and others.
  6. Career/context: Know the training/career pathway for Adult General Psychiatry, the 3 aspects of career satisfaction in this specialty, and key roles that the specialty plays in the health care system.
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This elective affords opportunities for third and fourth year students to observe and participate in “competency to stand trial” evaluations with a clinical team who make these assessments at the New Haven Correctional Center. In addition, they may attend Law School classes with students who represent psychiatric patients, observe civil commitment procedures, attend probate court hearings, as well as the criminal proceedings in local New Haven Superior Courts. Students attend work seminars where case evaluations and write-ups are discussed and prepared, and read appropriate legal cases and psychiatric literature. Students may be able to participate in parts of evaluations of insanity defense, custody determination, and other forensic issues. They attend the Law & Psychiatry seminar during their rotation.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction: Not offered 08/11/14–09/05/14; departmental approval required prior to scheduling

Student's Class Level: 4th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: yes

Learning Objectives:

  1. History skills. Observe and participate in competency to stand trial evaluations with a clinical team. Students participate in parts of evauations of insanity defense, custody determination, and other forensic issues.
  2. Mental Status Examination. The student should know how to perform and score a routine mental status exam and how to interpret its different elements..
  3. Attitude: Demonstrate professional responsibility in working with other members of the clinical team, patients and court/legal professionals.
  4. Career/context: Know the training/career pathway for forensic psychiatry.
  5. Knowledge. The student will be expected to demonstrate an understanding of the relevant Connecticut statues relating to competency to stand trial.
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The Yale University School of Medicine offers an elective clinical training experience in substance abuse for interested third and fourth year students. The primary training site is the Outpatient Service at the Veterans Administration Connecticut Healthcare System (VACHS) in West Haven. This experience is an intensive one in which students work closely with addicted patients with chronic mental illness. Students interested in learning about medical detoxification from alcohol and/or opiates may participate in an intensive 2 week elective in the Ambulatory Detoxification Clinic at the VACHS. Students will learn about the evaluation and treatment of alcohol withdrawal and detoxification. Patients with benzodiazapene and opiate dependence are also treated in this Clinic.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction:

Not offered 08/11/14–09/05/14; departmental approval required prior to scheduling

Student's Class Level: 4th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: yes

Learning Objectives:

  1. History skills. Gather the important information that is needed for a thorough substance use evaluation and complete a history in the medical record for at least 5 patients
  2. Physical + Psychiatric examination skills. Complete a pertinent physical + psychiatric examination for the evaluation of substance use disorders on at least 2 patients. The student should demonstrate the ability to perform this pertinent physical examination while being observed by at least one attending or fellow.
  3. Knowledge/diagnostic and treatment skills: Know about common substance use conditions.
  4. Procedural skills. Perform Withdrawal Assessment Screening for alcohol and opioids on at least 1 patient with each disorder while being observed by trained staff.
  5. Attitude: Demonstrate professional responsibility in working as a team member with other members of the outpatient treatment teams and patients.
  6. Career/context: Know the training/career pathway for Addiction Psychiatry.
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