Fourth Year Psychiatry Electives
In the fourth year, we offer many clinical electives. These clinical electives are open to visiting US or international students. Please contact Robert Rohrbaugh, MD, or Tammy Savercool for more information.
All students from US LCME accredited allopathic institutions or participating COCA accredited AACOM member colleges wishing to visit Yale for a clinical elective need to apply using the AAMC Visiting Student Application Service (VSAS). A nonrefundable registration fee of $20 is not due until an offer is confirmed.
Psych 203, Psychiatry Inpatient Elective (CMHC): 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, administration) with CMHC faculty. Prerequisite: required Psychiatry clerkship. Open to fourth-year students only. One student every four weeks. Director: R.M. Rohrbaugh
Psych 206, Law and Psychiatry Elective (CMHC): This elective affords opportunities for third- and fourth-year students to observe and participate in “competency to stand trial” evaluations with a clinical team that makes 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, and 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 and Psychiatry seminar during their rotation. Prerequisite: required Psychiatry clerkship. One student every four weeks. Director: R.M. Rohrbaugh
Psych 209, Addiction Psychiatry Elective (VACHS): An elective clinical training experience in addiction psychiatry for third- and fourth-year students. The primary training site is the Detoxification and Addiction Stabilization Service at the VA Connecticut Healthcare System in West Haven. Students learn about performing detailed initial evaluations; treating alcohol, opioid, and benzodiazepine withdrawal; initiating medication-assisted treatment; providing opioid overdose education and naloxone distribution, providing smoking cessation treatment, utilizing psychosocial interventions and mutual help, as well as the principles of harm reduction; and addressing psychiatric and medical comorbidities. The rotation includes a discussion of several readings in addiction psychiatry. Prerequisite: required Psychiatry clerkship. One student every four weeks. Director: R.M. Rohrbaugh
Psych 210, Psychiatry Inpatient Elective (YPH WS-2): 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 student 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 New Haven Psychiatric Hospital; clinical research and outpatient involvement may be options. Prerequisite: required Psychiatry clerkship. Open to fourth-year students only. One student every four weeks. Director: R.M. Rohrbaugh
Psychiatric Care at Hispanic Clinic of CMHC (CMHC): The elective is focused on the provision of outpatient mental health services for Spanish-speaking Latino communities in the United States and will cover three main themes: 1. Clinical assessment and conceptualization: Culturally-specific and linguistically appropriate clinical skills including interviewing, diagnosis, and formulation of a recovery-oriented treatment plan that includes psychopharmacology and psychotherapy. 2. Systems-based practice: Understanding the impact of community-academic partnerships and the characteristics of a culturally responsive behavioral health system of care for Hispanics 3. Recovery-oriented care: Culturally sensitive approaches to recovery from mental illness. This elective will provide linguistically appropriate and culturally sensitive training on mental health assessments for monolingual Latinos at an outpatient mental health clinic. Clinical interviewing techniques will be reviewed with an emphasis on the Latino culture. The cultural and structural evaluations will be taught and the student will have opportunities to practice these skills. The student will initially observe crisis consultations and eventually perform supervised evaluations followed by presentations in weekly clinical rounds. The student will attend meetings of the Connecticut Latino Behavioral Health System to learn about the expansion of local culturally sensitive behavioral health services, to hear progress, challenges and outcomes. The student will recognize qualities of recovery-oriented services for mental illness and how providers can foster recovery. The elective student will engage with “peers” and identify their contributions and valued role as a member of the clinical team. “Peers” are people who have suffered mental illness, are stable and trained to support mental health services in clinical teams. The student will become familiar with the Connecticut State Department of Mental Health Recovery Initiative and how community-academic collaboration is implemented at this level. The student will review and present summaries of assigned readings of mental health services, the challenges facing minority communities, and the best practices to address them. Stigma, implicit bias, health disparities, the social determinants of mental health, recovery from mental illness, and advocacy will be the main subjects for review.Psych 211, Clinical Neuroscience Research Unit Elective (CNRU) Elective, CMHC: 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, substance abuse, and psychiatric genetics. Prerequisite: required Psychiatry clerkship. Open to fourth-year students only. One student every four weeks. Director: R.M. Rohrbaugh
Psych 212, Mood Disorders and Neuromodulation Elective (ECT and TMS), VACHS: This elective offers senior medical students the opportunity to learn about neuromodulation techniques in the treatment of mood disorders, more specifically, by using electroconvulsive therapy (ECT) and repetitive transcranial stimulation (TMS). Students learn the theoretical basis for the use of ECT and TMS, among other neuromodulation techniques, in the treatment of mood disorders. They learn indications and contraindications to treatment, the process of evaluation of patients prior to and during treatment (including use of standardized depression rating scales), how to monitor for complications and side effects to treatment, and the latest research in the field. Students work closely with psychiatry attending physicians and residents at the VA in the evaluation of patients referred for ECT and TMS, and have the opportunity for supervised participation in the performance of these treatments. Patient population includes veterans of all ages with a variety of psychiatric conditions, including mood disorders with comorbid anxiety and substance use disorders. Prerequisite: required Psychiatry clerkship. One student every four weeks. Director: R.M. Rohrbaugh
Psych 234, Adolescent Psychiatry Elective (YPH): The purpose of this elective is to provide fourth-year medical students interested in child and adolescent psychiatry and/or adolescent medicine an experience in working with adolescents presenting with acute psychiatric illness. The elective is based on the adolescent inpatient unit at Yale New Haven Psychiatric Hospital, a short-term fifteen-bed unit serving patients aged 12–18. Students 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. Prerequisite: required Psychiatry clerkship. One student every four weeks. Director: R.M. Rohrbaugh
Psych 238, Early Psychosis Elective (STEP Clinic), CMHC: STEP (Specialized Treatment Early in Psychosis) is a multidisciplinary 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. Students 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 have the opportunity to observe or participate in any of these treatments. The multidisciplinary and pluralistic nature of the intervention presents a rich opportunity to participate in collaborative care with other mental health disciplines. Students can also participate in regular seminars sponsored by the STEP and PRIME (Prevention through Risk Identification, Management, and Education) clinics. The latter is a research clinic focused on prodromal psychosis. 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. Students are 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. This experience must be paired with a main placement at one of the available elective inpatient services. Prerequisite: required Psychiatry clerkship. Open to fourth-year students only. One student every four weeks. Director: R.M. Rohrbaugh
Psych 301, Psychiatry Inpatient Subinternship (CMHC): 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 subinternship occurs on the inpatient service (4th floor) of the Connecticut Mental Health Center (CMHC). Director: R.M. Rohrbaugh
Psych 302, Psychiatry Inpatient Subinternship (YPH, WS-2): 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 subinternship occurs on the general adult inpatient service at the Yale Psychiatric Hospital. Director: R.M. Rohrbaugh
Psych 303 SI Psychiatry Clinical Neuroscience Research Unit Subinternship (CNRU) (4WK)/Elective, CMHC:This sub-I experience affords the student an opportunity to gain insight into what is it like to work in clinical psychiatry. Students will function as high level clinical care providers and will be an integral part of the treatment team. The Clinical Neuroscience Research Unit (CNRU) is a specialized service dedicated to the diagnosis, treatment and research of neuropsychiatric disorders. The unit consists of an inpatient service, as well as outpatient specialty clinics for addictive, depressive, obsessive-compulsive, psychotic, and women's behavioral health disorders. Most patients voluntarily participate in clinical research studies designed to determine the neurobiological mechanism underlying these disorders. We additionally supplement our census with patients admitted to compliment resident and student education and training. Pharmacotherapy, individual psychotherapy, group therapy, and behavior therapy are provided as clinically indicated. Clinical treatment is provided free of charge to patients. The subinternship occurs on the Clinical Neuroscience Research Unit (CNRU) of the Connecticut Mental Health Center (CMHC). The Sub-I is scheduled throughout the year during regular subinternship rotations for a minimum of four weeks. Director: R.M. Rohrbaugh
Psych 325/CHLD 325, Child Study Center Psychiatry Elective (YNHH CPIS): The aim of this elective is to provide the student with an intensive experience in infant, child, and adolescent psychiatry. The curriculum includes assessments of normal development and psychopathology in childhood, treatment methods, and research in major disorders of childhood. Students are active team members of the Children’s Psychiatric Inpatient Service (CPIS) and the consultation service to the pediatric wards of Yale New Haven Hospital and can take advantage of the wide range of ongoing seminars, conferences, and clinical services in place at the Child Study Center. Teaching methods include seminars, conferences, field observations, ward rounds, and practicals selected by the student following consultation with the director of medical studies and the Child Study Center. One student every four weeks. Director: R.M. Rohrbaugh
Psych 333, Forensic Psychiatry Inpatient Elective: The Forensic Psychiatry Inpatient Elective at Whiting Forensic Hospital would provide medical students with an opportunity to be exposed to a variety of elements of mental health and medical care for forensically hospitalized individuals with severe mental illness and substance use disorders. Students would have the opportunity to learn about and actively participate in the longitudinal inpatient care for individuals in Connecticut who are found not guilty by reason of insandity (NGRI) and not competent to stand trial in both high security and enhanced (medium) security psychiatric treatment environments. Students will also have the chance to observe hearings for individuals found NGRI before the state’s Psychiatric Security Review Board.
For students with a particular interest in the medical care of forensic populations, there would also be an opportunity to work with the hospital’s internists to provide the patient’s primary medical care. For students with an interest in administration and leadership in health care, there would also be an opportunity to work with the hospital medical director to better understand the elements of leadership, policy development and hospital management inherent in overseeing the operations of a large state-operated forensic psychiatric hospital. Director: Tobias Wasser, MD
This elective is open to Yale and visiting U.S. students only.
The location of this elective is:
Whiting Forensic Hospital
70 O'Brien Drive
This elective will begin taking students for the 8/12/19 rotation period.
SI Psychiatric Emergency Room Subinternship (VACHS): The sub-internship will build upon these skills and have an increasing level of responsibility for direct patient care. Students will take a primary role in caring for patients, with direct supervision from chief residents and attending physicians. In addition, sub-interns will act as role models and mentors for MS3 students who will be rotating simultaneously. By the end of the 4-week rotation, sub-interns should be confident with supervised but independent management of complex psychiatric patients.