Psychiatry

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M85/805  Psychiatry Consult Service

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The fourth-year student will work closely with the consult resident and consult team that also includes the attending and advanced practice nurse in the evaluation and treatment of patients referred to the psychiatry consult service. Students will attend weekly consult/liaison teaching conferences during the summer, and Grand Rounds and Research Rounds in non-summer months.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 90%; Conferences/Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Attendings and residents and advanced practice nurses

Patients Seen/Weekly
3 workups per week expected; follow up to 10 or more

On Call / Weekend Responsibility
None

M85/836  Clinical Psychiatry- Inpatient Psychiatric Service

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This is a senior rotation that provides the students with an opportunity to expand their knowledge of inpatient clinical psychiatry by functioning as interns. Students attend all staffing and teaching conferences given to first-year psychiatry residents, take patients in rotation, and share night call with first-year residents approximately every fifth night.

Immediate supervision is provided by the inpatient attending, and additional supervision can be arranged as desired. Teaching emphasis is directed toward psychiatric diagnosis, appropriate use of psychopharmacologic agents, psychotherapeutic intervention, use of community resources and pursuit of the psychiatric scientific literature. The student will write a self-selected clinical topic relevant to treatment and management of psychiatric inpatients.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017
Student Time Distribution
Inpatient 85%; Conferences/Lectures 15%

Major Teaching Responsibility
Clinical attending, teaching attendings and residents

Patients Seen/Weekly
5-15

On Call / Weekend Responsibility
Every fifth night

M85/840  Child Psychiatry

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41 or contact Dr. Glowinski for modifications.

This elective in child psychiatry utilizes the Child Psychiatry Outpatient Clinic and the consult-liaison service at St. Louis Children’s Hospital. It provides experience in age-appropriate diagnostic and treatment methods in children and adolescents. A paper on topic of student’s choosing is required.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017
Student Time Distribution
Outpatient 75%; Conferences/Lectures 25%; Subspecialty Care 100%

Major Teaching Responsibility
Attendings and fellows

Patients Seen/Weekly
15-20

On Call / Weekend Responsibility
No, but can shadow fellow during call if requested by student

M85/844  Forensic Psychiatry

Valid starting weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.The medical student will be actively involved in many aspects of forensic psychiatry including civil litigation, workman’s compensation, malpractice, civil commitment, and guardianship. There may be opportunities to be involved in criminal forensic issues. The student will work with Drs. Jarvis, Harbit, and Garland, within the Department of Psychiatry but will primarily meet with Dr. Jarvis a minimum of 2 hours a week. They will also work with The BJH Manager of Case Management and The City of St Louis Probate Court. The student will also be assigned readings of landmark case, textbooks, psychiatric expert opinions, legal filing with the probate court and attend civil hearings.

The student will learn relevant criminal statutes regarding competency and civil commitment, causation in civil litigation, the concept of medical malpractice and risk assessment of violence and suicide. There may be the opportunity to witness sexually violent predator evaluations and/or treatment. The student will be required to research and write an opinion on a specific approved topic in forensic psychiatry. The objectives will be measured by attendance and by formal evaluation of the student’s participation and knowledge during the supervision discussion. It will also be determined by the originality, thoroughness and quality of the research paper.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 50%; Conferences/Lectures 50%

Major Teaching Responsibility
Dr. Jarvis, Dr. Harbit, Dr. Garland, Jim Hoerchler, Lisa Johnson, St. Louis Probate Court

Patients Seen/Weekly
No active patient treatment

On Call / Weekend Responsibility
None

M85/870  Psychiatric Oncology

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This elective will provide additional training related to consultation-liaison psychiatry with a special emphasis on caring for patients with cancer. The Institute of Medicine has identified the need to increase the availability of psychiatric services in the setting of cancer treatment, and this elective will allow students to gain additional experience working with inpatients and outpatients receiving treatment at Siteman Cancer Center. This elective will allow students to learn about the management of end of life issues, and experience the satisfaction of providing comfort to patients and families via psychotherapy and pharmacology. Opportunities also exist to focus on specific conditions, such as gynecological cancers. Dr. Bishop and Marty Clarke, PhD, PA-C will directly supervise students providing a unique opportunity for individualized teaching and autonomy.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 60%; Outpatient, 30%; Conferences/Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
The attending on the rotation

Patients Seen/Weekly
12

On Call / Weekend Responsibility
None

M85/880  Schizophrenia Precursors and Prodromal States

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This is an opportunity for trainees to gain experience in the evaluation of children and adolescents who may be at high risk for schizophrenia. The rotation would center around the “First Contact Assessment Service”, which evaluates patients who show characteristics suggestive of prodromal schizophrenia (such as new-onset attenuated psychotic symptoms along with recent deterioration in functioning) and/or early life characteristics that may indicate risk for developing schizophrenia later in life (for example, nonspecific social/emotional/behavioral symptoms in a child/adolescent with a strong family history of schizophrenia.). Since the full symptoms of schizophrenia are often preceded by a wide range of childhood behavioral & developmental abnormalities, this rotation would also help trainees integrate information regarding the continuity between childhood development and adult psychopathology. Trainee would observe all aspects of First Contact evaluations (including semi-structured diagnostic interviews & examination of subtle neurological signs), participate in case discussions, and observe follow-up consultations involving patients with psychotic and/or complex neurodevelopmental disorders. Trainee would also be required to write a literature review on a topic relevant to the rotation.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Outpatient 50%; Conferences/Lectures 50%; Subspecialty Care 100%

Major Teaching Responsibility
Coursemaster (psychiatry attending)

Patients Seen/Weekly
2 (possibly more if enrolled during summer months)

On Call / Weekend Responsibility
None

M85/889  Interventional Psychiatry

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.Interventional Psychiatry involves the application of ECT (Electroconvulsive Therapy), rTMS (Repetitive Transcranial Magnetic Stimulation) and VNS (Vagus Nerve Stimulation) in the treatment of medication-resistant psychiatric illness. The student will participate in the evaluations of patients referred to the Treatment Resistant Depression Clinic supervised by Dr. Charles Conway. The student will be involved in the neuropsychiatric assessment of patients referred for ECT. In addition, the student will receive training in the application of ECT and in the clinical management of patients receiving inpatient and outpatient ECT. As cases become available, the student will be involved in rTMS and VNS evaluations and treatment. The student will be encouraged to review appropriate literature and make clinically relevant case-oriented presentations. The student will be expected to write a review of a self-selected clinic topic relevant to interventional psychiatry.

As advances in the field occur, the rotation may also involve exposure to individuals receiving other modalities of intervention, including deep brain stimulation (DBS) and magnetic seizure therapy (MST).

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 70%; Outpatient 20%; Conferences/ Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Charles Conway, MD

Patients Seen/Weekly
20

On Call / Weekend Responsibility
None