Student Clerkship

The 6-week psychiatry clerkship provides you, the student, with an exciting opportunity to learn how the latest medical based brain research is impacting the diagnosis and treatment of patients with illnesses that are classified as “psychiatric” in nature.  You will interact with patients, whose illnesses range from mild to severe, giving you insight into the various ways in which a psychiatric illness affects a patient’s quality of life.  Psychiatry is a dynamic, growing and highly rewarding field of medical practice.

A Loyola student quote of their experience during the 6-week clerkship:

“This clerkship is extremely well-organized.  I like the fact that we got lectures on everything that is considered of importance in psychiatry.  If you leave these things up to clinical experience, you may never learn about some things very well.  I felt that the Psychiatry Department is one of the best representations for Loyola.  Overall just a great clerkship.”

The vast experience in lectures, clinical rotations, and Clinical Skills Experience provide students with opportunities to actively participate in the learning process.

DIDACTICS (just a few examples)

  Schizophrenia

  Depression, Bipolar Disorder

  Anxiety Disorders including Panic Disorder, 

     Generalized Anxiety, Obsessive-Compulsive  

     Disorder, Post-traumatic Stress Disorder, and   

     Social Phobia

  Neuropsychiatry

  Substance Abuse

  Sexual Dysfunction

ROTATIONS

Loyola Consultation Liaison Psychiatry:  The hospital population is roughly equally divided by gender and comes from a diverse range of ethnic and socioeconomic backgrounds.  All ages are represented.  The majority of consultations are for depression, delirium, dementia, and substance abuse, but all other psychiatric diagnoses including patients with somatization, conversion and factitious illnesses are seen frequently on the service.  Consultations are regularly requested on medically complicated and severely ill patients with advanced carcinoma or AIDS or organ transplantation. 

Hines VA Consult Service:  The patient population includes patients with a prior psychiatric history who are admitted to the VA for other medical or surgical reasons and patients who develop psychiatric issues while hospitalized at the VA.  Many of the consults involve Delirium, Dementia, and Depression due to medical illness, and help with managing psychiatric issues as requested by other services.

The Consult Service also provides consultation to the Emergency Medicine Department.  In the ED, the consult service is responsible for admitting patients to the general psychiatric floor or arranging for outpatient follow-up.  The Emergency Department offers a wide range of psychiatric pathology mostly in their acute stages:  mania, psychosis, suicidal/homicidal ideations or acts, substance induced depression, heroin, cocaine, alcohol withdrawal, post-traumatic stress disorder.

In general, the Hines VA consult service exposes students to the “Big Four” psychiatric illnesses:  Depression, Bipolar illness, Schizophrenia, and Anxiety.  Substance Abuse and PTSD also are common entities.  There is a wide range of psychiatric illnesses on the service, which is a necessary ingredient in any medical student’s education. 

Overall, the Hines VA Consult Service provides an opportunity for students to be exposed to a wide range of psychiatric illnesses in a learning, low stress environment.  To quote one student, “Having the same attending for the entire 6 weeks was also a positive.  As far as clerkships go, my experience at Hines VA was outstanding and one of my most valuable clerkships in Medical School.”  

Hines Substance Abuse:  The patient population includes those with dual diagnosis or “purely” substance related disorders.  The student gains experience in detoxification of various classes of drugs of abuse and learns about the biopsychosocial treatment modalities in helping patients overcome their addiction. 

VA Inpatient Service ( from a student’s perspective): “The Inpatient Hines VA Psychiatry Service is student-focused.  Most of the time I documented the admitting interview with the Attending and Resident present.  They would fill in or redirect as necessary.  I was given helpful feedback after most of my interactions and my attending and residents make a considerable effort to teach me topics relevant to patients we worked with.”

Madden Mental Health Center:  The institution cares for an indigent patient population that is racially and ethnically diverse.  Patient diagnoses primarily consist of severe acute and chronic mental illness, especially psychotic disorders, affective disorders and persistent substance related disorders.

Elgin Mental Health Center – Forensic Psychiatry:  The patient population is predominantly a mixture of chronic mentally ill patients of both sexes from a variety of socioeconomic backgrounds.  Specifically, all patients are Not Guilty by Reason of Insanity and/or Unfit to Stand Trial patients.  Treatment consists primarily of medication management and supportive therapy. 

Westlake Hospital Inpatient (from a student’s perspective) "Westlake Hospital Psychiatry offers the rare opportunity for a medical student to see how an inpatient psychiatry ward really works.  Exclusive to the inpatient service was the opportunity I got to directly assist patients towards improvement in their functioning and successfully transitioning to the next level of their care.  Also in the inpatient setting, I got the rare opportunity to work with a treatment team to help set up a complete program tailored to the individual needs of each patient.  The team consisted of an Attending Physician, Resident Physician, Medical Student, Nurse, Social Worker, Case Manager, Patient Care Associate, and Occupational Therapists.  As the student you get to work with each of these people and help them identify issues to work on during the hospitalization."

"Also at Westlake, I got the chance to see a wide variety of psychiatric conditions and concurrent medical problems.  Daily work consists of rounding on current patients and then the rest of the day is spent working on treatment plans decided during rounds, admitting any new patients, and occasionally doing consults in the main hospital.  I even had the chance to dictate complete admission and discharge notes.  Furthermore, at least once a week I got to work with the same attending and residents in an outpatient setting.  Many patients leave the psychiatry unit with an increased ability to care for themselves, but most do not feel 100% better upon discharge.  Thus, it was relevant to observe many of these same patients and other patients receiving ongoing psychiatric treatment in an outpatient setting.  I got to see both sides of psychiatry."

"One thing I found particularly great was the unique opportunity to directly observe Electroconvulsive Therapy (ECT) as a treatment option for psychiatric conditions. Overall the pace of work at Westlake Hospital is very manageable with the average day starting at 7:30 a.m. and ending between 3-4 p.m. on most days.  As a medical student I was very active at Westlake in taking care of patients, but I was never overwhelmed.  In the same respect, I also had time to read around my patients.  In general, it was one of my best rotations during third year."

Individualized Experiences

Two unique elements to this clerkship involve direct student preparation and presentation – SPPAM and the Professional Small Group.

 S.P.P.A.M. stands for Students Presenting the Psychiatric Aspects of Medicine.  During their psychiatry clerkship, the medical students do a twenty-minute oral presentation that counts toward their overall psychiatry clerkship grade.  This presentation (SPPAM) has received very positive reviews from the medical students.  The students appreciate the usefulness of developing oral presentation skills and the practical value of giving an oral presentation.  In the process, they learn about their chosen topic and the various topics their classmates present. Faculty facilitators report that they benefit themselves from this unique learning experience.

Each SPPAM group has two faculty facilitators.  The facilitator’s primary responsibility is to listen to the presentations, give immediate feedback to the student and evaluate the presentation for grade assignment.  An average SPPAM session of two presentations typically lasts 60-75 minutes.  There are typically 3-4 presentation sessions during each rotation. 

Student comments about the SPPAM experience include:

   “A very useful experience.  I think every clerkship should have this.”

   “I think SPPAM was very worthwhile because it gave me the choice to choose a topic I was interested in and explore it in more depth.”

   “I thought SPPAM was one of the best things about the rotation.  It gave us a chance to do a little extra reading on topics which interested us, but might not have been on our syllabus.” 

Professionalism Group Experience – This experience was introduced in the 2003/04 academic year. Students are asked to prepare for this group experience by identifying 3 incidents/episodes where professionalism was challenged or was somehow an issue.  The goal is to identify the ongoing and common everyday challenges to professionalism and to discuss the varied responses (some desired and some not so desired) to the challenges that presented themselves.

  Contact Information 

Vice Chair                     

David Schilling, MD

 

Clerkship Director           

Shara Grover, MD

 

Clerkship Coordinator       

Ms. Maralee Powderly

 708-216-5073

            mpower@lumc.edu

 

 

For additional information on Student Clerkship please see the Loyola University Medical Education Network (LUMEN):
http://www.meddean.luc.edu/lumen/MedEd/psych/index.htm