The third year medical student clerkship at the Medical College of Wisconsin is a four week rotation, working with psychiatrists and other mental health providers at Froedtert Hospital, Children’s Hospital, Community Memorial Hospital, Rogers Hospital, Milwaukee County Behavioral Health Division and the Clement J. Zablocki VA Medical Center. The clinical settings for the rotation include a wide variety of opportunities. Students may be assigned to assist attending psychiatrists in the following settings:
Inpatient psychiatric units. Students work in either and adult or child and adolescent inpatient unit. The inpatient settings include the Clement J. Zablocki VA Medical Center, Rogers Memorial Hospital, Milwaukee County Mental Health Complex, and Community Memorial Hospital.
Psychiatry consult liaison teams, which serve patients at Froedtert Hospital and at the Clement J. Zablocki VA Medical Center.
Emergency Psychiatry. Students can work at the Milwaukee County Psychiatric Crisis Service, a full service psychiatric emergency department, where they have the opportunity to assess and manage emergent psychiatric conditions.
Outpatient psychiatry clinics. Several of the sites include weekly outpatient clinic experiences for the students. There is also a rotation for students to work full time in an outpatient clinic at the Clement J. Zablocki VA Medical Center.
Students receive instruction and work alongside psychiatrists at each site. Students also receive a series of didactic lectures by adult and child psychiatrists. The clinical experiences and lectures together help teach students to recognize the difference between emotional problems and mental illness, demonstrate the ability to perform a psychiatric interview that will lead to a formulation of the problem and method of intervention, list major psychiatric diagnostic entities and apply them to case histories, learn about psychotropic medications, learn different modalities used in hospitals to treat patients, and demonstrate the ability to talk with ease to patients who have emotional problems, and effectively manage psychiatric emergency situations.
Clinical work in this elective will include working on a child and adolescent unit at Milwaukee County Behavioral Health Division, closely following several of the inpatients as part of a multi-disciplinary team. Much of the day is spent with the psychiatric nursing staff within the milieu program, as well as being involved in assessments, group therapy, treatment planning and supervision by the unit psychiatrists. Patient census is higher in the months of September through May. You will gain a greater understanding of child and adolescent psychopathology and its treatment. You will improve your knowledge involving child and adolescent developmental issues and gain experience working within a multi-disciplinary team format.
The Psychiatric Consultation Service at Froedtert Hospital sees approximately 1,000 new consults an academic year. Medical students will have the opportunity to see new and follow-up cases and in doing so will increase their clinical knowledge of the medically ill psychiatric population, as well as improve interviewing skills. Daily clinical rounds and supervision with attending PM psychiatrists provide a great deal of clinically relevant education as students will see a wide variety of complex patients experiencing significant medical, surgical and psychiatric comorbidity. With patient interaction and clinical rounds, it is expected that students will be able to describe psychiatric illness that occur in the medically ill population or due to the treatment of medical illnesses, as well as describe treatment options available in this population. Medical students will also have the opportunity to work closely with the general adult psychiatry residents (PGY III) and the Psychosomatic Medicine fellow. Weekly psychosomatic clinical case conferences, as well as Department of Psychiatry Grand Rounds, are also mandatory educational experiences for medical students on service.
This rotation is useful to all students, and may be especially helpful to those who have defined an interest in psychiatry, emergency medicine, or any of the primary care specialties. It is an experiential-based service where students are permitted to progress at their own pace to the point of being the first contact for patients in crisis. There is extensive one-on-one supervision by the staff psychiatrists. Opportunity also exists for time with the Mobile Crisis Service, Walk-in Clinic, Crisis Line, Observation Unit, and Crisis Respite House in the community for interested students. You will have the opportunity to enhance your diagnostic interviewing skills focusing on acuity and the acute precipitant, gain familiarity with techniques of crisis intervention, and expand your understanding of laws regarding involuntary psychiatric hospitalization, and improve familiarity with community resources.
Students will observe and perform inpatient and outpatient psychiatric consultations on children and adolescents. You will be expected to write-up at least two psychiatric cases. You will attend weekly rounds and a weekly consult/liaison case conference. You will also be expected to do a literature review and a short talk on a topic of interest. Goals: to be able to perform a mental status assessment on children and adolescents, to develop knowledge and skill in differential psychiatric diagnoses in children and adolescents with pediatric psychiatry illnesses. To develop the skill of presenting a case and increase knowledge of literature. And lastly, to develop compassion for children and adolescents without over-involvement and appreciate the impact on families of pediatric psychiatry disorders.
Students in this rotation have daily one-to-one interaction with faculty. They may participate in student lectures series and in ongoing psychopharmacology drug studies. They will gain inpatient psychiatry experience working in a team-oriented system and operating in a more independent capacity in the evaluation of patients.