HAPPY NEW FREAKING YEAR! Today, I will be telling you a little bit about my Psychiatry rotation. Psych was my 5th rotation and I’m so glad that it was somewhat in the middle since it was slower paced 😉 At least in my experience. If you want to check out some of my posts on previous rotations, check them out: HERE and HERE…
Alright so here we go!
My psychiatry rotation was basically all inpatient, which means I was in a different city for one month since the hospital I’m based in doesn’t have an inpatient psychiatry unit. I’m actually very glad that it was inpatient because I really have enjoyed being in the hospital. We would round on the unit patients every morning, then would do the consults the rest of the day and it just depended on how many there were. Psychiatry is such a unique field, because I truly saw how not only medical illnesses are dealt with but also the psychosocial, and socioecomonic aspects of the patient. Obviously, they’re dealing mostly with mental health problems, but psychiatry to me really showed how patients should be dealt with as a whole – mind, body, spirit, and even other external factors.
There were definitely a lot of medication management and getting extremely detailed histories. With the medications, it’s all about finding the right one AND dose for the patient so there’s a lot of trial and error. As for the histories, you would find that some of the questions asked are things medical doctors typically don’t. Another tough thing I saw was how many patients were withdrawing from opioids. If you don’t already know it’s a problem. I’m here to tell you it sure is. It was everywhere. Not just in the psychiatry unit but even on the floors, because we would get consulted. It was devastating. But also goes to show that doctors should not just give a quick fix for that LBP but to truly help patients gain back their function as best as possible in other means. (I say low back pain “LBP” because that’s the most common chronic condition that patients are on narcotics for). Anyway, I digress…
Although this rotation was extremely interesting and showed a different side of medicine, I realized that it was not for me. I love talking and getting to know patients, but I felt that it was lacking the procedure portion. It was very different for me to not have a stethoscope around my neck (BTW: psychiatrists don’t do physical exams, a medical doctor does since they avoid touching patients to maintain boundaries). I also missed doing a physical exam – like what?! Haha. I really did though. But, what I do what to take away from it was to make sure to take into account the mental or social aspects about a patient because that also plays a part into their entire well-being.
Now, as for tools I used to study for the DO-version of the shelf exam (aka: COMAT):
1. Case Files: Psychiatry. I mainly used this for looking up the diagnostic criteria for the different illnesses. Also, there’s a great section about drug classes.
2. First Aid USMLE Step 2. I read through the entire psychiatry chapter and felt it very useful. I annotated it with the Onlinemeded videos.
3. Online MedEd. I watched all the video for psychiatry and annotated it in the First Aid USMLE step 2 book
4. COMBANK – I always try to go through the specialty-specific qbanks twice before the shelf exam. The first time being more of a learning tool and the second time being more of a “testing” tool and timing myself. This one has less questions for psych but tends to be very similar to what you see on testday.
5. COMQUEST – this q-bank had more of the “neuro”-type questions which were helpful in brushing up on the different types of dementias, etc. Has more questions which is great for more practice but I can’t get through all of it.
Hope this helped you all! Stay tuned for the next Rotation post which will be on Internal Medicine!