Department of Psychiatry
Professor and Chair
Anthony F. Lehman, MD, MSPH
The goal of undergraduate psychiatric education is to assist students in acquiring an understanding of and an appreciation for the application of behavioral and psychiatric principles in patient care and health maintenance through an exposure to a progressive sequence of intellectual stimulations, clinical experiences and appropriate professional socialization within the interdisciplinary framework of the new curriculum. More specifically, the curriculum aims to assist the student in: 1) acquiring a foundation of knowledge regarding the biological, psychological, sociological and humanistic aspects of the practice of medicine; 2) mastering basic interpersonal and psychiatric skills relevant to the management of patients with medical and/or emotional illness; and 3) emulating attitudes and values that enhance the professional roles and practices of a physician.
Undergraduate Medical Program
(Psychiatry faculty teach in Blocks II, V and VI of the freshman curriculum.)
The Department of Psychiatry takes the lead in teaching the Human Behavior block which integrates information about human behavior from the biological, behavioral and social sciences as it applies to health, illness and treatment across the life span in our multicultural environment. The block introduces the important biopsychosocial framework, stressing the interacting influences of neurobiological, psychological and sociocultural factors on human behavior, illness and physician-patient interactions. The block is made up of lectures, small group sessions, demonstration/discussion periods and problem-based learning (PBL) groups. Psychiatry faculty contributes heavily to instruction and also serves as small group leaders in the Introduction to Clinical Practice Course.
This area of study is now taught as part of the neuroscience module of the Pathophysiology and Therapeutics course in the second year and through additional interdisciplinary teaching in other relevant systems (e.g., cardiovascular, endocrine, etc.) within the new curriculum. The module is designed to provide students with the basic concepts of pathophysiological and therapeutic interventions relevant to the neurosciences. This contains the core areas of clinical psychiatry, including psychopathology and the psychiatric treatment of mental disorders. The module seeks to foster an integrative approach to teaching by combining the knowledge and skills of faculty from the departments of Psychiatry, Neurology, Pharmacology, Pathology, Epidemiology & Preventive Medicine, Neurosurgery and Anesthesiology. The course format is based on lectures, audiovisual demonstrations (videotapes, live simulcast clinical interviews) small group discussions, problem-solving sessions and assigned readings for self-study.
Psychiatric Interviewing/Mental Status Examination
This component is part of the second-year Introduction to Clinical Practice (ICP) course which is devoted to specialty physical diagnosis and examination. The psychiatric course is devoted to psychiatric interviewing, history taking and the mental status examination. A general introductory lecture is followed by a series of two four-hour small groups sessions where each student performs a live psychiatric interview, observes fellow students performing interviews, and reviews interviewing techniques and psychopathologic concepts with the small group preceptor. Attempts are made to expose the students to patients with psychotic, affective and addictive disorders in their small groups of four to five students.
The required clerkship in psychiatry provides the main clinical experience in psychiatry for University of Maryland medical students. The psychiatry clerkship is now offered in a required four-week experience in the junior year. This course continues to provide the junior student with a core clinical psychiatric experience with additional seminars, small groups and case conferences.
The core four-week psychiatry experience involves a primary assignment on an acute inpatient unit for the majority of students and for a minority of students it involves 2 two-week assignments to our two hospital based psychiatric consultation services. Comprehensive diagnostic assessments are coupled to treatments invoking pharmacological, psychotherapeutic, biological and psychosocial modalities. Integrating the student into a multidisciplinary treatment team is stressed. In addition, emphasis is placed on the application of a mental status examination for each patient that you will encounter.
You will work under the preceptorship of a psychiatry attending and resident while assigned to the inpatient units. Four hospitals are utilized for these assignments. They are the University of Maryland Medical Center (UMMS), the Baltimore VA Medical Center (BVA), the Walter P. Carter Center (WPCC) and the Spring Grove Hospital Center (SGHC). Students are assigned approximately three to four patients from the inpatient team and serve as their primary medical manager under the direct supervision of the attending and resident psychiatrists. This responsibility and involvement with patients provides an ideal setting in which the student may apply the biopsychosocial concepts learned in the first year human behavior course to the specific knowledge of psychopatholgy and therapeutic interventions presented in the sophomore pathophysiology and therapeutics course. A goal of the clerkship is to integrate this knowledge with the acquired skills of psychiatric interviewing, medical history taking and physical diagnosis acquired in the Introduction to Clinical Practice courses. As a student, you will assume an integral role on the multidisciplinary treatment team and in the ward milieu.
Those students assigned to the consultation services are given an opportunity to see patients in a general hospital setting where other physicians have requested psychiatric consultation. Both of these services are offered at UMMS and are divided into a general psychiatry and an addiction psychiatry consultation service.
In addition to the clinical assignments, students are given a limited seminar series. These seminars occur throughout the four-week course on Thursdays from 8:30am-12 noon. The scope of the morning seminars (8:30-10:15am) includes child psychiatry and addiction psychiatry. However, other pertinent areas of psychopathology and psychopharmacology will be covered in a series of seminars with Dr. Perez-Madrinan following the initial 2 hour seminar(10:30-12:00). It should be noted that in a four week clerkship not all areas of psychiatry can be covered for which you will ultimately be responsible for on the USMLE examination. A more comprehensive study guide with specific goals and objectives is provided within the orientation packet to assist the student into expanding the breadth of material that might appear on the shelf exam. In addition, a clinical case conference is given weekly with a focus on interviewing, diagnostic assessment and treatment skills with a variety of faculty.
Additional responsibilities include in-house call responsibilities; attendance at a community based 12-step program (e.g., AA or NA) and the opportunity to observe electroconvulsive therapy. Each inpatient unit also has weekly administrative law hearings for involuntary civil commitments of persons suffering from severe mental illnesses that pose a danger to themselves and/or others and refuse a voluntary admission.
The Department of Psychiatry offers elective courses in all four years of the medical school curriculum. Elective courses offered in the senior year are numerous and include in-depth psychiatric experiences in: inpatient, community psychiatry, emergency psychiatry, forensic psychiatry, child psychiatry, geriatric psychiatry, substance abuse, consultation/liaison psychiatry and research electives.
Combined Accelerated Program in Psychiatry–CAPP Program
This longitudinal elective track has become nationally visible for its success in engaging students in psychiatry through an advanced three-year curriculum that begins in the freshman year. The program has continued to admit 12 freshman students each year. From early in the freshman year, the track provides an unfolding progression of combined small group seminars and clinical experiences in the behavioral sciences and clinical psychiatry. Students have seminars in advanced psychiatric interviewing, psychopathology, child psychiatry and a variety of psychotherapy modalities. In addition, an 8 week summer externship in clinical psychiatry is offered in the summer following the freshman year and a clinical mentorship (which can involve a longitudinal faculty supervised psychotherapy patient) is offered as part of the sophomore year.