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Medical Student Education

The goal of psychiatric education is to assist medical 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.

Medical Student Program

First Year

Psychiatry faculty serve as small group preceptors for the Introduction to Clinical Medicine course (ICM I), during which they meet with students weekly to practice taking a complete medical history. They also give mental health and substance abuse related lectures in ICM I. During their first year orientation, medical students shadow Psychiatry faculty on inpatient, outpatient, and consultation liaison teams.

Second Year

Psychiatry faculty teach in the Psychiatry portion of the Pathophysiology and Therapeutics course and in the Psychiatry blocks of the Introduction to Clinical Medicine course (ICM II).

Psychopathology: 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.). 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 Medicine (ICM II) 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 three-hour small group sessions distributed throughout the year. Each student is assigned to one session and 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 two to three students. Students also have the opportunity to participate in Virtual Voices, an optional activity during which auditory hallucinations are simulated to provide medical students a better understanding of psychotic symptoms and the difficulties patients encounter living with them every day.

Third Year

Junior Psychiatry Clerkship (four weeks): The junior year provides the main clinical psychiatric experience for University of Maryland medical students. The clerkship is designed to provide students with a core clinical psychiatric experience in addition to lectures and case conferences.

The core four-week psychiatry experience combines acute inpatient, outpatient, consultation, addiction, and emergency psychiatry assignments in which the student is exposed to an array of psychopathologies in a variety of treatment settings. Pharmacologic, psychotherapeutic, biological, and psychosocial treatment modalities are utilized.

Students work under the preceptorship of a psychiatry attending and resident while assigned to an inpatient or consult service. Three hospitals are utilized for these assignments. They include the University of Maryland Medical Center, the Baltimore VA Medical Center, and Sheppard Pratt Hospital. Students are assigned approximately three patients and serve as their primary medical manager under the direction of the resident and attending psychiatrist. This responsibility and involvement with patients provides an ideal setting in which the student may apply the biopsychosocial concepts learned in the second-year ICM II and Pathophysiology and Therapeutics courses. The student assumes an integral role on the multidisciplinary team and ward milieu.

Students are also given clinical exposure to patients with psychiatric or behavioral problems in a variety of other treatment settings. These are generally comprised of a morning or afternoon with psychiatric faculty in outpatient settings. Current assignments include community mental health clinics, a geriatric psychiatry clinic, a child psychiatry clinic, a primary care clinic, and telepsychiatry.

The scope of seminars includes the following: review of psychopathology, childhood behavioral disorders, addiction psychiatry and psychopharmacology, as well as a clinical case conference focusing on interviewing, diagnostic and treatment skills. In addition, there are weekly case conferences/walk rounds conducted by psychiatry chief residents to expose students to patients throughout the hospital.

Students are assigned short call with a psychiatry resident and also take a shift in the psychiatric emergency room as part of their rotation. Other opportunities for educational enrichment include a supervised experiential visit to a community 12-step program (e.g. AA, NA), observing electroconvulsive therapy, and observing administrative law hearings. Students who express interest also have the flexibility to rotate with the mobile treatment team in the community, observe a seasoned psychotherapist conduct a session in real time, or spend time with a forensic psychiatrist. Evaluation is based upon individual preceptor evaluations (2/3) and a national board multiple-choice examination (1/3).

Electives

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.

The Combined Accelerated Program in Psychiatry (CAPP): This elective track has become nationally visible for its success in engaging students in psychiatry through an advanced four-year curriculum that begins in the freshman year. The program has continued to admit 12 freshman students each year. From the first month of the freshman year, the track provides an unfolding progression of combined small group seminars and clinical experiences in the behavioral sciences and clinical psychiatry.

The Psychiatry Interest Group: This student run group is supervised by the Psychiatry Clerkship Director. It aims to provide a forum for discussion of mental health topics and to promote student interest in psychiatry. The group hosts lunch time talks on various psychiatric topics, organizes awareness activities like the annual NAMI Walk and mental health fairs, hosts social activities like movie nights and dinners with psychiatric faculty, volunteers to lead health education and recreation groups on the psychiatric inpatient units, and promotes involvement with national organizations like the American Psychiatric Association and PsychSIGN.