Core Competencies for Psychiatry Clerkship

Psychiatry Clerkship: Reno

  1. Patient Care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health
    1. Conduct a comprehensive psychiatric history and examination.
    2. Interpret the mental status examination
    3. Assess for substance dependence
    4. Construct a bio-psycho-social formulation of the psychiatric diagnosis
    5. Discuss psychiatric differential diagnosis
    6. Provide a concise and inclusive oral presentation and write-up of the psychiatric assessment
    7. Assess psychiatric emergencies, especially dangerousness to self and others
    8. Write progress notes that are legible, clear, concise, inclusive, and pertinent
    9. Assess for side effects of the major classes of psychotropic medications, especially extrapyramidal side effects
    10. Address substance dependence issues using motivational interviewing techniques
    11. Make basic treatment recommendations based upon the bio-psycho-social-spiritual formulation
    12. Be able to discuss the relevance of empathy, counter-transference, and cultural differences in medical practice
    13. Implement crisis intervention and brief psychotherapeutic techniques
    14. Have a respectful awareness of the impact of cultural differences on psychiatric presentation and intervention
  2. Medical Knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care
    1. Understand the use of the multi-axial system of psychiatric diagnosis
    2. Diagnostic criteria for Axis I and Axis II disorders
    3. Clinical presentation, course, etiological theories, and treatments for major psychiatric disorders with emphasis on mood disorders, psychotic disorders, anxiety disorders, personality disorders, dementia, delirium, substance-related disorders, and sexual disorders
    4. Familiarity with diagnostic criteria and course of psychiatric disorders of childhood and adolescence
    5. Intoxication and withdrawal syndromes for alcohol and other drugs of abuse
    6. Treatment of addictions, especially 12-step recovery programs
    7. Detoxification protocols for alcohol and other substances
    8. Pharmacology of antipsychotics, antidepressants, mood stabilizers, and anxiolytics including therapeutic applications, efficacy, hypothesized mechanism of action, side effects, teratogenicity, and drug interactions
    9. Know the indications, effects, and side effects of ECT
    10. Familiarity with fundamental aspects of non-pharmacologic treatments of psychiatric disorders including psychotherapeutic interventions, behavioral interventions, psychosocial rehabilitation, psychoeducational approaches, recovery models, and self-help
    11. Involuntary commitment laws, competency, duty to protect, and confidentiality
    12. Familiarity with psychiatric manifestations of medical conditions.
    13. Common co-morbid medical conditions in psychiatric disability and addiction
  3. Practice-Based Learning and Improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care
    1. Actively engage in self-examination and self-exploration regarding one's own strengths, weaknesses, and biases
    2. Take the initiative in the furtherance of one's education and knowledge
    3. Exhibit an openness to examination of one's emotional reactions to patients
    4. Be able to identify and manage stress
    5. Be able to critically evaluate current medical literature and research
  4. Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals
    1. Establish rapport and conduct a psychiatric interview
      • that is well-organized and comprehensive in content
      • using open and closed questions as appropriate
      • using empathic and supportive techniques
      • using non-verbal cues to further the interview process
      • that is well-paced
      • that follows the affect of the individual
      • using paraphrasing and summarizing to further the interview
      • using constructive confrontation and probing as appropriate
      • using appropriate closure
    2. Be able to maximize the empowerment of individuals having psychiatric or intellectual disabilities through active involvement in their services
    3. Collaborate with team members in a constructive manner
  5. Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population
    1. Demonstrate consistency, honesty, punctuality, diligence and thoroughness in performing professional duties.
    2. Understand patient advocacy and appropriate boundaries in medical practice.
    3. Have the ability to work in a non-judgmental fashion with a wide range of patients, including individuals having serious psychiatric disabilities and/or addictions
    4. Have an empathic understanding of addiction and its socioeconomic and spiritual consequences
    5. Understand obligations regarding clinician impairment
  6. Systems-Based Practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value
    1. Understand the multidisciplinary team approach and the roles of the various disciplines involved in mental health services
    2. Have an awareness of the obstacles faced by individuals having psychiatric or intellectual disabilities, or addiction due to prejudice and discrimination
    3. Be aware of the multiple roles and responsibilities of the psychiatrist in providing treatment (i.e., whose agent are you?)
    4. Understand the continuum of care in the public mental health system