Electives

Students rotating on the psychiatry consult-liaison elective will work within a multidisciplinary team of health care providers, including psychiatrists, social workers, a psychologist, and psychiatric nurses.  The team performs evaluations on patients admitted to University Hospital, VonVoigtlander Women’s Hospital, and the Frankel Cardiovascular Center.  Both comprehensive and focused psychiatric evaluations are requested for a variety of reasons, including: change in mental status/delirium, agitation, exacerbation of a previously diagnosed mental health condition, new onset psychiatric symptoms, capacity to make medical decisions, difficulty in adjustment to illness, and suicide risk evaluation, among others.  The psychiatry consult-liaison team provides diagnostic and treatment recommendations to primary medical teams, and helps support the mental health needs of patients admitted to the hospital.  Students will learn the indications for a psychiatric consult, understand how the psychiatry consult team can be helpful to both patients and primary teams, and will improve knowledge base around a variety of mental health, substance use, and neurocognitive diagnoses.  Students will also improve interviewing and oral presentation skills, and learn how to communicate recommendations to other health care providers.  The senior medical student will be encouraged to be the primary point of contact to the primary team, with extensive supervision from psychiatry residents and attendings.  The elective has broad appeal given its applicability to multiple different career pathways in medicine.

The Psychiatric Emergency Services (PES) is a busy clinical service where students can see a variety of the psychiatric and psychosocial problems that they will encounter in practice no matter what field they choose. Patients of all ages presenting with all psychiatric diagnosis are seen in PES. This elective is especially useful for students interested in psychiatry, emergency medicine, or any primary care specialty.  Students will have the opportunity to work closely with psychiatry faculty members and other PES clinical staff in direct patient care and become an integral part of our treatment team during the month-long experience. 

This elective can be tailored to the individual interests of each participating medical student and would be an especially valuable experience for those planning to pursue neurology, internal medicine, family medicine as well as psychiatry. A variety of settings allow clinical opportunities for participation in the evaluation and treatment of older patients with dementia and mental illness, to prepare future physicians to meet the need of the rising percentage of elderly in the population. Medical students will learn advanced skills in the assessment of geriatric psychiatry patients in both inpatient and outpatient settings as members of an interdisciplinary treatment team. Diagnoses focus on the 3 D's of geriatric psychiatry- Dementia, Depression, and Delirium. Advanced strategies in bedside neurocognitive testing will be presented. Learners will develop familiarity with geriatric community resources and family interventions. Interested students may sit in on neuro-psychometric testing sessions. Sites include the University Hospital for inpatient and ECT, and the East Ann Arbor Geriatrics Center for outpatient. Participation at a nursing home, and a dementia care assisted living unit at Chelsea Retirement Community will round out the experience. Clinical opportunities can be tailored to the individual student's interests, including palliative care, ECT and more.

The course provides students applying to psychiatry with a sub-internship experience. In addition to coverage of an adult inpatient psychiatry team, students will cover two evening Psychiatric Emergency Service (PES) short-call shifts and one weekend PES short-call shift. Students will function as a sub-intern and will have major responsibility for patient care. As with house officers, students will be responsible for comprehensive new patient evaluations, including history, mental status examination, safety assessment, case formulation, differential diagnosis, and treatment plans. For continuing inpatients, students will be the primary clinician responsible for on-going treatment, including daily evaluation of clinical progress, treatment selection and efficacy, medication side effects, safety assessment, discharge planning, collection of collateral information from family and outside clinicians, family meetings, and coordination with the interdisciplinary team. Students will be expected to provide primary documentation of all clinical work and order entry for their patients.

Scheduled clinical activities will include the following, expected to total about 60 hrs/week:

• Monday-Friday coverage of an inpatient team;
• 2 evening Psychiatric Emergency Service short-call shifts;
• 1 weekend daytime PES short-call shift.

Clinical care will be supervised by the attending psychiatry, assisted by a PGY-2 house officer.

The Pediatric Consultation-Liaison Psychiatry Rotation at the C.S. Mott Children's Hospital of the University of Michigan has been designed to provide the medical student with a comprehensive clinical and academic experience at the interface of pediatric medicine and child and adolescent psychiatry.

This rotation will focus primarily on the psychiatric consultation-liaison service at the C.S. Mott Children's Hospital.  This service provides inpatient consultation to a wide variety of general and specialty pediatric services within the larger pediatric hospital. The medical student will see patients with the consult faculty member and child psychiatry fellow and present them to one of a team of child psychiatrists who work in this setting.  The medical student will also be responsible to write notes on the patients they are following as well as engage in other clinical activities including brief psychotherapeutic interventions, attendance at care coordination meetings and providing psycho education. Over the course of the rotation, the medical student will gain increased autonomy in the care of their patients. In addition to this primary focus, medical students will also participate in clinical and educational activities specific to consultation psychiatry and have the opportunity to engage in unique educational opportunities in pediatrics, if so interested.  Lastly, the student will be have the opportunity to develop a small quality improvement project or brief review of the literature during their rotation. Throughout the rotation there will be opportunities for regular supervision and feedback from faculty with formal feedback occurring midway through the rotation and on the last day of the rotation.

We hope this broad exposure will provide a strong foundation in Pediatric Consultation- Liaison Psychiatry, and enrich the student's overall training in pursuit of a future career in Psychiatry, or Pediatric Medicine.