Medical School Education

A variety of fourth-year electives are available for medical students in the Department of Psychiatry at the University of Michigan. Clinical as well as research opportunities can be arranged. Students from other medical schools are welcome, and those interested in learning more about Michigan's Psychiatry Residency program are invited and encouraged to spend some elective time here.

Learning Objectives

See Institutional objectives

Learning outcomes have been developed for general psychiatric skills and for selected diagnoses and clinical settings. By the end of the psychiatry clerkship the student will be expected to be able to:

General Psychiatric Skills:

  1. Obtain, document, and present an age and gender-appropriate psychiatric history.

  2. Do a complete mental status examination.

  3. Assess suicidal and homicidal ideation, across the lifespan.

  4. Apply differential diagnosis skills using specific history and physical exam findings.

  5. Select appropriate diagnostic and laboratory tests and interpret results.

  6. Effectively communicate with patients and families using sensitive, non-judgmental language, and recognize the emotional impact of illness on patients and families.

  7. Select appropriate treatment (medication and/or therapy) and, if necessary, refer to specialty care.

  8. Develop skills for enhancing treatment adherence.

  9. Understand that the most common mental disorders (depression, anxiety, and substance abuse) are often co-morbid with other chronic diseases and impact course, severity, and clinical outcome.

  10. Understand the confidentiality requirements of psychiatric diagnoses.

  11. Understand legal requirements of civil commitment and competency evaluations.

Learning Outcomes:

Learning outcomes have been developed for selected diagnoses and clinical settings. By the end of the psychiatry clerkship the student will be expected to be able to:

Mood Disorders:

  1. Recognize the high prevalence of depression in medical patients.

  2. Identify various presentations and the natural history, onset, and prognostic features of depression across the life span.

  3. Select and monitor appropriate psychiatric medications used in treating depression.

  4. Assess an individual patient’s potential risk for subsequent depression.

  5. Recognize the signs and symptoms of major depression, bipolar illness, and dysthymia so that given a patient description you can recognize these syndromes.

  6. Assess the presence or absence of possible co-morbidities including dementia, anxiety disorder, adverse drug effect, substance abuse, and grief in any patient suspected of having depression.

  7. Assess a patient’s risk for suicide and be able to appropriately respond to high risk patients.

  8. Assess the impact of depression upon the patient’s level of function.

  9. Recognize that depression may be a potentially life-threatening illness.

  10. Recognize that uncomplicated depression can be diagnosed and treated by non-psychiatrists.

  11. Recognize that treatment of depression is interdisciplinary.

Anxiety Disorders:

  1. Differentiate between normal anxiety and specific anxiety disorders.

  2. Describe major clinical, etiological, and epidemiological characteristics of panic disorder, agoraphobia, generalized anxiety disorder, social phobia, specific phobia, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).

  3. Recognize the ways in which anxiety disorders may present in primary care and other medical settings.

  4. Recognize the general medical conditions and substances commonly associated with anxiety symptoms.

  5. Describe anxiety disorder symptom presentations as they vary across the life span (e.g. child andelderly).

  6. Describe major characteristics of anxiety disorders unique to childhood, including separation anxiety disorder and overanxious disorder of childhood.

  7. Recognize the precipitating factors and functional impact (e.g. work, school, family relationships) of anxiety disorders.

  8. Identify major classes of psychiatric medications used in treating anxiety disorders and discuss potential side effects of each.

  9. Select and monitor appropriate psychiatric medications used in treating anxiety disorders.

  10. Identify the primary psychosocial therapies used to treat anxiety disorders.

Substance Abuse:

  1. Understand the major models of substance dependence and implications for treatment.

  2. Differentiate between substance abuse and substance dependence (addiction).

  3. Know how to screen for alcohol and drug problems in general medical practice.

  4. Have working knowledge and an approach to the differential diagnosis of substance dependent patients with co-morbid psychiatric disorders.

  5. Know the signs, symptoms, clinical course, and treatment of withdrawal (outpatient detoxification) for the various drugs of abuse.

  6. Understand the difference between addiction to prescription drugs and taking medications due to legitimate medical need.

  7. Differentiate between abstinence and sobriety.

  8. Have a working knowledge of self-help groups such as Alcoholics Anonymous and Alanon and understand basic concepts in recovery.

  9. Know the indications, contraindications, and efficacies of pharmacotherapy to treat substance abuse.

  10. Become knowledgeable of community resources for treatment of addiction.

Psychosis:

  1. State the definition of psychosis and describe how to recognize and diagnose psychotic conditions.

  2. Perform an initial diagnostic evaluation of a patient with psychotic symptoms, including history and mental status examination.

  3. Give a medical and psychiatric differential diagnosis for psychosis.

  4. Summarize the epidemiology, diagnostic criteria, clinical features, course and complications of schizophrenia.

  5. Recognize current theories of the etiology and pathophysiology of schizophrenia.

  6. Recognize the common substances associated with psychosis during intoxication or withdrawal.

  7. Recognize the other major primary psychotic disorders including mood disorders, schizoaffective disorder, brief psychotic disorder, and delusional disorder.

  8. Describe common and serious side effects of frequently used antipsychotic medications.

  9. Recognize the pharmacologic and psychosocial treatments of schizophrenia and other psychotic disorders.

  10. Describe the initial and maintenance treatment of a manic episode.

Personality Disorders:

  1. State the definitions of personality trait and personality disorder.

  2. Describe each personality disorder cluster and name its component disorders.

  3. Describe the basic characteristics of each personality disorder.

  4. Describe the clinical features, epidemiology, diagnostic criteria, comorbidities, and treatments of borderline personality disorder.

  5. Demonstrate a working knowledge of Dialectical Behavior Therapy (DBT).

  6. Recognize the treatments for other personality disorders.

  7. Describe the implications for the doctor-patient relationship of each personality disorder.

  8. Conduct a suicide assessment that differentiates between acute and chronic suicidal ideation.

Child/Adolescent Component:

  1. Describe major characteristics of disorders first presenting in childhood or adolescence including ADHD, Pervasive Developmental Disorders, Learning Disorders, and Mental Retardation.

  2. Describe symptoms of mood, anxiety, and psychotic disorders presenting in children.

  3. Recognize the ways in which a specific psychiatric disorder may present differently in childhood/adolescence.

  4. Conduct and interpret a child/adolescent mental status exam with a child and conduct a parent interview.

  5. Identify major classes of psychiatric medications and their pharmacokinetic principles, used in treating child and adolescent disorders and discuss potential side effects of each.

  6. Recognize the potential biological, psychological, and social impact of child abuse/neglect on development in children, and describe the legal requirements and procedure for reporting suspected child abuse/neglect in children and adolescents.

Consultation Liaison / Emergency Services Component:

  1. Recognize medical symptoms of psychiatric disorders.

  2. Recognize psychiatric symptoms of medical disorders.

  3. Recognize, assess and manage the delirious patient.

  4. Conduct and interpret a Mini-Mental Status Exam or MOCA to assess cognitive function.

  5. Review commitment laws for involuntary treatment, and evaluate a patient’s capacity to give informed consent.

  6. Recognize psychiatric symptoms that are side effects of medications.

  7. Recognize the following somatoform disorders: somatization disorder, conversion disorder, hypochondriasis, pain disorder, body dysmorphic disorder.

  8. Discuss the management of somatoform disorders.

Geriatric Psychiatry Component:

  1. Demonstrate proficiency in taking a past/family psychiatric history from older adults.

  2. Recognize the importance of obtaining information from collateral informants. The student will develop an awareness that cognition may interfere with reliability of the patient’s report.

  3. Recognize how geriatric psychiatry conditions impact functionality, Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL), should be assessed and followed in every patient.

  4. Perform standardized cognitive screening tools (e.g. MMSE and MOCA).

  5. Define dementia and dementia subtypes, recognize symptoms of Dementia of the Alzheimer’s type (DAT), describe the typical progression for dementia, and recognize treatments for dementia.

  6. Articulate that depression is not a normal part of aging and that depression may have an atypical presentation compared to younger adults.

  7. Use the Geriatric Depression Scale (GDS) as a standardized screening tool for depression in older adults, identify treatments for geriatric depression including the use of ECT, recognize that geriatric depression may be associated with reversible cognitive decline (i.e., pseudodementia) and recognize that late life depression may be precursor to dementia.

  8. Recognize the complexity of the geropsychiatric patient and the interactions between medical, neurological, and psychiatric illnesses.

  9. Demonstrate understanding of how physiological changes with aging and medical comorbidities affect psychotropic prescribing.

  10. Recognize, assess, and treat delirium.

  11. Categorize the differential diagnosis of late onset psychosis.

How students will be evaluated to ensure that each objective is met:

Students will be given opportunities to participate in direct patient care under attending and resident

supervision. This will include individual interviews with patients, written initial evaluations and progress notes, review of diagnostic test results, contact with families and outside care providers, presentation of cases to attendings and other staff, and participation in patient-related meetings and discussions.

 

Last updated: 1/22/2016

How to apply

Inquiries about senior electives in the Department of Psychiatry or other opportunities in pursuing individual interest may be directed to:

Dayna LePlatte, MD

Inquiries about course descriptions and application/credentialing process should be directed to:

Cindy Murphy
Clinical Phase Scheduling Secretary,
Office of the Registrar
C5124 Med Sci I
1309 Catherine Street
Ann Arbor, MI 48109-0611
(734) 936-2608
Email: camurphy@umich.edu

4th Year Electives

Students from other medical schools are welcome to apply for the following electives:

Child and Adolescent Psychiatry (001DEVI.U)

Students will be involved in admissions to the Child and Adolescent Inpatient Psychiatry Service, attending to patient care, management and treatment planning. Students will participate in the multidisciplinary team responsible for diagnosing and treating children and adolescents with a variety of psychiatric disorders, as well as co-morbid medical diagnoses. Students will participate in admission interviews involving patients and families and participate in daily rounding. Students will also help coordinate care with outside providers, appropriate consultative services and primary care.  Students may also have some exposure to the child and adolescent consultation service, looking at psychiatric/psychological issues of children with illness working with children and their families and with the pediatric teams. By individual arrangement this rotation can provide the opportunity for doing supervised outpatient evaluations. Elective should be considered by students thinking of pediatrics and family practice as well as psychiatry.

Note: In addition to experiences listed here, other experiences and programs within the Department of Psychiatry can be individually arranged based on a student's background, previous experiences, and future interests.


 

Psychiatry Consult-Liaison (1CONI.U)

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 a nurse practitioner.  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 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. 


 

Emergency Psychiatry (001 EMRO.U)

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.


Geriatric Psychiatry (001GERP.X)

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.


Inpatient Psychiatry (1GENI.U)

The elective consists of active involvement on an inpatient psychiatry unit as a functioning member of the treatment team. Students will conduct initial and follow-up evaluations of psychiatric inpatients, lead treatment team discussions of diagnosis and treatment, and serve as the primary therapist (under attending and house officer supervision) of 2-3 patients at a time. Clinical activities will be similar to those of a house officer on the service. The experience is designed primarily for students interested in psychiatry or students who wish to see severe or complicated manifestations of psychopathology.

 


Pediatric Consultation-Liaison Psychiatry  (2PCLI.U)

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 senior medical student with a comprehensive clinical and academic experience at the interface of pediatric medicine and child and adolescent psychiatry. This four-week 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, such that by the end of the rotation they should be functioning at the level of an early psychiatry intern. 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 expected to develop either a small quality improvement project or brief review of the literature during their rotation with regular weekly supervision with Dr. Malas on Friday afternoons for guidance and support. 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.


 

Alcohol/Substance Abuse (001SUBO.U)

Learn the essentials of identification, assessment, and treatment of patients with substance-related disorders. Emphasis on screening and brief intervention techniques. Learn principles of detoxification for alcohol, opioids, and cocaine; interpretation of drug testing results; proper prescribing practices for patients with substance use disorders. Students follow patients and accompany the attending during psychiatric evaluations of patients with substance use disorders.


 

For more information about studying at the University of Michigan Medical School, please visit the Visiting Student Program Website

Updated: December 7, 2017

Student Interest Group (PsychSIGN)

The University of Michigan Psychiatry Student Interest Group is run by medical students and resident physicians, and is affiliated with the U of M Department of Psychiatry.

We act to educate and enrich the medical student community on topics of psychiatry and mental illness as well as to promote interest and provide resources on psychiatry as a profession. We coordinate a lunchtime lecture series on psychiatry-related topics, host movie nights to discuss relevant themes in current films, and coordinate a mentorship program to match interested students with resident mentors.

We are affiliated with the national Psychiatry Student Interest Group Network (PsychSIGN).