And I thought my friends and family were nuts

The long-awaited blog entry about my Psychiatry rotation is here. Hopefully it is what you were waiting for.

I finished my Psychiatry rotation about a week ago. It was quite an interesting block -- 6 weeks of focusing on everything NOT to do with the heart, lungs, GI tract, urinary tract, skin, etc. You get the idea. If you ask me, it only has a few things in common with medicine in general. In fact, I still wonder why psychiatrists don't get their own school. If you think about it, podiatrists go to podiatry school, and dentists to dental school. Why don't psychiatrists go to psychiatry school? Perhaps it is because psychiatrists have the ability to prescribe a wide range of psychoactive drugs to alter the moods and even the activities of their patients. Or perhaps it is because a psychiatrist must know how to differentiate diseases of a neurological origin from those of a psychiatric origin. Anyhow, psychiatry is a part of medical school. So important, in fact, that all third year medical students must rotate through it for about 6 weeks. I have to admit that I did enjoy the rotation. I just don't see myself as having the patience to deal with some of the issues in this field.

My experience was a sort of hodge-podge of some of the facets of psychiatry. Three of the weeks were spent in the hospital, on the consult/liaison (C/L) service. Whenever a patient in the hospital is in need of a psychiatrist, whether s/he be on a medicine service, surgery service, or on the physical rehab floor, the C/L team gets consulted and sees and examines the patient. This entails writing a long note about the patient and making appropriate recommendations regarding their psychiatric state. Most of the consults were for patients with preexisting psychiatric conditions. Their doctors wanted us to consult them, and make sure their medications were at the correct doses, and that they did not interact with their new meds or their most recent medical condition/procedure.

Intermittently, I would spend 3-4 hours in the Crisis Center. This is part of the hospital that is basically a small ER for psychiatric emergencies. Our main job here is to determine whether or not the patient is a danger to himself or others. If the patient is threatening suicide or homicide, or their mental state is so unstable as to be a harm to those around them, then the patient will be admitted to the inpatient psych unit. And let me just say that the psych unit is NOT a place that you want to be. Between depressed drug addicts, borderline personality disorder drug addicts, and paranoid schizophrenic drug abusers, it's not a place to write home about.

As students, we also got to spend some time on the child psych unit, the methadone clinic, and the early childhood psych clinic. These were excellent.
Br Overall, psychiatry was the most relaxed rotation yet. It was definitely a nice breather between surgery and OB/Gyn, which I am on now. I can't believe there are only 5 more weeks until I am officially a 4th year medical student!!