For my psychiatry rotation I was at Elmhurst Hospital, which was in an inpatient setting.I think the inpatient setting really made my experience much more enjoyable as I was able to see my patient daily and the progress they had made throughout my time there.Psychiatry was a subject that I was always intrigued with but my general knowledge was something I needed improvement on. I was able to gain more knowledge throughout the 5 weeks I was at Elmhurst by pre-rounding on patients, presenting my progress notes to residents, joining group therapies with the patients and attending multiple case study presentations.

Psychiatry when compared to other rotations, would be one that is unlike the others. Psychiatry, unlike medicine, focuses more on patients’ thoughts and cognition instead of physical exam findings. Throughout this rotation, I didn’t perform many physical exams but more often did MMSE, depression screening and safety plans. Doing these throughout my rotation, helped highlight the importance of asking the right questions in psychiatry to better gauge how my patient is doing and if the therapy is working. This is helpful for my other rotations as mood disorders are sometimes overlooked in patient care settings, but by asking them specific screening questions, I would be able to diagnose them more frequently.

Throughout the rotation I was told to write progress notes for some of the patients and take collateral information to help understand the patient situation better. This is an area I would need some improvement on as this was a new experience for me. Progress notes consisted of going through the patient’s mood,medication adherence, response to medication and why the patient needed further evaluation. This was a learning experience for me as I was taught that progress notes need enough information for us to state that the patient requires further evaluation. Patients are not in the psychiatric unit because they gave consent to be admitted but rather against their will as they need psychiatric stabilization. Progress notes had to include which specific reasons patients needed to still be admitted. Collateral information was not as hard, but was a new experience. With this experience I was able to understand the significance of making these calls. At times,some patients would not speak to us as they were overwhelmed with their current situation. With collateral calls we are able to get a better understanding of the patient situation. 

From this rotation I was able to improve on my patient interviewing skills, by attending multiple peer counseling groups or relaxation groups. In these groups I was able to sit with my patients in a group setting for about an hour and help the patients work on themselves. This would include activities that helped patients understand why they are here, ways to cope with potential triggers and how they can work on improving themselves going forward once they are discharged. At first, I would attend the meeting and just shadow but towards the end of the rotation I was able to lead some discussion and offer my input to the patients as well. Throughout these groups, I was able to learn so much more about my patients and specific experiences that give me more insight.

My next rotation is family medicine. While the setting is not much like the inpatient psychiatric unit that I am in right now. Some skills that I can take moving forward are the quick screening tools that I learned throughout my psychiatric  rotation. Depression and anxiety are a common psychiatric condition seen in all age groups and can be easily screened. As I was not able to perform many components of the physical exam in my psychiatric rotation, this is something I will definitely want to improve on in my next rotation .