Essential Resources for the Psychiatry Clerkship

Emily T. Cooper, BA

Disclosures

October 17, 2008

The goal of this column is to provide you with the resources you need to excel in medical school. Each edition focuses on a different preclinical course or clinical rotation, providing tips and resources to master that subject. For more clinical resources, visit Emily Cooper's blog, Med-Source which she maintains as a "one-stop guide" for med students.

The psychiatry clerkship exposes you to mental illness, the struggles that patients afflicted with these disorders face in the world, and the roles of medicine and therapy in treating these conditions. As a member of a treatment team, you will gain a lot of practice interviewing patients and you will become familiar with the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), psychiatric drugs, and medico-legal issues. You will hopefully gain exposure to the inpatient, outpatient, and consult services, each of which offers a vastly different set of patients. The hours on psychiatry clerkship are some of the lightest that you will experience during your clinical year, so enjoy your free time!

The American Psychiatric Association (APA) provides downloadable copies of their practice guidelines, indexed by disease.

If your school has a subscription to Psychiatry Online, you will have full access to the DSM-IV, which can be downloaded by section to your PDA, as well as a host of other literature.

The University of Utah offers a set of tools to help you on the mental health wards. These include a psychiatric evaluation and a daily SOAP note template with a list of common terms to aid in documentation.

Key tools that you should always have on hand (or in pocket) during your psychiatric clerkship include: the Mental Status Exam, Beck Depression Index, Abnormal Involuntary Movement Scale (AIMS), and Psych-Patient Tracker. Templates for each of these tools can be downloaded from my blog.

As mentioned above, the psychiatry clerkship has pretty sweet hours, so you should have plenty of time to study for the shelf exam (and do everything else you've been putting off). The books below are excellent resources.

Stead L, Stead SM, Kaufman MS, eds. First Aid for the Psychiatry Clerkship (First Aid Series). 2nd ed. New York: McGraw-Hill; 2002.

I found this book very helpful and manageable and a good intermediary between Blueprints and NMS. I skimmed it and then focused on the exam questions, which worked out very well.

Scully JH. NMS Psychiatry (National Medical Series for Independent Study) 4th ed. Philadelphia: Lippincott, Williams & Wilkins; 1990.

This is the most comprehensive of the review books, recommended if you are interested in the field of psychiatry.

Murphy MJ, Cowan RL, Sederer LI. Blueprints Psychiatry (Blueprints Series) 4th ed. Philadelphia: Lippincott, Williams & Wilkins; 2006.

This book provides a good overview but is fairly bare-bones. The content is sufficient for the shelf exam but may not be enough for pimping.

Hahn RK. Psychiatry, 2006 Edition . Mission Viejo, Calif: Current Clinical Strategies Publishing; 2005.

This pocket book is excellent. It contains great summaries of the disease processes as well as drug guides.

After you finish skimming/reading the review books, do some questions. The more, the better.

Kaplan USMLE Step 2 CK Qbook . 3rd ed. New York: Kaplan Education; 2006.

Do the psychiatry tests. Just as when preparing for the medicine and surgery shelf exams, these questions are money.

Pan P, Klamen DL. Psychiatry: PreTest Self-Assessment and Review (Pretest Series).10th ed. New York: McGraw-Hill; 2003.

These questions provide good coverage of topics seen on the shelf exam; however, the stems are shorter than on the real exam. Now and then an answer is marked incorrectly, but the explanations are accurate.

Toy EC, Klamen DL. Case Files: Psychiatry (Lange Case Files). 2nd ed. New York: McGraw-Hill Medical; 2006.

This is an easy read with high-yield information. It does not cover all of the information on the shelf exam, so make sure to also do Kaplan and/or Pre-Test.

Oransky I, Blitzstein S. Lange Q & A: Psychiatry . 9th ed. New York: McGraw-Hill Medical; 2007.

The questions are more difficult than those on the shelf exam, but they cover relevant topics.

  1. Be patient. Progress in mental health patients can be slow and often requires watchful waiting rather than action.

  2. Know your drugs (generics) and their major side effects for each of the axis 1 disorders.

  3. For the shelf exam, know how patients present when they have overdosed on common street/recreational drugs (PCP, alcohol, cocaine, heroin, marijuana, etc.).

  4. Be able to distinguish between atypical and typical antipsychotics (including side-effect profiles).

  5. Read case reports or a review article with anecdotes (do a quick PubMed search) to get a picture in your mind of the different personality disorders. This will help you stay focused when reading the long vignettes on the shelf exam.

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