Rotation Specific Overview

Psychiatry rotations emphasize mental health evaluation, interviewing techniques, therapeutic relationships, and psychopharmacology. This rotation requires a different skill set, focusing heavily on communication, empathy, and observational skills. Students must learn to manage complex psychiatric conditions with sensitivity and insight. Study should be organized around diagnostic criteria (DSM-5), medication management, therapeutic modalities, and crisis intervention strategies.

 

Core Principles and Focus Areas

• Psychiatric Interviewing and Clinical Assessment:

  • Master the psychiatric history, mental status exam (MSE), and risk assessments (suicide, homicide, self-harm).

  • Understand diagnostic criteria (DSM-5), including distinguishing among similar presentations.

• Psychopharmacology:

  • Familiarize yourself with medication classes (SSRIs, SNRIs, antipsychotics, mood stabilizers, anxiolytics), their indications, side effects, contraindications, and monitoring requirements.

• Mood Disorders:

  • Recognize and manage depressive disorders, bipolar disorders, including diagnostic criteria, treatment approaches, and medication choices.

  • Emphasize differentiating primary psychiatric conditions from mood disorders due to medical conditions or substance use

• Psychotic Disorders:

  • Understand the evaluation and management of schizophrenia, schizoaffective disorder, and acute psychosis.

  • Emphasize pharmacologic management, including acute stabilization and long-term treatment considerations.

• Anxiety and Trauma-Related Disorders:

  • Master clinical presentations and treatment strategies for generalized anxiety disorder, panic disorder, PTSD, OCD, and phobias.

  • Understand role of psychotherapy (CBT, exposure therapy) in conjunction with pharmacologic management.

• Substance Use Disorders:

  • Learn diagnosis, acute intoxication/withdrawal management, long-term treatment (medication-assisted therapies, harm reduction strategies), and motivational interviewing techniques.

• Personality and Behavioral Disorders:

  • Identify key features and management principles of borderline, antisocial, narcissistic, and other personality disorders.

  • Emphasize therapeutic communication, setting boundaries, and crisis management strategies.

• Consultation-Liaison Psychiatry:

  • Understand psychiatric manifestations of medical conditions, management of delirium, capacity assessments, and decision-making regarding medical/surgical care.

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Core Resources (Resources, Links, and More Detailed Descriptions Listed Below) 

• UWorld/Amboss Qbanks – The cornerstones of practicing rotation-specific knowledge 

  • Approach questions systematically, identify key phrases and concepts, differentiate critical information from distractors, analyze all answer choices (why they’re right or wrong), and hypothesize how changes in the vignette could alter correct answers.

• DSM-5 (Diagnostic and Statistical Manual of Mental Disorders)

  • ​Familiarize yourself with diagnostic criteria for core psychiatric conditions, particularly to clarify subtle distinctions.

• First Aid for the Psychiatry Clerkship

  • Concise summaries, high-yield topics, clinical pearls, and practice scenarios aligned directly with shelf exam content.

• Case Files: Psychiatry

  • ​​Excellent for practice questions, scenario-based learning, and real-world case discussions

• BRS/Blueprints (Prep-book resources) 

  • Important resources for structured review to pair with practice questions and for diving deeper into material. ​

• NBME Practice Exams 

  • Pivotal for evaluating progress throughout the rotation. Target your first NBME for the mid-point of the rotation followed by a NBME every 1-1.5 weeks following​

 

Maximizing UWorld Effectiveness

• Active Learning: UWorld Notebook

  • Write down one or more key takeaways per question (new fact, forgotten detail, high-yield point).

    • Option: Convert notes into Anki flashcards for spaced repetition.

  • UWorld is for learning, NOT assessment – Read explanations in detail, even for correct answers.

• Question Block Strategies

  • Random Question, Timed Blocks = Best for self-assessment and tracking progress.

  • Subject-Specific, Tutor Mode Blocks = Useful for targeted content mastery. This should be the focus for the majority of your rotation

  • Quality > Quantity – A thoughtful review of a few questions beats rushing through many.

 

General Approach to Studying on the Wards

• Weekly Topics: Dedicate each week to core topics. Align these with your clinical rotations.

• Daily Integration/Practice: Allocate daily review sessions to UWorld practice questions and corresponding Anki reviews for spaced repetition. Recommended to break down the total number of Uworld questions for the rotation and schedule a set number a day that will put you on pace to finish by 1 week before the shelf exam. 

• Longitudinal Learning: Regularly revisit health maintenance guidelines and common clinical presentations throughout the rotation as patients present to the clinic/on the wards. 

• Pre-Clinic/Ward Preparation: Briefly review anticipated patient presentations or conditions prior to clinical encounters to enhance engagement and confidence.

• Post-Clinic Reflection: After clinical experiences, revisit related guidelines or resources to deepen understanding of real-life application.