MD Courses — Psychiatry

Second year

M85 676A DISEASES OF THE NERVOUS SYSTEM: PSYCHIATRY
Instructor: Marcie Garland, MD  314-362-2432
This course emphasizes the diagnosis of major psychiatric illnesses in adults and children. Psychiatric diseases are described in terms of epidemiology, clinical presentation, natural history, genetics, differential diagnosis and clinical management. Interviewing techniques and performance of the mental status exam will be demonstrated by patient interviews.

Third year

M85 770 PSYCHIATRY CLERKSHIP
Instructor(s): Brendan O’Connor, MD, 362-2469
During this 4-week rotation, students will further enhance their understanding of psychiatric disorders and develop necessary clinical skills through active participation in the evaluation and treatment of psychiatric patients under the supervision of resident and attending physicians, teaching conferences and lectures, and other assigned learning experiences and educational requirements. The primary experience will be in inpatient adult psychiatry; however there will also be variety experiences in outpatient settings and with the electroconvulsive therapy (ECT) service.

M85 771 AMBULATORY CLERKSHIP: PSYCHIATRY FOR GENERALISTS
Instructor(s): Brendan O’Connor, MD, 362-2469
Students may elect to pursue their ambulatory medicine selective through the Department of Psychiatry. This rotation is intended to provide clinical experience in Psychiatry relevant to other medical fields, including Internal Medicine and Pediatrics. Students may request experience in psychiatry consult-liaison, outpatient adult psychiatry, outpatient child and adolescent psychiatry, and/or addiction psychiatry.

Fourth year

Electives

M85 805 / PSYCHIATRY CONSULT SERVICE
Instructor(s): Fay Y. Womer, MD, 314-362-2469
Location: Barnes-Jewish Hopsital
Elective Contact: Fay Y. Womer, 314-362-2469

Other Information: Students should report to Renard Building 4410 at 8:00 a.m. first day. Tammie Repko is available in Renard 4408 and can be reached at 314-362-2469 for any questions or issues.
Enrollment limit per period: 2
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Students will participate in the evaluation and treatment of patients referred to the psychiatry consult service. They will attend departmental conferences and other educational sessions.

Student time distribution: Inpatient 90%; Conferences/Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attending psychiatrist and psychiatry residents
Patients seen/weekly: 5-10
On call/weekend responsibility: None

M85 810 / OUTPATIENT COMMUNITY PSYCHIATRY
Instructor(s): Aninkunle Owoso, MD
Location: The Psychiatry Clinic and community sites
Elective Contact: Patricia Sharp, 314-362-1251

Other Information: Please e-mail one month prior to the elective to arrange meeting time and place.
Enrollment limit per period: minimum 2; maximum 3.
Valid start weeks for four-week blocks are: Weeks 9 and 13

This is a flexible clerkship where effort is made to tailor the activities to the students’ interests. Students will assist in diagnosis and treatment of adult psychiatric clinic patients. The patients present with a wide variety of psychological and interpersonal problems, as encountered in an everyday office practice. In this setting, the student will have the opportunity to learn a variety of treatment techniques under supervision.

Student time distribution: Outpatient 80%; Conferences/Lectures 20%; Subspecialty Care 100%
Major teaching responsibility: Attending Psychiatrist and psychiatry residents
Patients seen/weekly: 20
On call/weekend responsibility: None

M85 836 / CLINICAL PSYCHIATRY – INPATIENT PSYCHIATRIC SERVICE
Instructor(s): Michael Jarvis, MD, PhD, 314-362-1816
Location: Barnes-Jewish South
Elective Contact: Michael Jarvis, MD, PhD, 314-362-1816

Other Information: Contact Cindy Bander prior to first day of elective at 314-362-1816.
Enrollment limit per period: 3
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This is a senior rotation that provides the students with an opportunity to expand their knowledge of inpatient clinical psychiatry by functioning as interns. Students attend all staffing and teaching conferences given to first-year psychiatry residents, take patients in rotation, and share night call with first-year residents approximately every fifth night.

Immediate supervision is provided by the inpatient attending, and additional supervision can be arranged as desired. Teaching emphasis is directed toward psychiatric diagnosis, appropriate use of psychopharmacologic agents, psychotherapeutic intervention, use of community resources and pursuit of the psychiatric scientific literature. The student will write a self selected clinical topic relevant to treatment and management of psychiatric inpatients.

Student time distribution: Inpatient 85%; Conferences/Lectures 15%
Major teaching responsibility: Clinical attending, teaching attendings and residents
Patients seen/weekly: 5-15
On call/weekend responsibility: Every fifth night

M85 840 / CHILD PSYCHIATRY
Instructor(s): Anne Glowinski, MD, 314-286-2217
Location: Montclair Building, 24 S. Kingshighway, Outpatient Psychiatry Clinic
Elective Contact: Brigitte Northrop, MD, 314-286-2217

Other Information: Interested students should contact Dr. Anne Glowinski at 314-286-2217 in the Department of Psychiatry.
Enrollment limit per period: 2
Valid start weeks for four-week blocks are: Weeks 9, 13, 17, 21, 25, 29, 33, 37, and 41 or contact Dr. Glowinski for modifications.

This elective in child psychiatry utilizes the Child Psychiatry Outpatient Clinic and the consult-liason service at St. Louis Children’s Hospital. It provides experience in age-appropriate diagnostic and treatment methods in children and adolescents. A paper on topic of student’s choosing is required.

Student time distribution: Outpatient 75%; Conferences/Lectures 25%; Subspecialty Care 100%
Major teaching responsibility: Attendings and fellows
Patients seen/weekly: 15-20
On call/weekend responsibility: No, but can shadow fellow during call if requested by student

M85 844 / FORENSIC PSYCHIATRY
Instructor(s): Michael R. Jarvis, MD, PhD
Location: Barnes-Jewish Hospital Plaza, West Pavilion, Suite 15430
Elective Contact: Cindy Bander, 314-362-1816, banderc@wustl.edu

Other Information: Students should report to Barnes-Jewish Hospital Plaza, West Pavilion, Suite 15430, at 9:00 a.m. on the first day of the elective.
Enrollment limit per period: 1
Valid starting weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The medical student will be actively involved in many aspects of forensic psychiatry including civil litigation, workman’s compensation, malpractice, civil commitment, and guardianship. There may be opportunities to be involved in criminal forensic issues. The student will work with Drs. Jarvis, Harbit, and Garland, within the Department of Psychiatry but will primarily meet with Dr. Jarvis a minimum of 2 hours a week. They will also work with The BJH Manager of Case Management and The City of St Louis Probate Court. The student will also be assigned readings of landmark case, textbooks, psychiatric expert opinions, legal filing with the probate court and attend civil hearings.

The student will learn relevant criminal statutes regarding competency and civil commitment, causation in civil litigation, the concept of medical malpractice and risk assessment of violence and suicide.  There may be the opportunity to witness sexually violent predator evaluations and/or treatment.  The student will be required to research and write an opinion on a specific approved topic in forensic psychiatry.  The objectives will be measured by attendance and by formal evaluation of the student’s participation and knowledge during the supervision discussion.  It will also be determined by the originality, thoroughness and quality of the research paper.

Student time distribution: Inpatient 50%; Conferences/Lectures 50%
Major teaching responsibility: Dr. Jarvis, Dr. Harbit, Dr. Garland, Jim Hoerchler, Lisa Johnson, St. Louis Probate Court
Patients seen/weekly: No active patient treatment
On call/weekend responsibility: None

M85 855 / INTRODUCTION TO EATING DISORDERS
Instructor(s): Kimberli McCallum, MD, 314-968-1900, ext. 111
Location: 231 W. Lockwood Ave., Suite 201, St. Louis, MO 63119
Elective Contact: Kimberli McCallum, MD, 314-968-1900 ext. 111

Other Information: Students report to Dr. McCallum’s office, 231 W. Lockwood Ave., Suite 201, St. Louis, MO 63119, 9:00 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 9, 13, 21, 29, and 33

Students will learn the basics of assessment, participate in groups that focus on family education, gain experience in interdisciplinary psychiatric team work, attend case discussions with psychiatrists, and participate in treatment planning.  Students will be able to describe core symptoms, recommend treatment options, and discuss the medical, nutritional, and psychiatric components of treatment.

Student time distribution: Inpatient 80%; Day Program 10%; Conferences/Lectures 10%; Primary Care 20%; Subspecialty Care 80%
Major teaching responsibility: Kimberli McCallum, M.D.
Patients seen/weekly: 5
On call/weekend responsibility: Second Saturday of each month

M85 870 / PSYCHIATRIC ONCOLOGY
Instructor(s): Monica Bishop, MD, 314-362-2469, and Eugene Rubin, MD
Location: Center for Outpatient Health  (COH), Suite 441
Elective Contact: Cristina Gonzalez, 314-362-8251

Other Information: Students should contact Cristina Gonzalez at 314-362-8251, prior to the first day to coordinate meeting time/place.
Enrollment limit per period: 3
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This elective will provide additional training related to consultation-liaison psychiatry with a special emphasis on caring for patients with cancer. The Institute of Medicine has identified the need to increase the availability of psychiatric services in the setting of cancer treatment, and this elective will allow students to gain additional experience working with inpatients and outpatients receiving treatment at Siteman Cancer Center. This elective will allow students to learn about the management of end of life issues, and experience the satisfaction of providing comfort to patients and families via psychotherapy and pharmacology. Opportunities also exist to focus on specific conditions, such as gynecological cancers. Dr. Bishop and Marty Clarke, PhD, PA-C will directly supervise students providing a unique opportunity for individualized teaching and autonomy.

Student time distribution: Inpatient 60%; Outpatient, 30%; Conferences/Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: The attending on the rotation
Patients seen/weekly: 12
On call/weekend responsibility: None

M85 880 / SCHIZOPHRENIA PRECURSORS & PRODROMAL STATES
Instructor(s): Angela M. Reiersen, MD, 314-747-6793
Location: Dr. Reiersen’s office at East Building Suite 1153-Room B, and the Washington University Child  Psychiatry Clinic at 4444 Forest Park Blvd., Suite 2600.
Elective Contact: Angela M. Reiersen, MD, 314-747-6793, reiersea@wustl.edu

Other Information: Students should contact Dr. Reiersen via email 1-2 weeks prior to rotation to confirm schedule and obtain some preparatory reading materials.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This is an opportunity for trainees to gain experience in the evaluation of children and adolescents who may be at high risk for schizophrenia. The rotation would center around the “First Contact Assessment Service”, which evaluates patients who show characteristics suggestive of prodromal schizophrenia (such as new-onset attenuated psychotic symptoms along with recent deterioration in functioning) and/or early life characteristics that may indicate risk for developing schizophrenia later in life (for example, nonspecific social/emotional/behavioral symptoms in a child/adolescent with a strong family history of schizophrenia.). Since the full symptoms of schizophrenia are often preceded by a wide range of childhood behavioral & developmental abnormalities, this rotation would also help trainees integrate information regarding the continuity between childhood development and adult psychopathology. Trainee would observe all aspects of First Contact evaluations (including semi-structured diagnostic interviews & examination of subtle neurological signs), participate in case discussions, and observe follow-up consultations  involving patients with psychotic and/or complex neurodevelopmental disorders. Trainee would also be required to write a literature review on a topic relevant to the rotation.

Student time distribution: Outpatient 50%; Conferences/Lectures 50%; Subspecialty Care 100%
Major teaching responsibility: Coursemaster  (psychiatry attending)
Patients seen/weekly: 2 (possibly more if enrolled during summer months)
On call/weekend responsibility: None

M85 889 / INTERVENTIONAL PSYCHIATRY
Instructor(s): Charles Conway, MD; Donald Bohnencamp, MD; Pilar Cristancho, MD, Nuri Farber, MD; Michael Jarvis, PhD, MD; Yvette Sheline MD; Dragan Svrakic PhD, MD; Charles Zorumski, MD; and ECT staff
Location: Barnes-Jewish Hospital, South Campus
Elective Contact: Charles Conway, MD, 314-362-1816

Other Information: Students should call Cindy Bander 314-362-1816 prior to scheduling the elective.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Interventional Psychiatry involves the application of ECT (Electroconvulsive Therapy), rTMS (Repetitive Transcranial Magnetic Stimulation) and VNS (Vagus Nerve Stimulation) in the treatment of medication-resistant psychiatric illness. The student will participate in the evaluations of patients referred to the Treatment Resistant Depression Clinic supervised by Dr. Charles Conway.  The student will be involved in the neuropsychiatric assessment of patients referred for ECT.  In addition, the student will receive training in the application of ECT and in the clinical management of patients receiving inpatient and outpatient ECT.  As cases become available, the student will be involved in rTMS and VNS evaluations and treatment. The student will be encouraged to review appropriate literature and make clinically relevant case-oriented presentations. The student will be expected to write a review of a self-selected clinic topic relevant to interventional psychiatry.

As advances in the field occur, the rotation may also involve exposure to individuals receiving other modalities of intervention, including deep brain stimulation (DBS) and magnetic seizure therapy (MST).

Student time distribution: Inpatient 70%; Outpatient 20%; Conferences/ Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Charles Conway, MD
Patients seen/weekly: 20
On call/weekend responsibility: None