SALEM VETERANS AFFAIRS MEDICAL CENTER
BEHAVIORAL MEDICINE AND PSYCHIATRY
Welcome to the Salem VAMC! We hope to make your time with us as educational, yet enjoyable, as possible. Your four-week rotation with us will include a balanced combination of ambulatory care and inpatient psychiatry experience, as well as a didactic lecture series and a variety of other educational activities.
During your rotation, you will be assigned to one of our acute inpatient psychiatric units. There you will be expected to participate in the neuropsychiatric assessment, planning, and management of patients on your service. You should be involved in the work-up of approximately three new patients per week and will be expected to participate in daily rounds, multidisciplinary team meetings, family meetings, and commitment hearings. During this portion of your clerkship rotation, we hope to provide a better understanding and appreciation for the management of patients with acute neuropsychiatric syndrome.
The services through which you will be rotating include the following:
1. Mental Hygiene Clinic (Salem VAMC-based ambulatory care psychiatry clinic): During this experience you will have the opportunity to work closely with outpatient psychiatry attendings in evaluating and managing ambulatory psychiatry patients one afternoon during each of the four weeks of your rotation with us. You will be exposed to a variety of psychotherapeutic and psychopharmacologic treatments as well as participate in the continuity of care for these patients.
2. Psychiatric Emergency Room: You will be assigned to the Psychiatric ER for one afternoon during each of the four weeks of your rotation with us. Report to the VA Emergency Room at the times assigned on your schedule. You will be expected to thoroughly assess ambulatory patients who present to the Emergency Room with a complete history, mental status exam and physical exam (when appropriate). Dr. Bhandari will staff each patient with you and will help develop a complete assessment and plan. In this setting, you will be exposed to a variety of neuropsychiatric emergencies, including patients who are acutely suicidal, homicidal, and/or psychotic. In addition, you will gain experience in crisis intervention.
3. Tellian Case Conference: These rounds are designed specifically for student teaching and to date have been one of the most popular and informative activities offered during our clerkship. Tellian Case Conference begins at 3:00 p.m. every Monday (location will be noted on your Lecture Schedule).
4. UVA Conference with Dr.
Perez: This conference takes place at 10:00 a.m. on
the first and second Fridays of the month (unless otherwise noted on
your Lecture Schedule). One student assigned to the inpatient
service should bring a patient to each conference to be
interviewed. You will have the opportunity to interview patients
with Dr. Perez observing. Interviewing skills and the patient
psychopathology will be discussed following the interview.
Improving interviewing skills and understanding non-verbal forms of
communication will be major focuses of the conference.
5. Patient Communication Conference with Dr. Ray Mayberry: Students will meet with Dr. Mayberry each Thursday at 10:30 a.m. during their rotation and will observe and participate in patient interview techniques. This conference will focus on subtle aspects of patient communication and the psychodynamic aspects of understanding psychiatric symptoms and syndromes.
6. Lectures: Your behavioral medicine and psychiatry clerkship at the Salem VAMC will include an extensive didactic lecture series. Lectures will be held from 12:00 noon to 1:00 p.m. on Monday, Tuesday, Wednesday and Fridays (unless noted otherwise on the Lecture Schedule). The lectures are intended to build upon the fundamental knowledge-base obtained in the first and second years of your medical school training. We strive to make these lectures pertinent to your clinical experience. Each of the major psychiatric disorders will be covered with appropriate handouts and audiovisual materials as needed.
Again, each of these activities will be explained in greater detail on the day of orientation and specific dates and times will be assigned.
Student Feedback: At the end of the clerkship, you will receive anonymous clerkship evaluation forms. Please take these evaluations seriously and provide candid feedback regarding your clerkship experience. We use this information to update and restructure the rotation periodically in our efforts to provide excellent medical student training.
UVA Final Grades:
50% of your final grade will depend upon your clinical performance as evaluated by the attendings and residents with which you worked. The evaluation by your inpatient attending will be weighed the heaviest followed by evaluations from attendings and residents in the Emergency Room and on the consultation service. Attendings and residents with whom you have much briefer periods of contact will not be asked to evaluate you.
50% of your final grade will be based on your performance on the written examination.
General work hours are 7:30 a.m. until 4:30 p.m. Monday through Friday, although students should expect to alter those hours dependant on patient needs and attending requests. Students should expect to arrive early enough to be fully familiar with their patients prior to the beginning of morning rounds and stay on the unit until all work for the day is completed. The attendance policies of each institution will be followed strictly and may differ. All requests for leave will be approved through both the assigned unit attending and Dr. Perez (UVA) or Dr. Wood (VCOM).
Enrique Perez, M.D.
University of Virginia Medical Student Clerkship Program
Veterans Affairs Medical Center, Salem, Virginia