Rotation #5: Psychiatry

I have been horrible about posting about the different rotations lately!! Things have been a little hectic around here and they are now starting to calm down (sort of). With making the big decisions that come at this point in time, such as out rotations and ultimately, where we will want to go for residency, there is never a moment of silence when my hubby is around. We are always talking about our options and choices. However, that's not really the point of this post, so I will save that for another time . . .

I actually started righting about my hubby's fifth rotation in Psychiatry quite a while ago (so the timeline is wrong in what is written below!). In fact, it was more than a month ago!! However, I did not want to post until you could also get a student perspective as well which my husband finally got a chance to write. So now, I am finally posting it!! Enjoy!!

Well, as of last Friday, my hubby finished his Psych rotation. Let me tell you . . . I didn't even realize that he was rotating in Psych!! Okay, okay, it really wasn't that bad!! But, to be blunt . . . I personally think that he got the shaft on this rotation!! Coming from a pretty extensive background in psychology (only about 7 years in higher education in it!), I was shocked at what he learned or rather, the lack thereof, especially on the first-hand experience side. There is more to treatment options than just the drugs! And, when it comes to those treatment options, there are so many schools of thought that play such a significant role in the history and healing, that I was just plain bummed that my hubby did not get to see more of it in action. Of course, then again, I may be biased since I come from a talk therapy background! All I really have to say is . . . Good thing he was not thinking of Psych for his career! However, to give a little benefit of the doubt to those in charge . . . mental health issues can be tough to talk about. Many individuals that see a Psychiatrist will have to do so for very long periods of time. They tend to be more private or not as willing to share their experiences with your primary care provider, nonetheless some strange student that they have never seen before. And, considering that mental health issues are talked about more in today's society, whether they are truly more prevalent or not, they do play a huge role in the medical side of treatment, whether you are a Psychiatrist, Surgeon, or Family Practice Physician. Afterall, the D.O. philosophy is Mind, Body, & Spirit. It's just too bad that there was not more of a focus on the mind and spirit this month!

Now, as for my hubby's perspective . . .

I felt that the psychiatry rotation is the one true weakness that my particular clinical site has to offer at this time. During our year, half of the students went to one northern location about 1 hour away and the other half went to a more urban site south about 45 minutes. I was in the group that went south for my rotation. My typical week involved going to the physician’s outpatient clinic on Monday, Wednesday, and Friday (he had Thursday’s off and we had didactics on Tuesday afternoon making it pointless to go down there). On a typical day, I would arrive around 10:00 a.m. and leave by 3:00 p.m.. The day usually involved the student observing him interviewing the patient. On certain days of the week (I can’t remember which ones) his days were dedicated to medication review visits. Basically, this involved the patient coming in, telling him how the treatment was going, any side-effects from the medications, etc. The physician would then adjust the medication, take away or add another medication, and send the patient on their way. This would take about 15 minutes total. He would have a couple of new patients mixed in during these days, but not many.

The new patients were the interesting ones. These would be individuals new to the practice and the interview would take close to an hour. It was very in-depth and he would eventually quiz you a little on what you felt the patient had by making you leave the room and discuss the diagnosis with him later.

The major downside to this rotation was that there was no inpatient care. It was all outpatient, making it difficult to learn a lot. This may change in the future, but I am unsure of that at this time. The northern rotation did have inpatient psychiatric medicine however and those individuals had only a slightly better experience (but still not that great from what they tell me).

Overall, I didn’t feel this was a great rotation. I did most of my learning from a book and felt it was almost a waste of time and money being on the road for 2 hours for only 2-4 hours of limited exposure.