Electives

CHILD PSYCHIATRY

PBSCI 695 P – Advanced Clerkship in Child Psychiatry, CSTC
Offered: All blocks; 2/4 weeks
Prerequisite: Psychiatry core clerkship.
Total Enrollment: 2 per block
Preceptor: Dr. Mick Storck, (206) 469-6282, storck@uw.edu
Clerkship Coordinator: Margie Trenary; 206.744.4564; (trenam@uw.edu)
Clerkship Site: Child Study and Treatment Center, Lakewood, WA

Objectives:  At the end of the clerkship, the student will be able to:

  • Conduct a complete psychiatric interview with a child or adolescent and his family

  • Formulate a diagnosis for children and adolescents

  • Develop a biopsychosocial formulation taking into account the issues salient for children and adolescents

  • Develop a comprehensive treatment care plan

  • Effectively communicate the results of the assessment and treatment plan to the family, child or adolescent

  • Communicate and work effectively with other treating professionals.

Lakewood is approximately 60 minutes from Seattle. Student will need a vehicle for this elective.  Students generally spend one day per week at Seattle Children’s and must be credentialed by SC in advance in order to participate in this elective.  Failure to provide requested information and/or complete online training will result in cancellation of this elective.  Additional paperwork and background check will be required by the Child Study & Treatment Center.

PBSCI 696 P – Advanced Clerkship in Child Psychiatry
​Offered: All blocks; 4 weeks

Prerequisite: Psychiatry core clerkship.
Total Enrollment: 2 max
Preceptor: Dr. Shannon Simmons
Clerkship Coordinator: Margie Trenary; 206.744.4564; (trenam@uw.edu)
Clerkship Site: Seattle Children’s Hospital

Goals:
This clerkship is an introduction to child and adolescent psychiatry for fourth-year medical students who have taken the general psychiatry core clerkship. It provides students an opportunity to participate in evaluation and treatment of children and adolescents in a number of settings, including an acute inpatient psychiatric unit and consultation/liaison service at Seattle Children’s Hospital and outpatient child psychiatry clinic at Lake City. Experiences in outpatient and specialized clinics are also available, with an opportunity to visit other child and adolescent mental health programs, including Child Study and Treatment Center in Tacoma, the children’s wing of Western State Hospital, and Echo Glen, a facility for incarcerated youth. Students will work closely with the Child and Adolescent Psychiatry resident both on the IPU and in the OPD.

Objectives:

  • Student will be able to interview a child or adolescent and his family and formulate a diagnosis, an assessment of need for care and a treatment approach and describe them to the family, the child or adolescent, and other care givers.

  • Student will be able to discuss a biopsychosocial formulation of child or adolescent interviews.

Students must be credentialed by Seattle Children’s in advance in order to participate in this elective.  Failure to provide requested information and/or complete online training will result in cancellation of this elective.

CONSULTATION-LIAISON PSYCHIATRY

PBSCI 670 P – Clerkship in Consultation-Liaison Psychiatry UWMC

Join the inpatient C/L team at University of Washington (HMC) in the evaluation of psychiatric and/or behavioral problems in patients on medical and surgical services, and in effectively consulting with their health care providers regarding their clinical management.

Offered: Year round; 4 weeks
Prerequisite: Completion of psychiatry core clerkship
Total Enrollment: 1
Preceptor: Dr. ​Ryan Kimmel (rjkimmel@uw.edu)
Clerkship Coordinator: Margie Trenary; 206.744.4564; (trenam@uw.edu)
Site: UW Medical Center, Seattle WA

Objectives:

  • To recognize and demonstrate the differential diagnosis of the psychiatric conditions most commonly encountered in medical settings (e.g., delirium, dementia, depression, somatoform and factitious disorders, substance abuse and withdrawal).

  • To assess and describe behavioral conditions commonly seen on medical and surgical services (e.g., suicidal and homicidal threats, grief, anxiety, personality problems and pain).

  • To evaluate a patient hospitalized because of a suicide attempt or attempted self-harm and to assess risk of self-harm while on medical or surgical services, as well as the level of psychiatric care needed after discharge.

  • To adapt psychopharmacologic and psychotherapeutic treatments for medically ill patients.

  • To demonstrate an understanding of legal issues involved in consultation psychiatry, particularly to help direct the treatment approach when a patient’s ability to make needed medical treatment decisions (e.g., competency or decisional capacity) is questioned.

  • To help non-psychiatric staff understand and manage psychiatric conditions in their patients.

Schedule:
Daily Monday – Friday, 8:00 am – 5:00 pm, no night or weekend call.

PBSCI 671 P – Clerkship in Consultation-Liaison Psychiatry HMC 

Join the inpatient C/L team at Harborview Medical Center (HMC) in the evaluation of psychiatric and/or behavioral problems in patients on medical and surgical services, and in effectively consulting with their health care providers regarding their clinical management.

Offered: Year round; 2 or 4 weeks.
Prerequisite: Completion of psychiatry core clerkship

Total Enrollment: 2
Preceptor: Dr. Shaune DeMers (sdemers@uw.edu)
Clerkship Coordinator: Margie Trenary; 206.744.4564; (trenam@uw.edu)
Site: Harborview Medical Center, Seattle WA

Objectives:

  • To recognize and demonstrate the differential diagnosis of the psychiatric conditions most commonly encountered in medical settings (e.g., delirium, dementia, depression, somatoform and factitious disorders, substance abuse and withdrawal.)

  • To assess and describe behavioral conditions commonly seen on medical and surgical services (e.g., suicidal and homicidal threats, grief, anxiety, personality problems and pain).

  • To evaluate a patient hospitalized because of a suicide attempt or attempted self-harm and to assess risk of self-harm while on medical or surgical services, as well as the level of psychiatric care needed after discharge.

  • To adapt psychopharmacologic and psychotherapeutic treatments for medically ill patients.

  • To demonstrate an understanding of legal issues involved in consultation psychiatry, particularly to help direct the treatment approach when a patient’s ability to make needed medical treatment decisions (e.g., competency or decisional capacity) is questioned.

  • To help non-psychiatric staff understand and manage psychiatric conditions in their patients.

Schedule:
Daily Monday – Friday, 8:00 am – 5:00 pm, no night or weekend call.

PBSCI 672 P – Elective Clerkship in Primary Care Psychiatry at Boise VAMC 

Offered: Year round;  4 weeks
Prerequisite: Completion of psychiatry core clerkship
Total Enrollment: 1; open to visiting students interested in the Boise Psychiatry Residency
Faculty Contact: Dr. Anne Kelly (Anne.Kelly4@va.gov)
Clerkship Coordinator: Gayle Schneider (gschneid@uw.edu). phone 206.744.3443
Clerkship Site: Boise, ID

Goals/Objectives:

  • Students will learn about the assessment and treatment of patients with acute psychiatric problems in a primary care/rural setting.

  • Students learn how to provide consultation for general medicine and surgery settings.

  • Students will learn how to asses and deal with outpatient psychiatric problems as they initially present.

  • Students will learn evaluation techniques.

  • Students will learn crisis intervention strategies.

  • Students will learn psychopharmacology.

  • Students will learn brief therapies.

Other:  This elective is intended for those considering psychiatry residency training in Idaho. There are opportunities to participate in satellite clinics in rural areas and Indian Health Service. Other participation negotiable depending on interest and experience. Student is responsible for providing their own housing and vehicle.

EMERGENCY PSYCHIATRY

PBSCI 680 P – Clerkship in Emergency Psychiatry
To provide organized instruction and supervised clinical experience in emergency psychiatry. Emphasis on clinical evaluation, acute management, and treatment planning for individual patients.

Offered: AWSpS; 4 weeks. ​
Prerequisite: Psychiatry core clerkship.
Total Enrollment: 1 per 4 weeks.
Preceptor: Dr. Paul Borghesani
Clerkship Site: Harborview Medical Center
Clerkship Coordinator: Margie Trenary; 206.744.4564; (trenam@uw.edu)

Objectives:

  • Show in an interview establishment of rapport with acutely disturbed patients.

  • Outline elements of dangerousness in a patient who was assessed.

  • Outline medical, neurological, and physiological causes for observed psychiatric symptoms.

  • Demonstrate why inpatient care is required rather than outpatient (and vice versa) after interview of a patient and review of data base.

  • Discuss patient data base and assessment in complete and succinct manner.

INPATIENT GERPSYCHIATRY

PBSCI 681 APC Sheridan – Sheridan

Please Note this Site has a 2 month credentialing process.

OUTPATIENT PSYCHIATRY

PBSCI 673 P – Outpatient Psychiatry Elective 

Offered: Year round; 4 weeks
Prerequisite: Psychiatry core clerkship
Total Enrollment: 1
Faculty Contact: Dr. Paul Borghesani (paulrb@uw.edu)
Clerkship Coordinator: Margie Trenary; 206.744.4564; (trenam@uw.edu)
Clerkship Site: Harborview Medical Center, or, VA Puget Sound HCS

Join outpatient mental health treatment team at either Harborview Medical Center or the VA Puget Sound. You will learn to assess acute mental health crisis, participate in ongoing mental health care, and work with multidisciplinary staff (case managers, pharmacists, therapists) in the outpatient setting.

Specific goals include:

  • To develop skills in acute diagnosis, assessment, and crisis intervention for urgent care psychiatric complaints, as well as for those with combined drug/alcohol problems.

  • To develop skills in medication management, psychosocial support, and teamwork in managing severely mentally ill patients.

Objectives:

  • Students will be able to conduct diagnostic interviews.

  • Students will be able to initiate and manage pharmacotherapeutic treatment regimens appropriate to patient problems.

  • Students facilitate co-therapy in groups under the supervision of attendings, resident and other trained staff.

  • Students provide crisis intervention under the supervision of attendings, resident and other trained staff.

SUBSTANCE USE

Conjoint 680 P – Introduction to Detoxification and Rehabilitation Programs for Alcoholism and Drug Abuse 

Offered: All blocks; 2 or 4 weeks – 2 weeks preferred.
Prerequisite: Psychiatry core clerkship
Total Enrollment: 1 student maximum at any time
Preceptor: Dr. Joseph Reoux (Joe.Reoux@va.gov)
Clerkship Coordinator: Margie Trenary; 206.744.4564; (trenam@uw.edu)
Clerkship Site: VA Puget Sound HCS – Seattle, WA

A supervised introduction to alcohol and drug detoxification and rehabilitation as they apply to the general physician. The student will have supervised clinical experience in a variety of addiction treatment programs, which will be accompanied by a core series of discussions. Students with particular interest in psychiatry may choose to spend most of the rotation in the Addictions Treatment Center and focus on the therapeutic/intervention process.

Objectives:

  • The student will be able to list DSM-V criteria for substance related disorders.

  • The student will be able to outline methods of detoxification for alcohol, opioids, and stimulants.

  • The student will participate in interdisciplinary treatment planning and describe the advantages to patients of such collaboration.

  • Observe/participate in addiction treatment group therapy.

  • Become familiar with medications for relapse prevention such as naltrexone and disulfiram, and demonstrate an understanding of the indications and dosages of these medications.

  • Develop a broad perspective on the range of bio-psycho-social-spiritual resources available for addiction treatment and relapse prevention and be able to describe them.

Other: Student will need to complete all required VA paperwork, HR appointment, and be fingerprinted before starting this rotation.  Failure to do this by deadline given will result in cancellation of elective.

SUBINTERNSHIPS

PBSCI 688 P – Subinternship in General Psychiatry – Seattle

Offered: All blocks;  4 weeks
Prerequisite: Permission by preceptor required. Psychiatry core clerkship.
Total Enrollment: Variable.
Faculty Contact: Dr. Paul Borghesani (paulrb@uw.edu)
Clerkship Coordinator: Margie Trenary; 206.744.4564; (trenam@uw.edu)
Clerkship Site: Harborview Medical Center, Seattle VA Medical Center

Goals:
Students will function as interns under the supervision of house staff and attending psychiatrists. Further development of the diagnostic and therapeutic skills will be emphasized. Special areas of interest such as family intervention, substance abuse, psychoses, neuropsychiatry, community psychiatry, administration, research, etc., may be pursued.

Objectives:

  • Be able to make assessments of immediate risk for violence and suicide of inpatients and appropriate interventions.

  • Be able to outline a thorough differential diagnosis.

  • Be able to manage patient care including writing orders, determining appropriate laboratory and other testing.

  • Be able to interface with a multidisciplinary team for effective patient care.

  • Be able to determine and put into place effective outpatient plans.

  • Be able to interface effectively with other treating health professionals.

  • Be able to document care and complete discharge summaries that are accurate, coherent, and succinct.

PBSCI 689 P – Subinternship in General Psychiatry – Spokane is especially relevant for students interested in the Spokane Psychiatry Residency Training Program.  Students are expected to provide their own housing and transportation.

 

PBSCI 689 P – Subinternship in General Psychiatry – Spokane

Offered: All blocks;  4 weeks
Prerequisite: Permission by preceptor required. Psychiatry core clerkship.
Total Enrollment: Variable.
Faculty Contact: Dr. John Wurzel
Clerkship Coordinator: Margie Trenary; trenam@uw.edu
Clerkship Site: Providence Sacred Heart Medical Center, Spokane

Description of the student program

Describe how student might spend his/her time during the average day/week and the types of procedures student will provide.

Current options include:

4 weeks Consult/Liaison or

4 weeks Outpatient/Child

Hospital Experience

Consult Psychiatry: The Adult Psychiatry Consultation Teaching Service provides psychiatric services for a broad range of patients with psychiatric and neuropsychiatric disorders in the context of medical, surgical, and obstetric (and other) inpatient settings at Providence Sacred Heart Medical Center. Our service offers an opportunity to see the intersection of psychiatric conditions with medical illness. Commonly treated conditions include delirium, dementia, depression, anxiety, suicide attempts, substance withdrawal, conversion disorder, somatic symptom disorder, and factitious disorder. Regardless of the diagnosis, we also help with agitation management and capacity evaluation. The sub-intern will work alongside a psychiatry resident and become an integral part of the team with direct supervision by a faculty psychiatrist.

Inpatient Psychiatry: The residency program manages six teaching beds as part of a busy 42 bed locked psychiatric unit. We treat patients with a truly remarkable mix of presentations and complexity, including anxiety, depression, bipolar disorder, schizophrenia, catatonia, cognitive disorders, and medically-induced psychopathology. The level of acuity is quite high at times, with about 1/3 to ½ of the team on an involuntary hold at any given time, and not-infrequent ECT cases.  In order to maintain a good learner-to-patient ratio, we cannot currently accommodate sub-interns for extended experiences on the inpatient unit.  However, sub-I’s will be able to join the inpatient team for 2-4 days in order to get a sense of the work.

Outpatient/Clinic Experiences

Child/Adolescent and Outpatient Sub-I: A blended sub-I experience working with children/adolescents in two different care settings with a few days of work in the adult outpatient clinic is available.  The child experience is divided between our RISE program, which is a partial-hospitalization program serving patients aged 12-18 and our BEST program, a partial-hospitalization program serving patients aged 6-12.  Both programs work with patients with diverse presentations, often of high acuity and coming from underserved backgrounds.

An additional outpatient experience at the Spokane Teaching Health Clinic is part of this rotation, with time spent in the addictions and general outpatient clinics. This outpatient experience serves a vulnerable and otherwise significantly underserved population. Because of this, the severity of psychiatric illness in this population is often quite high. There are frequently situations in which access to psychiatric care is both critical to overall health and significantly limited.

Integrative (or Collaborative) Care:

The Spokane Teaching Health Clinic is a major site for integrative care, with multiple care coordinators and multiple psychiatrists practicing this form of mental health care. This is an unusual and exciting opportunity to learn about a health care delivery system that will likely become quite prominent over the upcoming years. Although we cannot offer a full rotation in integrative care, opportunities to work integrative care time into a consult or outpatient/child sub-I are available if you are interested.

Underserved Populations:

On both inpatient and consult psychiatry at Sacred Heart Medical Center, we serve an underserved and vulnerable population. As with the outpatient setting, this fact results in a fairly high level of psychiatric morbidity among this population. Frequently, our teams are deeply involved in addressing social determinants of illnesses (both medical and psychiatric), and as such these rotations provide an excellent opportunity to develop this skill.

PBSCI 689 P – Subinternship in General Psychiatry – Spokane is especially relevant for students interested in the Spokane Psychiatry Residency Training Program.  Students are expected to provide their own housing and transportation.