||Adrienne Bentman, M.D.
||All months, except August
|# of Students:
||Maximum of one
||Third Year Curriculum, including Clinical Psychiatry Rotation
Coordinator, Medical Student Education
This elective is designed to provide advanced training in the psychiatric care of seriously ill patients in a large metropolitan general hospital. The elective is a valuable adjunct to the CORE requirements for those students interested in, or curious about, pursuing a career in psychiatry. The rotation is also appropriate for those students who are interested in pursuing alternate fields, but who desire advanced training in the diagnosis and management of emotional and behavioral problems in the general medical setting.
The student will learn medical aspects of psychiatry, including diagnosis of psychiatric and neurologic syndromes, behavioral neurology, psychopharmacology, and dealing with difficult patients. Common problems addressed include depression, anxiety, delirium, dementia, palliation in terminal illness, physical and drug-induced psychiatric states, functional psychiatric states in the medical setting, competence to engage in treatment decisions, and refusal of treatment. Patients are seen on all services, but most prominently on the general medical and surgical, oncology, ICU, organ transplantation, cardiology, trauma, and HIV services.
The student is responsible, under the supervision of the consultation/liaison attending group, for the care of patients referred to the Consultation/Liaison Psychiatry Service at Hartford Hospital. The responsibilities of the student include the initial psychiatric diagnostic evaluation, assessment of the needs and interrelationships of members of the multidisciplinary treatment team, pharmacologic management, individual/family short-term psychotherapy when indicated, and daily progress notes and communication with members of the patient’s treatment team. The student carries 5-10 patients in consultation at any one time. Night call is not required but remains an elective adjunct to this rotation.
- To learn biological psychiatry in patients with medical/psychiatric illness.
- To develop a basic knowledge of psychopharmacology in the medical setting.
- To develop a framework for thinking about behavioral neurology.
- To enhance one’s capacity to listen to patients.
- To develop a framework for deciphering the complexity of the patient-family-medical team interface.
The student functions as an integral part of the Consultation/Liaison Psychiatry Service. Teaching is clinically based and socratic in nature. It consists of daily rounds and daily educational walk rounds with the attending and other members of the consultation team. Weekly individual supervision is provided by the fellow and a senior attending psychiatrist. More structured educational experiences include weekly Psychiatry Grand Rounds, weekly Emergency Psychiatry Conferences, monthly Psychosomatic Medicine and Neuropsychology Conferences, bimonthly Psychopharmacology and Neuroscience Rounds, and regular case-based medical/psychiatric literature reviews.
Hartford Hospital is the city’s largest general hospital, with a capacity of 850 beds. The patient population ranges in age from 18 to 80 and beyond, and patients hail from a wide variety of socioeconomic, ethnic, and cultural backgrounds. The length of stay on the consultation service ranges from one to 90 days, with the average being seven days. Fifteen hundred consultations are provided each year to the Hartford Hospital medical population.
Evaluation information is solicited from all supervising attendings and residents on the service. The primary supervisor provides the student with feedback on his/her progress at midpoint and with a final verbal and written evaluation at conclusion of the rotation.