Oklahoma State University Center for Health Sciences
Oklahoma State University Center for Health Sciences

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Clerkship in Psychiatry - Class of 2016

Syllabus - CE 9185

General Description

The Clerkship in Psychiatry is a course (CE 9185) in the undergraduate medical curriculum that culminates in the D.O. degree. As part of the core clerkship program, the rotation is offered during the third year of study and is directed by the Department of Behavioral Sciences. Successful completion of this course is required for graduation.

This rotation is a four-week experience, during which the student, under supervision, extends his/her knowledge of clinical psychiatry and develop psychiatric skills. Students advance their knowledge base in pursuit of answers to questions that arise during patient care through assigned reading and interactions with faculty. Skill development occurs as students apply this knowledge and information from pre-clinical course work to clinical problems encountered in clerkship activities.
The majority of the course is conducted in clinical sites including College-affiliated psychiatric facilities.

The course is taught by OSU-COM clinical adjunct faculty. The Course Coordinators are responsible for the overall organization and conduct of the course. A Preceptor who is an Attending Physician at each training site is responsible for the organization of that site’s training activities and supervision of students’ activities.. Attending Physicians may be Medical Residents in Psychiatry or a  practicing Psychiatrist at the site. The roles of Preceptor and Attending Physician may be carried out by the same or by different individuals who may be referred to as Site Faculty.

This Syllabus is effective for the Class of 2016. That is, it applies to those third-year students who take this Clerkship during the 2014-2015 academic years.

Prerequisites

The first four semesters of the required OSU-COM curriculum must be successfully completed prior to starting clerkship rotations as well as any other requirements which may be imposed on the student by the College.  This coursework contains exposure to basic behavioral science and psychiatric knowledge and skills.

Course Objectives

Certain knowledge and skills are fundamental to the diagnosis and management of mental health problems. Development of this core knowledge and these skills in clinical psychiatry is emphasized in this clerkship.

Clinical psychiatry is based on distinctive information. Development of a knowledge base that will enable primary care physicians to recognize and prescribe first-line treatment for patients with common psychiatric disorders is an integral part of this clerkship. The assigned readings, formative exams, and COMAT Prep Day instruction are designed to assist students with accumulation and application of this information.

Certain clinical psychiatric skills are fundamental to the diagnosis and management of mental health problems. This rotation is oriented toward helping the student increase his/her readiness to perform the following basic skills.

Conducting diagnostic interviews, including activities such as:

  • Responding to a patient’s concerns in an empathic manner,
  • Obtaining relevant psychosocial and medical histories, and
  • Performing a Mental Status Exam.

Formulating and clarifying diagnostic findings and treatment recommendations involving, for example:

  • Summarizing medical and psychosocial histories,
  • Describing physical exam and lab results,
  • Organizing interview data and treatment recommendations into comprehensive, integrated, cogent case presentations, and
  • Explaining findings to the patient, family, and/or other health care professionals.

Collaborating with various disciplines in the treatment team by:

  • Researching medical tests and diagnostic procedures,
  • Searching for information about medications and other somatic treatments,
  • Conducting diagnostic and/or treatment interviews, as directed by the attending physician,
  • Documenting evaluation and treatment procedures, involving duties such as recording results of diagnostic interviews, lab studies, and/or treatment plans in a timely way according to the medical records protocols of the rotation site, and
  • Sharing information and developing intervention plans with other members of the treatment team, including the patient and family.

 
Curriculum

The instructional program consists of the following:

  • Observing clinical interviews conducted by Site Faculty,
  • Performing clinical activities under direct supervision,
  •  Participating in mini-lectures or directed discussions (i.e., one-on-one instruction) with Site Faculty about clinical topics,
  •  Attending at least one (required) 12-step meetings (e.g., Open Meetings of Alcoholics Anonymous, Narcotics Anonymous, Overeaters Anonymous, Al-Anon, etc.); for example, an AA (Alcoholics Anonymous) or NA (Narcotics Anonymous) Open Meeting. Each student should discuss experiences in this meeting with his/her attending Site Faculty.  Information about 12-step meetings can be obtained from the site Site Faculty or from:

Alcoholics Anonymous
Tulsa:  918-627-2224
Oklahoma City:  405-524-1100
Eastern Oklahoma:  www.211tulsa.org

Narcotics Anonymous
Eastern Oklahoma:  918-747-0017, 888-749-0017; www.okna.org

  • Reading assigned material,
  • Attending didactic presentations both at the rotation site (as per the Site Faculty), the Psychiatry Clerkship Orientation Session, and the COMAT Prep Day,
  • Completing and submitting Formative Examinations, and
  • Performing other assigned duties that are designed to assist the student in learning to perform core psychiatric skills with increased proficiency.


Required Readings

The following books are required readings for this course. The questions on the Departmental Written Exam are based on the Toy & Klamen text and questions.  The questions on the Formative Exam are based on the specified chapters in the Black & Andreasen (2014) text.  

Toy, E.C. & Klamen, D. (2009). Case Files: Psychiatry (4th ed.). New York: McGraw Hill. [This text contains case presentations with Q&As designed to develop clerkship-level clinical reasoning and knowledge in psychiatry.]

Black, D.W. & Andreasen, N.C. (2014). Introductory Textbook of Psychiatry (6th ed.) Washington, D.C.: American Psychiatric Press. [This text is recommended by NBOME for COMAT in Psychiatry preparation.]

  • Chpt 3-Neurobiology and Genetics of Mental Illness, pp. 57-81
  • Chpt 5-Schizophrenia Spectrum and Other Psychotic Disorders, pp. 125-154
  • Chpt 6-Mood Disorders, pp. 155-189
  • Chpt 7-Anxiety Disorders, pp 191-217
  • Chpt 8-Obsessive-Compulsive and Related Disorders, pp. 219-238
  • Chpt 15-Substance-Related and Addictive Disorders, pp. 391-431
  • Chpt 16-Neurocognitive Disorders, pp. 433-460

Additional readings may be assigned in preparation for the COMAT Prep Day.  Other specific readings may also be announced.

Supplemental Resources

The following are highly recommended resources for increasing depth and breadth of knowledge as well as effectiveness of skills:

Stevens VM, Redwood SK, Neel JL, Bost RH, Van Winkle NW, and Pollak MH. (2007). Rapid Review Behavioral Science, 2nd ed. Philadelphia: Mosby/Elsevier.

Sadock, BJ, Sadock, VA, & Ruiz, P. (eds). (2014). Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. Washington, D.C.: American Psychiatric Association.

Carlat, D.J. (2012). The Psychiatric Interview: A Practical Guide (3rd ed.) Philadelphia: Lippincott, Williams, & Wilkins.

Diagnostic and Statistical Manual of Mental Disorders,    Fifth- Edition (DSM- 5). (2013). Washington, D.C.: American Psychiatric Association

Formative Exams

These exams will be given over selected chapters from the Black & Andreasen, 6th ed.(2014) text.  Formative exams are designed to be learning experiences, in contrast to summative exams that are achievement tests used for grade determination.  As such, students are encouraged to take the exams while using the course texts and in consultation with preceptors to clarify material that is not well understood.
The material to be covered on the first exam includes Chapters 3, 15, and 16  from this text.  The materials to be covered on the second exam are chapters 5, 6, 7, and 8 from this text.
Exam questions will be e-mailed to you.  These questions require a short-answer format.  Answers should be brief and to the point; bulleted style is preferred.  As a guideline, answers to each question should be no more than a ½ page long, typed, single-spaced.
Both exams are to be submitted via email by sending them to karen.mull@okstate.edu. The first exam is due by midnight on the first Sunday of the rotation; the second exam is due by midnight on the second Sunday of the rotation.
Students are encouraged to read and consult with preceptors in developing correct answers.  Student responses will be reviewed by faculty members and used as guidance for discussion during the subsequent COMAT Prep Day.

Departmental Written Exam

The Departmental Written Exam, usually consisting of 50 multiple choice questions, is required for all students and is offered on the last Friday of the 4-week clerkship rotation at a time announced in advance but preceding the COMAT Exam in Psychiatry.  Information about study suggestions for the Exam will be provided during the Clerkship Orientation Session at the beginning of the rotation and/or COMAT Prep Day.

COMAT Prep Day

The Day is a case-based structured review of psychiatric knowledge that is designed to help students prepare for the COMAT in Psychiatry and the COMLEX, Part 2.  The Day will be led by a psychologist and psychiatrist faculty.  It will be held on the OSU-CHS campus from 8 AM till 5 PM on the 3rd Friday of each 4-week rotation; location TBA. Attendance is required.

Student Responsibilities

Student responsibilities that apply to all rotations are explained in the Clerkship Handbook. Students should refer to this document to review these responsibilities.
Each student must be prepared to present the results of his/her OSBI background check and immunization record to the Preceptor or designated administrative official at the training site if requested by the preceptor or facility as well as completing any other forms with accurate information required by preceptors or facilities.
In addition to these general requirements, some sites have known specific requirements, as follows:

Veterans Affairs Medical Center

Students who are to complete this clerkship at the Veterans Affairs Medical Center in Tulsa/Muskogee must complete required fingerprinting and VA background checks. Students will normally receive an e-mail to start this process about 60 days before beginning the rotation, but must take responsibility for initiating this process if this e-mail is not received as expected.

This process involves the following steps:

First,  complete and return the application form.  This form is available from Ms. Olivia Harmon (see below for contact information). This form may be emailed or faxed (918-835-5760) to her; alerting her before faxing about their arrival is advised.  This form must be returned to her before beginning step 2.

Second, contact the Human Resources department at the Jack C Montgomery VAMC in Muskogee at 918 577-3600 to set an appointment for fingerprinting.  Fingerprinting is available Mon-Fri, 9-10 am and 1-2 pm.  Fingerprinting is located in Bldg 8; processing is located in Bldg 9 (both buildings are located across the street from the main hospital).  You will need to take two forms of ID or a passport.  This must be completed at least 30 days prior to the beginning of the rotation. 

Third, notify Ms. Harmon via email of the completion of this process.

Finally, on the first day of the rotation, report to the Tulsa VA outpatient clinic located at 10159 E. 11th Street.

If students have questions or concerns about this, they should feel free to contact Ms. Olivia Harmon directly (918-610-2027).

Laureate Psychiatric Clinic and Hospital (St Francis Health System)

Students who are to complete this clerkship at this site must complete and submit a packet of information. This packet is to contain two completed forms: (1) the Medical Student Check-in Form, and (2) the Confidentiality Agreement form. The packet is also to contain a letter of good standing, malpractice insurance verification, a photo ID, and a current TB skin test. Robert Sammons in the OSU-COM Clinical Education Office can supply to students a letter of good standing that includes insurance verification (robert.sammons@okstate.edu). In addition, please read the Medical Student Information Sheet and the Employee Parking Garage documents for helpful information.

Students must submit the packet at least two weeks prior to beginning this clerkship so that computer and security access can be arranged by the starting date. This packet should be submitted to Rita Sorrels at rksorrels@saintfrancis.com. Click on the following link for the forms and map: St. Francis/Laureate

On or before the first day of the rotation (before is desirable), students are to report to the Medical Staff Office to get their ID badge before reporting to a clinical area. Students may not be on a clinical floor without this badge. Students are to be in the company of an attending physician or a resident when in a clinical area. Students may wish to consult a map provided by Saint Francis (see Ms. Sorrels) for directions to specified locations in the St. Francis/Laureate site.

Griffin Memorial Hospital

Students who are to complete this clerkship at this site must complete and submit a packet of information. Ms. Pam Melton will initiate contact about a month before the rotation is to begin to initiate this process. If a student has not been contacted by three weeks before the start of the rotation, that student must initiate contact with Ms. Melton. She can be reached by email at psmelton@odmhsas.org. Also, complete the following form Indian Health Care Center and submit to Ms. Tammy Davis at tdavis@ihcrc.org.

Indian Health Care Resource Center of Tulsa

The Center requires a background check and drug test prior to beginning the clerkship at their site.  The Center reserves the right to refuse acceptance of a student based on information gained through the background check and/or the drug test. Ms. Karen Mull, OSU COM Department of Behavioral Sciences, or her designee will contact students assigned to this facility about four weeks in advance to initiate the process for obtaining clearance – if there are questions, contact Ms. Mull at 918-561-8474 or karen.mull@okstate.edu.

 

General       

Sites for the core Clerkship in Psychiatry are typically but not exclusively in the Tulsa and Oklahoma City metropolitan areas. In keeping with the Clerkship Handbook, students who must travel an extended distance from one of these areas to their next rotation will take travel time from the distant rotation, not from the Psychiatry Clerkship.

Performance Evaluation

Preceptor Evaluation

The performance of each student at the training site will be evaluated by the Preceptor with input from the Attending Physician(s), if applicable.

At the completion of the rotation, a formal evaluation of each student’s overall performance will be conducted by that student’s Preceptor. This evaluation will be submitted in an OSU-COM form, the Oklahoma State Clinical Education Clerkship Survey. It is an on-line tool that yields quantitative ratings of each student’s performance. It is to be filled out by the Preceptor in consultation with any Attending Physicians who have worked with the student.

The ratings on this form and the comments provided by the Site Faculty will reflect a careful assessment of the student’s performance. The first 13 ratings provide a quantitative assessment of each student’s performance. The 14th rating, the overall rating, provides the numerical basis for this portion of the grade. It will constitute 50% of each student’s final grade for this course.

Midway through the rotation, the Preceptor and/or Attending Physician is asked to give informal, verbal feedback to the student about his/her performance to date – students are encouraged to prompt the preceptor to provide such feedback at about the midway point in the clerkship. The physician is encouraged to use the evaluation form described in the preceding paragraph as the format for this feedback. This information should help the student identify strengths and weaknesses in his/her performance and improve weaknesses prior to the final evaluation.

Formative Exams

Each student must take a written exam each week covering the specified readings as otherwise described in this Syllabus. Students will receive credit for successful completion of the exam.  Exam results will not otherwise be used for course grade determination.  Completion of these exams constitutes 10% of the course grade.

Departmental Written Exam

The Departmental Written Exam, referred to previously in an above section, is required for all students.  The value of the Exam represents as much as 30% of the student’s final grade apportioned based on performance on the examination.

COMAT Exam in Psychiatry

Each student must also take the COMAT Exam in Psychiatry (the pass rate is determined by the College but currently set at achieving a standard score of 90 or greater). It is administered by the Clinical Education Department. It will be given at 2:00 p.m. on the last scheduled day of the rotation. The COMAT will be given in the OSU-Tulsa computer lab; students must be in place by 1:45 p.m. unless otherwise notified by the Clinical Education Department.

If a student does not pass the COMAT Exam, he/she must enter a formal remediation process as described by a Course Coordinator including entering into a mentorship with a designated faculty member in the department. The designated faculty member will direct the student to review specific topics of weakness as identified by their personalized COMAT Exam score sheet. After remediation, the student will be eligible to retake the COMAT Exam. If the student fails the same COMAT Exam a second time, a letter grade of "I" for incomplete will be assigned and the student will be referred to the Academic Standards Committee for a plan of corrective action.

Questions or concerns about the COMAT Exam should be addressed to Mr. Robert Sammons by phone (918-561-1181) or email (robert.sammons@okstate.edu), or to Drs. Wansley or Bost.

COMAT Prep Day

Attendance is required at the Psychiatry Clerkship COMAT Prep Day.  Attendance at all of the day’s events constitutes 5% of the course grade.

Site Evaluation

Students are required to formally evaluate their rotation experience. This evaluation is to be submitted through OSU-COM’s on-line Education Management System. Site Evaluations are due within 7 days of the completion of the rotation. Grades are normally computed and submitted to the Dean soon after this date; if this material is not available to the Course Coordinator by this time, grade computation will include a “0” for this portion of the grade. This requirement constitutes 5% of the course grade.

Attendance

Each student must be in attendance at all assigned rotation activities.  Students are expected to attend the Clerkship Orientation session held on the first morning of the first day of the rotation. Attendance also includes attending a 12-step meeting (e.g., AA or NA Open Meeting).  Failure to complete these requirements will result in a grade reduction, unsatisfactory non-cognitive grade, and/or that the rotation requirement be completed at a later date as per the judgment by the Course Coordinators.

Grading Procedures

Grade computation will utilize the following procedures:

  • Evaluation by Preceptor.  Preceptors report their evaluations of student performance via the on-line Education Management System provided by OSU-COM. The preceptor’s final score as described in greater detail elsewhere in this Syllabus will constitute 50% of the student’s course grade.
  • Formative Exams.  Credit for successful completion of both exams will constitute 10% of the final grade.
  • Site Evaluation. Credit for successful completion of the Site Evaluation will constitute 5% of the final grade.  No points will be credited in the Site Evaluation if it is not completed by the student and entered into the Education Management System.
  • COMAT Prep Day.  Five (5) percentage points will be credited for attending and participating in all COMAT Prep Day activities.  Successful completion of this requirement will constitute 5% of the final grade.
  • Departmental Written Exam.  The score on this multiple choice test will constitute as much as 30% of the final grade.

The Total Course Points will be derived by adding points earned on the Evaluation by Preceptor, Departmental Written Exam, Formative Exams, COMAT Prep Day attendance, and Site Evaluation completed by the student with maximum values as follows:  

  • Preceptor Evaluation – 50%
  • Departmental Written Exam – 30%
  • Formative Exams – 10%
  • COMAT Prep Day Participation – 5%
  • Site Evaluation – 5%
  • Total Possible Course Points (Percent) – 100% but also requiring passage of the COMAT Exam in Psychiatry and demonstrating full attendance at all required activities.

Total Course Points ending in .50-.99 will be rounded up to the next higher whole number; Total Course Points ending in .49 or less will be rounded down to the next lower whole number.  Letter grades will be assigned according to procedures outlined in the Student Handbook.  Both letter grades and Total Course Points are reported to the Dean and to the College Registrar.  The Course Coordinators determine and issue a grade for each student.

Elective Rotations

Many students choose to pursue additional psychiatric clerkship training beyond the required core rotation.  Interested students should refer to the “Clerkship Elective” section of the Clerkship Handbook for information on requirements for these rotations.

Faculty

The sites and faculty members for this clerkship include the following:

Laureate Psychiatric Hospital & Clinic (St Francis Health System - Tulsa)
6655 S. Yale Ave.
Tulsa, OK 74136

Contact:
Ms. Rita Sorrels
Saint Francis Hospital
Medical Staff Office
Phone: 918-494-1459
Fax: 918-494-1854
E-mail: rksorrels@saintfrancis.com

Patty Costner, D.O. (preceptor)
Adjunct Clinical Assistant Professor of Behavioral Sciences – Psychiatry
Adm Asst: Ms. Dyan Wilson
Phone: 918-491-5926
E-mail: pacostner@saintfrancis.com

Heather Hall, M.D. (preceptor)
Adjunct Clinical Assistant Professor of Behavioral Sciences – Psychiatry
Adm Asst: Marilyn
Phone: 918-491-5782
918-384-8114 (cell)
E-mail: hlhall@saintfrancis.com

Jimmie D. McAdams, D.O. (preceptor)
Adjunct Clinical Assistant Professor of Behavioral Sciences – Psychiatry
E-mail: jmcadams@saintfrancis.com
Adm Asst: Shannon
Phone: 918-481-4009 or 918-481-8005
E-mail: sajones@saintfrancis.com

Griffin Memorial Hospital (Norman)
900 East Main St.
P.O. Box Box 151
Norman, OK 73070

Contact: Pam Melton, Program Coordinator
Phone: 405-573-6602
Fax: 405-573-6684
E-mail: psmelton@odmhsas.org

Clayton Morris, M.D. (preceptor)
Adjunct Clinical Assistant Professor of Behavioral Sciences – Psychiatry

Family & Children’s Services (Tulsa)
2325 S. Harvard Ave.
Tulsa, OK 74114

Contact: Rachel Maxon
918-991-6372
918-560-1165 (fax)
E-mail: rmaxon@fcsok.org

Chariny Herring, D.O. (preceptor)
Adjunct Clinical Assistant Professor of Behavioral Sciences – Psychiatry
Phone: 918-712-4301
E-mail: cherring@fcsok.com

Mind Spa (Tulsa)
3314 East 46th Street, Suite 200
Tulsa, OK 74135

Contact: Jamie
Phone: 918-645-5400
E- mail: landandassociates@ymail.com

Sarah E. Land, D.O. (preceptor)
Adjunct Clinical Assistant Professor of Behavioral Sciences - Psychiatry

Private Practice (Muskogee)
The Pavilion, Muskogee Regional Medical Center
101 Rockefeller Drive, Suite 202
Muskogee, OK 74401

Contact: Ms. Stephanie Anderson
Phone: 918-687-9227
Fax: 918-687-5676

Charles A. “Chuck” Lester, M.D. (preceptor)
Adjunct Clinical Assistant Professor of Behavioral Sciences – Psychiatry
E-mail: clestermd@gmail.com

Private Practice (Tulsa, Cushing)
Tracy Loper, M.D. (preceptor)
Adjunct Assistant Professor of Behavioral Sciences – Psychiatry
Tulsa City/County Jail and Cushing Hospital
David L. Moss Criminal Justice Center
300 N. Denver
Tulsa, Oklahoma
Contact: Dr. Loper (918-519-4993, mobile) / Best to text him

Strength of Mind (Henryetta, Cushing)
Jeff McIlroy, M.D. (preceptor)
Adjunct Clinical Assistant Professor of Behavioral Sciences – Psychiatry
Henyretta Hospital and Cushing Hospital
Contact: Ms. Jodie Seitz
Phone: 918-342-2622
E-mail: jseitz@strengthofmind.com

Veterans Administration Medical Center (Tulsa)
Tulsa VA Behavioral Medicine Clinic
10159 E. 11th St (11th & Hwy 169)
Tulsa, OK 74128

Contact: Olivia Harmon
918-610-2027
E-mail: Juanita.harmon@va.gov

Emanuel Román, M.D. (preceptor)
Adjunct Clinical Assistant Professor of Behavioral Sciences – Psychiatry

Madhusan Koduri, M.D. (preceptor)
Adjunct Clinical Assistant Professor of Behavioral Sciences – Psychiatry

Psychiatric Associates
4612 S. Harvard Ave.
Tulsa, OK 74135

Contact: Ms. Melody Houk
Phone: 918-747-5565
Fax: 918-747-5568
E-mail: drdavidshadid@tulsacoxmail.com

David Shadid, D.O. (preceptor)
Adjunct Clinical Assistant Professor of Behavioral Sciences – Psychiatry

Michelle Hubner, M.D. (preceptor)
Adjunct Clinical Assistant Professor of Behavioral Sciences – Psychiatry

Indian Health Care Resource Center (Tulsa)
Dean Martin, MD (preceptor)
Indian Health Care Resource Center
550 S. Peoria Avenue
Tulsa, OK 74120
918-588-1900
Fax: 918-582-6405
deanmartinmd@cox.net

Contact: Ms. Tammy Davis
IHCRC Human Resources Department
918-382-1205

Course Co-Coordinators (OSU COM – Tulsa)
Department of Behavioral Sciences
1111 W. 17th Street
Tulsa, OK 74127
Phone: 918-561-8474

Richard H. Bost, Ph.D., ABPP
Professor of Behavioral Sciences
E-mail: richard.bost@okstate.edu

Richard A. Wansley, Ph.D.
Associate Professor of Behavioral Sciences
E-mail:  richard.wansley@okstate.edu

For general information, contact:
Karen Mull, Program Specialist
E-mail: karen.mull@okstate.edu
or
Camillia Estes, Program Specialist
E-mail: k.estes@okstate.edu
OSU COM Department of Behavioral Sciences
Phone: 918-561-8474
Fax: 918-561-8428

Grievance Authority

Questions about a Clinical Performance Evaluation should be directed to the Preceptor during the formal evaluation at the end of rotation.  If a grievance cannot be satisfactorily resolved in this manner, the assistance of the Course Coordinator may be requested.

Students with Disabilities

If any student taking this course feels that he/she has a disability that requires special accommodations to enable full participation in the course, the Course Coordinator will work with that student and the Office of Student Services to provide reasonable accommodations to ensure that the student has a fair opportunity to perform in this class.  Students wishing to request such accommodations should advise the Course Coordinator of this as soon as possible before, during, or immediately after the first of the month in which the course is to be taken.

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