Medical Student Education in the Department of Psychiatry enlivens all 4 years of medical school. Our courses, taught by a multidisciplinary faculty, include:

• Human Behavior I in the first year of medical school
• Human Behavior II in the second year of medical school
• MSIII Clerkship in the third year of medical school
• MSIV Electives in the fourth year of medical school

Course Director: E. Michael Smith, M.D.

Associate Director: Jenny Boyer, M.D., J.D., Ph.D.

First Semester (Fall):

1. This course emphasizes major challenges facing physicians relevant to human behavior:
1. The widespread prevalence of mental and emotional disturbances, the importance of effective interpersonal and communication skills and an empathic doctor-patient relationship, and the recognition of basic human emotions (Dr. Smith)
2. Biopsychosocial model of disease and behavioral principles of medicine; lectures and demonstrations will illustrate mechanisms of stress-induced illness, social factors in disease, and fundamentals of behavior modification and learning theory (Dr. Scott):
1. Biopsychosocial Model of Disease, based on scientific methods and principles
2. Behavioral Principles in Medicine (i.e. culture, age, gender and ethnicity)
3. Behavioral Medicine Applications
3. Adult developmental stages (Erickson and beyond) will be explored:
1. Adult Development (Dr. Morgan)
2. Marriage and Family (Dr. Sherman)
3. Later Adulthood (Dr. Morgan)
4. Adult developmental stages are explored through death, dying and bereavement followed later by Psychosocial Issues in Health Care Delivery:
1. Death and Dying/Palliative Care (Dr. Morgan)
2. Death and Dying (Module Exercise) where students will explore mourning, the psychological, social and physical reactions that follow loss and the process of coping with an emotional response to death (Dr. Smith w/departmental faculty)
3. Explore psychosocial issues in health care delivery (Dr. S. Allen)
5. Human behaviors throughout the life cycle are presented through social behavioral sciences relevant to patient care. These include principles of growth and development throughout childhood and adolescence (Dr. J. Allen):
1. Models of Erickson and Piaget
2. Infancy and Toddlerhood
3. Preschool, School Age and Adolescence
6. Students will develop and learn ways of coping with stress in the career of medicine and improve their test taking skills (Victoria Christofi, Ph.D.).
7. "Spirituality in Medicine" problem based learning activity integrating a panel discussion with various spiritual leaders followed by a module exercise. This will enhance students' understanding of the importance of providing culturally sensitive health care (Dr. Trautman w/departmental faculty).
8. Defense mechanisms, personality styles and character patterns (Dr. Monnot).
9. Finally, the course transitions into areas of psychopathology:
1. Examples of human misbehavior include terrorism and violence, child and spousal abuse (Dr. Tucker)
10. The semester climaxes with human sexuality, both normal and abnormal: Students will develop professionalism as manifested through a commitment to carrying out professional responsibilities with adherence to ethical principles, and sensitivity to a diverse patient population (Dr. Smith):
1. Introduction and Sexual Response Cycle
2. Heterosexuality, Birth Control, and STD Prevention
3. Different Sexual Preferences and Orientation, Sexual Dysfunctions, Aging and Sexuality and Sexual Diversity (panel discussion w/diverse participants from alternate lifestyles and sexual orientations)

Second Semester (Spring):

11. The role of intelligence and intellectual functioning will be explored (Dr. Adams).
12. The second semester of HBI will integrate with PCM-I:
1. Neurobiology of Human Emotion (Dr. Ruwe)
2. Highlighting the doctor-patient relationship; the therapeutic sequence and a "Human Emotions" module exercise improving communication through the use of simulated patients (Dr. Smith)
13. The chemical dependency team of instructors will teach about:
1. Introduction into disease and concept of addiction and treatment (Dr. Anderson)
2. Alcohol use and its effect on older adults (Dr. Sorocco)
3. Fetal Alcohol Syndrome and its effects across the life span (Dr. Gurwitch)
4. Narcotics addiction and treatment including designer drugs and stimulants (Dr. Duncan)
5. Alcoholism and substance abuse in patients and physicians, assisted by doctors from the Physicians' Recovery Program (panel discussion) and multiple guest lecturers. This issue is vital in developing professionalism founded on firm ethical principles in future physicians (Dr. Anderson)
6. Nicotine dependence and changing behaviors (Drs. Hudson/Tassey)

Lectures, role-play in modules with faculty and peers, problem-based learning exercises, and computer patient management formats will be used. These exercises will enhance students' communication skills and awareness of ethical principles. They will draw on experience-based learning and systems-based practice. These will include a module exercise on "Death and Dying", a panel discussion on "Spirituality in Medicine" integrated with a module activity and research assignment, a "Human Sexuality" diversity panel discussion including participants from alternate lifestyles and sexual orientations, a simulated patient module exercise on "Human Emotions", along with an interactive "Physician Recovery" panel discussion. All module activities are a requirement of this course. Selected lecturers may provide brief, extra credit exercises during the semester. These will add additional raw points to the final exam score.

Course Overview
This course is designed to reinforce learning of course material with didactic, interpersonal and experiential learning tasks. Role plays by simulated patients and small group practice sessions in modules will assist you with interviewing skills. Attendance at lectures will therefore be essential to your successful performance on the group assignments. Examination questions will draw from role plays as well as audiovisual materials presented in class and in the on-line syllabus. (These cannot be reproduced effectively by note groups.) Reading assignments from the textbook and the syllabus are also sources of test questions. You are advised to read the assigned section of the book and syllabus in advance of the lecture. Copies of the text are available at the Reserve Desk in Bird library.

All module sessions will be graded on a pass/fail basis. These assignments are designed to prepare you for more effective communication with your patients as medical students and as doctors in less than four years. Moreover, it is anticipated that in several years, licensing examinations (USMLE) requires you to interview a live standardized patient. Continued practice can help you develop this skill.

Attendance at all module sessions is required. Students must participate meaningfully to be given credit. A student who will miss a module session must notify the Course Director and/or Lori or Zelma before the session begins. Only students with valid excuses, according to College of Medicine policies, may miss a session. If you do not sign in during these sessions, you will be considered to be absent. Students with unexcused absences will have 1 raw point deducted from their exam score per missed session in each exam block.

Selected lecturers may provide brief, extra credit exercises during the semester. These may add additional raw points to your exam score.

Examinations:
This course has four written examinations consisting of multiple choice and matching questions. The degree to which each examination will affect your final grade is as follows:

The denominator of each of the (4) exams will be decreased by the number of bonused questions given per test block.
Scores will be posted on the Blackboard system. The URL for Blackboard is: https://ouhsc.blackboard.com. There is a link to Blackboard on the Hippocrates system. You log on to Blackboard using your OUHSC username and password.

If you believe that your exam was misgraded, you must notify the course director within 1-week of the exam scores being posted; for the final exam only, you must notify the course director within 1-day of the scores being posted. Once these time limits have expired, the scores cannot be changed.

Students who miss an exam must notify the course director (X-47763) prior to the exam; otherwise, the student will receive a score of zero on that examination.

Learning occurs through auditory, visual and kinesthetic educational experiences. Students often have a predominant mode by which they learn best. What kind of learner are you? Learning is enhanced in the following ways:

1. With attention and focus on the material or task
2. When multiple channels are used (many sensory areas)
3. When the material is relevant to the learner
4. With active participation
5. With emotional involvement or arousal by the material
6. With repetition over time

Course Director: E. Michael Smith, M.D.

Course Objectives
This course introduces the student to the psychopathology of human behavior, or mental disorders. The epidemiology; psychosocial, genetic and biological factors contributing to illness; and treatments of mental disorders are presented. This course is a bridge between normal human behavior presented in Human Behavior I and clinical care of patients with mental illness in the MSIII Psychiatry Clerkship. Specific areas presented are:

1. The psychopathology of human behavior is presented as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR).
   
   1. Knowledge about mental disorders will incorporate molecular, biochemical, cellular and organ system (brain) mechanisms contributing to illness and health.
   
   
   2. Students will learn how to synthesize information obtained from a patient’s medical history, mental status and physical examinations and diagnostic studies to diagnose mental disorders.
2. Mental disorders classified as Axis I disorders are presented:
1. Anxiety disorders (panic, phobias, generalized anxiety, posttraumatic stress disorder, social phobia, obsessive-compulsive disorder)
2. Mood disorders (major depression, dysthymia, bipolar disorder (manic-depressive illness) and cyclothymia)
3. Somatoform, factitious disorders, and mental disorders due to a medical condition
4. Eating disorders (bulimia, anorexia nervosa)
   
5. Psychotic disorders (schizophrenia, schizoaffective and related disorders)
6. Mental disorders of the elderly and of children and adolescents
3. The dynamics of personality, including personality disorders, is explored, with emphasis on challenges to physicians treating personality-disordered patients.
4. Students will learn about effective treatments of mental disorders identified by evidence-based learning that is founded in scientific methods and principles:
1. Psychotropic medications
2. Electroconvulsive Therapy (ECT)
3. Alternative medicines
4. Psychotherapy
5. Students will learn about areas especially important in providing compassionate and effective clinical care of patients with mental disorders:
1. Providing culturally-sensitive interpersonal and communication skills
2. Establishing and sustaining an effective therapeutic alliance with patients and their families
3. Maintaining professional commitment to ethical principles of autonomy, beneficence, non-maleficence and justice
4. Respecting contributions made by non-physician members of the health care team
5. Understanding the role of managed care in mental health care delivery
6. Psychological assessment

Course Overview
Lectures and review sessions will be the main teaching modality. A "Literature in Medicine" session will be held with faculty and students in the modules. A "Team Based Learning" exercise in the lecture hall will review course material for the exam. A module exercise will provide an interactive exam review, with students providing sample test questions for self-assessment and discussion with faculty facilitators. Hippocrates contains a syllabus with video clips to illustrate mental disorders and doctor-patient interactions.

All module sessions will be graded on a pass/fail basis. These assignments are designed to prepare you for more effective communication with your patients as medical students and as doctors in less than four years. Moreover, it is anticipated that in several years, licensing examinations (USMLE) requires you to interview a live standardized patient. Continued practice can help you develop this skill.

Attendance at all module sessions is required. Students must participate meaningfully to be given credit. A student who will miss a module session must notify the Course Director and/or Lori or Zelma before the session begins. Only students with valid excuses, according to College of Medicine policies, may miss a session. If you do not sign in during these sessions, you will be considered to be absent. Students with unexcused absences will have 1-point deducted from their course average per missed session.

Selected lecturers may provide brief, extra credit exercises during the semester. These may add additional raw points to your exam score.

Examinations:
This course has two written examinations consisting of multiple choice and matching questions. The degree to which each examination will affect your final grade is as follows:

Course Director: Anne Cuccio, M.D.

This is a six-week course combining inpatient and outpatient clinical experiences. Students rotating through the Psychiatry Clerkship are assigned to one of a variety of inpatient settings and one of several outpatient, partial hospitalization or specialty settings. Each treatment setting has been selected for its ability to offer an exposure to a wide range of psychopathology. In addition, the attending physicians present in each of the locations have expressed a specific interest and ability in teaching medical students. It is anticipated that the primary source of experience for the students will be their interaction with the patients. A major experience will be discussions with the attending/resident physicians. It is expected that students will interact with the supervisor to maximize their own learning and to capitalize on the specific assets of the physicians available.

Course Objectives

1. Students will demonstrate supervised care of psychiatric patients that is compassionate and effective in promoting mental and physical health.
   Clerkship students will demonstrate:
   1. The ability to obtain, record and present a Mental Status Examination and Psychiatric History (including cognitive evaluation)
   2. Effective, compassionate interviewing and communication skills
   3. The ability to integrate medical history, physical examination and diagnostic studies to formulate a differential diagnosis and treatment plan for psychiatric patients
2. Students will gain evidence-based medical knowledge using a comprehensive biopsychosocial model in evaluating psychiatric patients. Knowledge will be demonstrated and assessed through patient write-ups, verbal presentations, OSCE's and written examinations. Clerkship students will demonstrate:
1. Basic knowledge base for diagnosis (DSM-IV-TR), differential diagnosis,classification and treatment planning of common mental disorders:
   1. Substance use disorders*
   2. Mood* and anxiety* disorders
   3. Mental disorders due to general medical conditions.substances*
   4. Cognitive disorders
   5. Psychotic disorders*
   6. Axis 2 disorders
   7. Somatoform disorders
   8. Attention deficit-hyperactivity disorder
   9. Mental disorders of childhood/adolescence
   *Denotes required patient diagnosis/problem students must encounter
2. Knowledge of basic psychopharmacology
3. An understanding of psychiatric emergency screening and evaluation* (including suicide and violence assessment)
4. An awareness of psychotherapy (including basic types, indications, case formulation, developmental issues, indications)
5. An understanding of uses of other evidence-based biological treatments (ECT, Vagal Nerve Stimulation)
6. An awareness of issues related to psychiatric practice (patient referral, levels of care, managed care, stigma, forensic issues)
7. Skills promoting lifelong learning to stay current with scientific advances in pathophysiology and treatments of mental disorders
3. Students will incorporate experience-based learning and improvement in care of psychiatric patients. Sources for scientific knowledge will include the medical literature, textbooks, expert consensus guidelines. Knowledge will serve to improve quality of care and reduce medical errors.
4. Clerkship students will develop interpersonal and communication skills with patients, families, the health care team and managed care entities. Communication will show cultural sensitivity and will safeguard privacy and confidentiality of psychiatric patients.
5. Students will develop professionalism in patient care, respecting ethical principles of autonomy, beneficence, non-maleficence and justice. They will demonstrate ethical principles vital to mental health care: compassion, respect for psychiatric patients' dignity and rights for privacy, honesty, altruism, and collaborative care with other health professionals.
6. Students will demonstrate an ability to work within systems-based practice relevant to psychiatric care.
   1. They will begin to utilize contributions from non-physician members of the mental health care team (psychologists, social workers, occupational therapists, psychiatric aides and technicians).
   2. They will understand community resources and different levels of psychiatric care (inpatient units, outpatient clinics, day hospitals, extended-care facilities, nursing homes, transitional living centers).
   3. They will become familiar with peer review and quality improvement, limitations on inpatient stays and outpatient therapies, cost-effective options.

7. Students will successfully complete an Objective Structured Clinical Examination (OSCE). This will involve students conducting a focused interview of a standardized patient with a mental disorder, developing a differential diagnosis, communicating preliminary diagnostic and treatment to the patient, and writing a focused medical note. The exercise will objectively assess students' clinical skills and prepare them for USMLE Step 2CS.
8. Students will document their clinical experiences and procedures on the Online Clinical Experiences and Procedures Tracking System, consistent with ED-2 (quantified criteria for patient contacts and clinical skills). A total of 20 diagnoses must be logged in. Minimal patient diagnoses/problems encountered are:
• Emergency psychiatric care
• Mental disorder due to a general medical condition/substance
• Psychosis
• Alcohol/substance abuse
• Bipolar (manic/depressed/mixed)
• Depression
• Anxiety disorder

Procedures and all patients seen should be entered online by each student for the psychiatry clerkship.

Students lacking contact with a particular diagnosis should contact the Course Director, who will direct them to another clinical site to obtain that experience.

Failure to log in patient contacts by one week after the end of the course may lower the Professionalism Component of the student evaluation.

Course Director: Anne Cuccio, M.D.

Procedures for Enrolling in 4th Year Electives
Students interested in enrolling in a 4th year elective in the Department of Psychiatry and Behavioral Sciences should contact Ms. Jeannie Brown, Undergraduate Psychiatry Education Office (WP3440) 271-4488. Ms. Brown will direct the student to the appropriate instructor to be contacted for permission to take the elective.

Student should contact the instructor for the elective of their choice and receive permission two months prior to the time they wish to take the elective.

All electives are 4 weeks in length. Students must receive special permission from Dr. Anne Cuccio to take an elective for any time less than 4 weeks.

After making arrangements with the instructor, the student may obtain a permission form from either Ms. Brown or from Ms. SuAnn White in the Dean's Office, College of Medicine (BMSB-357).

The student must take the completed form to the Psychiatry office (WP3440) for Dr. Cuccio's signature in order to be valid. The form may be left with Ms. Brown to obtain Dr. Cuccio's signature and make a copy for the Dean's Office.

The Dean's Office will send a class roll, evaluation form, and grade sheet for the elective to the department. At the end of the elective, the evaluation form will be completed by the instructor and returned to Dr. Cuccio to complete the grade report.

Psych-OU Officers
2008 - 2009

President
Meitra Doty

Vice President
Lauren Schwartz

Secretary
Jordan Bell

Treasure
Nikhil Rao

Student Council Rep
Julia Edwards

Student Council Rep
Justin Rousseau

Faculty Sponsor: E. Michael Smith, M.D.

Membership in the Psych-OU is voluntary and open to all medical students of the College of Medicine and other interested students enrolled in programs of study at the Health Sciences Center. All members shall be classified as active.

Membership entitles students to:

1. Receive notification of and attend meetings and group-sponsored functions.
2. Vote in the election of officers.
3. Be eligible to hold office and participate in Psych-OU committees (within the guidelines set forth by the College of Medicine).
4. Receive health and mental health publications.
5. Be included in the group directory.