Medical Students
Medical Student Elective Opportunities
The Department of Psychiatry at Harbor-UCLA Medical Center offers several elective clerkships for visiting medical students. Application for these must go through the Office of Education, Department of Psychiatry and Biobehavioral Sciences at UCLA. Please note all additional requirements for Harbor-UCLA applications as explained on the UCLA website including but not limited to a clinical letter of recommendation.
Information can be obtained at http://www.medstudent.ucla.edu/visitingstudents/.
You may also contact M. Read, M.D.: mread@dmh.lacounty.gov.
EMERGENCY PSYCHIATRY
This is a singular opportunity to work in the exciting frontier of Emergency Psychiatry. The Psychiatry Emergency Service (PES) at Harbor-UCLA Medical Center typifies the stimulating and rapidly evolving environment of this field. The PES is the referral center for an estimated 2.3 million Los Angeles County residents. In this busy emergency setting, medical students are exposed to a wealth of clinical material and gain experience with a wide spectrum of psychiatric disorders, in addition to performing consultations to the hospital’s medical emergency departments. You will be able to learn the art of crisis intervention and the management of acute psychotic agitation from an experienced group of emergency psychiatric attending staff and residents. We have a newly remodeled emergency room and a supportive multidisciplinary team of psychiatric attendings and residents, nurses, and social workers. This is a wonderful experience, one that is not offered in many training programs. (For further information about the Emergency Psychiatry Elective, see below.)
PSYCHIATRIC CRISIS MANAGEMENT
The inpatient psychiatric services at Harbor-UCLA consist of two locked inpatient units: 8-West, a 24-bed unit, and 1-South, a 14-bed unit, both with an average length of stay of one to two weeks. Students electing an advanced clinical clerkship on the inpatient units will have the opportunity to work independently with a number of acutely psychotic, manic, or severely depressed patients under the direct supervision of the three unit attending psychiatrists. Additional opportunities include participation in group and family therapy sessions, as well as chances to attend mental health court hearings. There is a focus on diagnostic workups and biological interventions within a psychosocial and sociocultural framework. Inpatients at Harbor-UCLA reveal a unique and fascinating array of psychopathology, cultures, and presentations, offering a very rich learning experience. The two units are well-staffed, with each inpatient team consisting of an attending psychiatrist, three psychiatric residents, and a full complement of nursing, social work, and therapy staff. (For further information about the Psychiatric Crisis Management Elective, see below.)
CONSULTATION/LIAISON AND HIV PSYCHIATRY
The consultation/liaison service (C/L) has a large volume of varied patients who initially are seen in consultation with the Medical/Surgical housestaff and then can be followed up with brief outpatient treatment. In addition, the service receives requests for evaluations from outpatient clinics such as the HIV clinic, family medicine, and surgical subspecialty clinics. Medical students will have opportunities to perform these evaluations under supervision of senior psychiatric residents and to develop their own caseloads. They will attend daily rounds where they will present their cases, and also attend the weekly presentation and discussion of journal articles relevant to C/L psychiatry. This service provides a wonderful opportunity to work at the psychiatry/medicine interface in a busy and academically oriented public hospital.
DUAL DIAGNOSIS
This elective emphasizes the treatment of dual diagnosis patients. The rotation will occur at the Dual Diagnosis Treatment Program (DDTP) at the Harbor-UCLA Medical Center. Students will learn skills to conduct psychiatric and substance abuse assessments, outpatient detoxifications, medications management for psychiatric conditions (as well as medications for substance abuse problems), and for running groups. Students will also take part in consultations and assess patients from the psychiatric emergency department, as well as the outpatient clinic. Our principal aim is to help patients reduce the harm they are doing to themselves by substance abuse and/or psychiatric issues. Psychosocial treatment strategy will be a focus, and medications such as buprenorphine, disulfiram, and naltrexone will be emphasized.
PS320.01 – Emergency Psychiatry (Detailed)
Subinternship Location: HARBOR-UCLA MEDICAL CENTER
COURSE CHAIR: David Ruskin, M.D.
PHONE #: (310) 222-3144
SUPPORTING FACULTY: K. Burgoyne, M.D., C. Chung, M.D., A. Djenderedjian, M.D., R. Mendoza, M.D., W. Procci, M.D., D. Stone, M.D.
STUDENT COORDINATOR: M. Read, M.D.
PHONE: (310) 222-3344
REPORT TO: Psychiatric Emergency Room, Harbor-UCLA Medical Center @ 8:00 am
PREREQUISITES: Psychiatry
AVAILABLE TO EXTERNS: Yes
STUDENTS PER PERIOD: max. 3; min. 1
DURATION: 4 weeks
INTRODUCTION:
The Psychiatric Emergency Service at Harbor-UCLA Medical Center provides evaluation and treatment to approximately 5000 patients a year. Its catchment area includes over 1% of the population of the United States. Direct clinical experience is provided to medical students with an emphasis on bedside teaching.
COURSE OBJECTIVES
1. Gain proficiency in formulating differential diagnoses for psychiatric illnesses and in managing these illnesses in an emergency setting, i.e., schizophrenia, bipolar disorder, major depression, substance-induced psychosis, etc.
2. Acquire familiarity with emergency psychopharmacologic interventions through the use of various psychotropic medications.
3. Develop skills in psychiatric interviewing techniques, performing mental status examinations, and gathering information for a complete initial psychiatric history.
4. Learn to make accurate assessments of suicidal and/or dangerous patients and develop plans for proper management.
5. Learn crisis intervention strategies to intervene with nonpsychotic patients.
6. Learn to assess and treat patients with various dual diagnoses, i.e. medically and psychiatrically ill patients, as well as those with coexisting substance use disorders.
Student Experiences
COMMON PROBLEMS/DISORDERS
1. Schizophrenia
2. Drug psychosis and substance abuse
3. Bipolar disorder
4. Major depression
5. Personality disorders
6. Panic and anxiety disorders
7. Obsessive compulsive disorder
8. Adjustment disorder
CLOSE CONTACT WITH: Full-time faculty, clinical faculty, fellows, residents, interns, and nurses.
APPROXIMATE # OF PATIENTS EVALUATED EACH MONTH PER STUDENT: 30
TOTAL # OF PATIENTS EVALUATED EACH MONTH BY ENTIRE SERVICE: 600
REQUIRED WEEKEND ACTIVITIES: None
PS220.01 – Psychiatric Crisis Management (Detailed)
Subinternship location – Harbor-UCLA Medical Center Inpatient Units (8W and 1S)
COURSE FACULTY: Benjamin Furst, M.D., Michael Makhinson, M.D.,Ph.D., Samuel Sessions, M.D.,J.D.
STUDENT COORDINATOR: M. Read, M.D.
PHONE: (310) 222-3344
PREREQUISITES: Psychiatry
AVAILABLE TO EXTERNS: Yes
STUDENTS PER PERIOD: max 3
DURATION: 3-4 weeks
REQUIRED WEEKEND ACTIVITIES: None
COURSE OBJECTIVES
1. To gain experience with the formulation of differential diagnoses and treatment plans for acutely ill psychiatric inpatients. The most common disorders seen in this setting are schizophrenia, bipolar disorder, major depressive disorder, and substance-induced psychiatric disorders.
2. To gain experience and familiarity with evidence-based psychopharmacology in treating psychiatric disorders and evaluating for treatment-emergent side effects.
3. To gain experience and competence in psychiatric interviewing, mental status examinations, and techniques to enhance doctor-patient rapport.
4. To gain experience and familiarity with California’s mental health legal system and to witness and understand legal hearings for probable cause, Riese, and writ of habeas corpus. To understand what an LPS Conservatorship is and when it is used.
5. To learn the basics of inpatient psychiatric care, including collaboration with a multi-disciplinary team, suicide and violence assessment, documentation, and medico-legal issues.
6. To have a good time in an environment that promotes learning and providing care in the best interest of the patient.