Outpatient US Clinical Experience in Psychiatry in Atlanta

Information about this clinical experience:

You will be under the supervision of a physician who is board-certified in psychiatry and neurology. Although the physician has completed training in both psychiatry and neurology, the practice is largely psychiatric in its focus although there are some patients with neurological conditions like dementia that may be seen for management of behavioral problems. The split between patients seen in this office is 80% psychiatry and 20% neurology. This physician has extensive experience educating medical students and international medical graduates. The physician has hospital privileges at Wellstar Atlanta Medical Center.

In this clinical experience, you will be asked to take on an increasing role in patient encounters. Under the preceptor's supervision, you will perform the initial interview and document the findings in the EMR. When documenting in the EMR, you will be asked to offer your diagnosis and recommendations, an exercise that will help you build your problem-solving skills. Approximately 30 patients are seen per day (2/3 in person; 1/3 tele-health). Please note that this is a high-volume clinic with significant patient interaction. While the volume of patients will limit the amount of time that can be spent on teaching per patient, the preceptor will spend more time teaching on the particularly interesting cases that come to the clinic.

For follow-up patients, you will learn how to assess the chief complaint, properly explore the reason for visit, identify new stressors or triggers, and understand the severity of their symptoms. This will also include the use of different scales like PHQ-9 for depression and GAD-7 for anxiety, Part of the encounter will be spent reviewing the medication list to determine effectiveness and presence of any side effects (i.e., using AIMS score to record any side effects from antipsychotic medication). In contrast to these follow-up appointments which will be more focused, you will also be involved in new patient evaluations that will be comprehensive.

For patients taking opioids, benzodiazepines, stimulants, and other controlled substances, you will learn how to use the Prescription Drug Monitoring Program. This is an electronic database that provides information on prescriptions of controlled substances and allows practitioners to combat misuse or abuse of these substances.

Large numbers of patients seen in this practice are underserved with a significant percentage on Medicaid. Working with this patient population will provide rotators with insight into how the social determinants of health affect mental health, increasing the risk for mental illness, and impacting outcomes. Among the conditions you will encounter as a rotator:

• Major depressive disorder

• Schizophrenia

• Schizoaffectie disorder

• Opioid use disorder

• Bipolar disorder

• Obsessive-compulsive disorder

• ADHD

• Generalized anxiety disorder

• PTSD

• Panic attacks

During your experience, you will learn the following U.S. medical practices under the preceptor’s supervision:

• Taking histories.

• Presenting cases, including your assessment and plan.

• Entering notes in the EMR (Valant).

• Researching the literature to answer clinical questions at the point of care.

• Working with a wide range of healthcare professionals, including nurses, nurse practitioners, psychologists, and therapists, and understand their roles on the healthcare team.

Please note that there are typically 4-5 students at a time. However, during peak periods, there may be up to 8 students.