Combining Psychiatry and Family Medicine Clerkships: A Novel Pathway for Training the Next Generation of Primary Care Physicians

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Article

Publication Date

1-1-2010

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Abstract

Background: Because a high percentage of patients with psychiatric disorders seek care from primary care physicians, and there are limited follow-up opportunities during separate Psychiatry and Family Medicine clerkships, the psychiatry and family medicine clerkship directors developed a combined 3-month clerkship. Unlike the traditional 6-week inpatient psychiatry rotation, the combined rotation occurred exclusively in outpatient settings. Methods: Students had the option of choosing the traditional separate rotations or the combined clerkship in family medicine and psychiatry, the latter of which was offered to two students every 3 months. Those that opted for the combined clerkship spent about 21/2 days per week in psychiatry and 21/2 days per week in family medicine for 12 consecutiveweeks. Theyworked primarily with faculty members and followed patients over time. Psychiatry didactics were provided during the first 6 weeks, and psychiatry final examinations given at the midway point of the 3- month clerkship. During the final 6 weeks, the students attended family medicine didactics with that examination given at the end of the combined clerkship. All of the participating students completed online clerkship evaluations with 18 (5-point scale) Likert-type questions ranging 1 (strongly disagree) to 5 (strongly agree) as well as with open-ended questions for comments. Results: The sample size was small (n = 6), as this rotation option was offered to only two students every 3 months and had been in existence for 1 year. The responses yielded the following: A score of 4.33 to "I developed greater confidence in counseling patients about behavior changes (e.g., smoking cessation and weight loss)" 4.67 to "With doing the family medicine and psychiatry concurrently, I have greater confidence with mental health issues in family medicine" and 4.83 to "I developed greater confidence through working with the same attendings for 3 months." Conclusions: Although the conclusions are limited by a small sample size, the students valued this combined rotation. They especially liked opportunities to see the same patients over time, thus seeing psychiatric symptoms improve in response to treatment more often. One theme that developed was the synergy between the two fields improving the students' understanding of family medicine and psychiatry. Students interested in primary care saw this rotation as especially valuable. © 2010, Taylor & Francis Group, LLC.

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