Psychiatry (PSYC)

PSYC 3005. Psychiatry Clerkship. 6 Credit Hours.

The psychiatric clinical clerkship is designed to familiarize the student with the personality traits, illnesses, and emotional disturbances that affect health and productivity. It is an opportunity for the student to develop and strengthen clinical skills in interviewing patients, formulating treatment plans, and carrying out treatment with patients who have psychiatric illness. The clerkship is arranged so the student may select the assignment area on the basis of particular interest, i.e., an inpatient/outpatient setting. The student's role in the clerkship is arranged to allow for considerable experience in the working relationship between patient and "physician" in the treatment process. Seminars have been developed to allow the student an in-depth appreciation of the various psychiatric states and emotional problems that affect the general practice of medicine. The student-staff ratio allows for small groups of students to meet with faculty, thereby enhancing learning. The clerkship is an opportunity for the students to look at their personal feelings and values and understand how they influence patient care, to learn how to deal with psychiatric disease, and to become more comfortable in dealing with the personalities of patients with organic disease. Prerequisites: Successful completion of all required preclinical courses is prerequisite to enrollment in any of the clinical clerkships.

PSYC 4000. Special Topic. 4 Credit Hours.

This is a self-designed course created by both the student and the department to cover a specific topic. A Course Approval Form must be completed along with documentation of the designed course description.

PSYC 4001. Clinical Psychiatry. 4 Credit Hours.

The fourth-year medical student inpatient rotation is designed as a bridge between the role of third-year clerk and the very active, responsible role of the intern. The fourth-year medical student will act as the primary psychiatrist under the supervision of a full-time attending. The student will be an integral member of the team, and will participate in all team activities. All activities for this experience will be on an inpatient psychiatric service at the University Hospital, Veterans' Administration Hospital, in San Antonio. These are busy units with brief lengths of stay. The student will have the opportunity to gain considerable experience with crisis management of serious mental illness as well as an understanding of acute exacerbations of chronic mental illness.

PSYC 4015. Geriatric Psychiatry. 4 Credit Hours.

This courses teaches student how to manage the developmental, psychological, and neurodegenerative changes associated with aging. Students rotate through academic geriatric psychiatry clinics that treat elders with mood, anxiety, thought, and cognitive disorders. Students rotate through VA memory clinics where they learn how to administer, score, and interpret psychometric assessments and how to treat and prevent cognitive decline. Prerequisites: Psychiatry Clerkship.

PSYC 4020. Consultation-Liaison Psychiatry. 4 Credit Hours.

The course includes participation in the evaluation and management of medical and surgical inpatients with psychiatric conditions at the University Hospital or the VA. Students commonly treat patients diagnosed with delirium, depression following severe suicide attempts, illness anxiety disorder, and abuse. Student learn the interface between medicine and psychiatry and how to assess decisional capacity. Prerequisites: Psychiatry Clerkship.

PSYC 4023. Child & Adolescent Psychiatry. 4 Credit Hours.

To gain clinical experience in outpatient child/adolescent psychiatry, students will attend the Clarity Child Guidance Center outpatient psychiatry clinics. Students will also be assigned to various selected sites including the Bexar County Juvenile Detention Center, the Cyndi Taylor Krier Secure Juvenile residential treatment center, the Roy Maas Youth Alternatives outpatient clinic, Trauma Clinic and Child Consultation/Liason service. During the rotation, students will attend seminars and journal club with the child and adolescent psychiatry residents.

PSYC 4024. Telepsychiatry. 4 Credit Hours.

The rotation introduces the medical student to some of the technical, legal, and patient care issues arising from the use of telehealth technologies. Telehealth is defined as providing services remotely through technology including phone contact and videoconferencing. This technology is being used increasingly to provide needed psychiatric services for underserved rural areas. Studies have demonstrated non-inferiority of services provided through telehealth services. Medical students will participate in a 1:1 supervised experience with a faculty member providing telepsychiatry for mental health evaluation and treatment using a Tandberg unit from the remote site in San Antonio to an originating clinical site in VA Texas Valley Coastal Bend Healthcare System (VATVCBHCS). There are no in-person patient contacts during this rotation as all services are provided through videoconferencing to the originating VA clinics. This educational experience will be provided under the supervision of the telehealth psychiatrist located on site in San Antonio with the medical student. Notes and orders will be documented through the VA's Computerized Patient Record System (CPRS). Patients will be asked to complete clinical rating scales at the time of the appointment and a satisfaction survey following each clinical encounter, which are tracked for quality improvement purposes. The rotation will include 1/2 hour weekly didactic sessions for the students. Material will include information on clinical skills such as interviewing, mental status exam, and diagnostics as they are performed using the videoconferencing equipment.

PSYC 4025. Introduction to Psychotherapy: Principles and Practice. 4 Credit Hours.

In the Introduction to Psychotherapy Principles and Practice elective, fourth year medical students will learn how to apply the fundamentals of psychotherapy, including empathy, identifying affect, transference phenomena, therapeutic alliance, patient motivation, and boundaries with guidance from an established psychodynamic therapy clinical manual [1]. Students will have opportunities to practice basic psychotherapy skills with patients in a variety of clinical settings, including UT Health outpatient psychiatry clinics and University Hospital inpatient and consult-liaison psychiatry services. Students will be assigned readings and videos on core psychotherapeutic modalities, including Supportive Psychotherapy, Dialectical-Behavioral Therapy, Cognitive Processing Therapy, and Motivational Interviewing. Interactive weekly meetings will be held to review assigned readings and process patient encounters. Students will be evaluated on participation in scheduled activities and development of basic clinical psychotherapy skills. References: [1] Cabaniss, D., Cherry, S., Douglas, C., and Schwartz, A (2017). Psychodynamic Psychotherapy: A Clinical Manual (2nd ed.). John Wiley & Sons Inc. Prerequisites: PSYC 3005.

PSYC 4040. Interventional Psychiatry. 4 Credit Hours.

During the Interventional Psychiatry Elective, third and fourth-year medical students who have completed their Psychiatry Clerkship rotation will learn about the subspecialty of psychiatry that utilizes procedures to address psychiatric conditions. Examples include electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), and intranasal esketamine (Spravato). Students will participate in screening patients for these outpatient interventions, monitoring them during interventional procedures, and performing pre-/post-interventional assessments. They will learn about the neurobiological theories and research supporting the use of each intervention, as well as the limitations of each procedure. Students are evaluated using the Clinical Elective Rotation Performance Assessment of Student tool. A pass is awarded if the student's overall performance meets or exceeds expectations. Prerequisites: Psychiatry Clerkship.

PSYC 4044. Sleep Medicine Psychiatry. 4 Credit Hours.

Learning Objectives: Obtain sleep history in compassionate, caring and emphatic manner. Perform focused clinical examination with skilled bedside manners and respect for patient's privacy and dignity. Demonstrate basic understanding of common sleep disorders and their impact on health and well-being. Understanding of basic sleep physiology and neurotransmitters involved in sleep and wake regulation. Understanding of pharmacology of commonly used sleep and wake promoting medications. Basics of polysomnographic testing. Understanding of different sleep stages and EEG features. Describe and discuss Spielman's 3P model of insomnia. Brief Description: Sleep medicine is a relatively new medical discipline that has grown tremendously and has become an independent discipline over the last 30 years. Sleep is a fundamental part of our lives, and about one-third of our life is spent sleeping. It is a multidisciplinary field with overlap with psychiatry, neurology, ENT and pulmonology. Asking about sleep is an integral part of a psychiatric consultation. Almost all of the psychotropic medications have an effect on sleep architecture. Understanding sleep can help enhance comprehension and understanding of psychiatric illness. Many psychiatric patients have comorbid sleep disorders and vice versa. There is a need for sleep medicine trained physicians; in recent years an increasing number of residents are pursuing further training in sleep medicine. The sleep medicine elective at the University of Texas School of Medicine is a flexibly structured clinical experience for clinical students. The course consists of various experiences in the (1) sleep medicine outpatient clinic (2) in a 4 bed sleep laboratory at the VA medical center and (3) at the University Hospital affiliated sleep lab and clinic. Students will receive an introduction to common sleep disorders including insomnia, parasomnia, sleep related breathing disorders, hypersomnias and sleep related movement disorders. There will be an opportunity to learn how to obtain a sleep history and perform a focused sleep related examination. Students will observe board certified physicians every other week interpret polysomnograms, multiple sleep latency tests and actigraphy. This four-week elective is tailor made to fit the interest, learning needs and aspirations of the student. At times, opportunities will be available to spend time with a sleep psychologist learning basics of Cognitive Behavioral Therapy for insomnia and dental sleep exposure. Prerequisites: Successful completion of the internal medicine, psychiatry and neurology clerkships.

PSYC 4045. Community Psychiatry and Substance Use Disorder MS4 Clinical Elective. 4 Credit Hours.

Learning objectives: Substance use disorder is a common psychiatric condition encountered with high frequency in psychiatric and other medical practice areas. However, physicians and other health professionals often receive little training in how to manage substance use disorder in routine clinical practice. In this 4-week elective experience, the student will 1) Assist in evaluation of typical community psychiatry outpatients, learn to effectively screen for substance use problems and learn to manage this psychiatric co-occurring condition in the outpatient setting. 2) Assist in formal substance use disorder evaluation and treatment in the Be Well substance use disorder treatment clinic including group psychotherapies and medication management of opioid, alcohol, and other substance use disorders. 3) Read and discuss 3-4 journal articles on substance use disorder topics over the 4-week period. 4) Receive and read other directed readings from the course directors relevant to patients treated in the clinics. Conditions: Medical students must complete the Psychiatry MS3 rotation prior to this elective. No visiting students may be enrolled. Most medical students will have very limited or no exposure to a comprehensive outpatient substance use disorder treatment clinic in their standard psychiatry rotation. This elective fills an important gap in training exposure that can benefit not only students applying to psychiatric residencies but also those applying to general medicine or other medical specialty residencies. Location: University Plaza Bldg., 7526 Louis Pasteur, 3rd floor. Types of instructional methods: Clinical demonstration and observation with attending physicians, residents, psychotherapists; 1:1 discussion with course director/ co-director during weekly 1-hour meetings. Average number of contact hours per week: 20 hours When offered and number of students: 1-2 students (per period) by mutual agreement and approval with the course director for all periods throughout academic year(course director reserves right to exclude occasional periods based on vacation times, etc.) Assessment: Direct feedback to student and completion of the standard on-line medical student evaluation instrument. Additional information: this course is an elective, it involves interprofessional interactions, there is no travel requirements, and no enrollment of visiting students. No Memorandum of Understanding is needed with the clinic (already exists) and no medical equipment. Prerequisites: Medical students must complete the Psychiatry MS3 rotation prior to this elective; No visiting students may be enrolled.

PSYC 7000. Off Campus. 4 Credit Hours.

All off campus rotations must be approved by the designated faculty member prior to the beginning of the rotation (at least one week before the course begins). Credit will not be given for any rotation that has not been approved in advance. Required paperwork includes: "Course Approval" form, a written letter or email for acceptance form the physician preceptor with the start and end dates of the course/rotation, and a course description of your learning objectives and responsibilities during the rotation. Forms must include a complete address and telephone number for the off campus location or residence address for the student while at the off campus site. Forms will not be approved after the rotation has already begun. Contact the department for assistance with enrolling in this course.