One more rotation has come and gone! I can honestly say psychiatry has been the clerkship i’ve probably learned the most on during this year. I wouldn’t say it was my favorite, as I really can’t see myself as a psychiatrist based on a variety of things, but I really felt like I learned a good basis of psychiatry that will help me in whatever specialty I eventually choose.
As mentioned before, I was at Larue Carter, the state psych hospital. Initially, I was pretty intimidated when it came to working with these patients. However, this turned around and by the end of the month it was actually kind of tough to leave some of my patients. There were a lot of small victories along the way: getting patients who typically ignored me to say hello. Or seeing a patient in a brief moment away from their psychosis and feeling a more typically patient/physician relationship with them. It ended up working out like every clerkship has so far. Initially, it can be pretty intimidating and makes you wonder how you’ll get through it, but by the end of the month, you’ve really learned a lot and have been able to overcome these initial fears.
The requirements for the psych rotation are pretty straightforward at IUSM. There are no weekend assignments!! You take one night of “call”, which involves going to the Crisis Intervention Unit (CIU) at Eskenazi hospital from 5-10pm and working with the team on taking care of acute psych emergencies. You have to submit a few HP’s from patient encounters, and there are the typical lectures to attend. Overall, its a really manageable month, and even the exam felt pretty straightforward!
I enjoyed the month, but it by no means made me consider psychiatry as a profession. Theres a few reasons for this. First of all, I really didn’t see myself fitting in with the residents and faculty I worked with. This isn’t a bad reflection on anyone, its simply a matter of fact. As you progress through rotations, you’ll pick up on different types of people you see predominantly in the various specialties. It’s extremely important that you “feel” like you belong with the group of physicians you’re with. I just didn’t get this feeling throughout the month, and that’s totally OK. Another reason is that I don’t feel like I could handle the internal struggle of dealing with these patients who can have such devastating histories and illnesses. As i said in a previous post, it’s hard for me to really understand how a person does/doesn’t change throughout a mental illness. This struggle is something I don’t think I could fully come to understand and I think it would keep me from being a good psychiatrist.
So Physical Medicine and Rehab (PM&R) is still in the lead..But right now its on to the next thing, which is Internal Medicine. I’m really excited! For one thing, it might be the most “medical” of all the rotations and the time during which we’ll get to apply the most knowledge from years 1/2 and the time when we’ll learn the most “typical” medicine. Also, I get to complete the clerkship back in Terre Haute, my hometown and where my fiance currently lives! So it will be a great rotation of learning combined with being around family and loved ones during the holidays. I’ll post an update on my initial thoughts on medicine here at the end of the week. As always, comments are welcome!
-Brian
