MDC7830
PSYCHIATRY

PSYCHIATRY – CLERKSHIP SYLLABUS – 2025/2026
Duration: 6 weeks
Clerkship web page: MDC7830: Psychiatry Clerkship

CLERKSHIP INFORMATION

Clerkship Description
This course is a six-week clinical rotation that provides a general experience in both Psychiatry and Addiction Medicine. The clerkship consists of three major clinical rotations (inpatient psychiatry, consultation-liaison service, and addiction medicine), a comprehensive lecture series, and a case conference in ethics. Other activities include exposure to outpatient psychiatry, ECT, self-assessment lectures, and two non-graded OSCEs. Students will get an overview of the major diagnostic categories, therapeutic modalities, and settings of
modern clinical psychiatry. Additionally, students will gain competence in the psychiatric diagnostic interview, including the mental status exam. Students will gain competence in the assessment and treatment of various psychiatric disorders, including those related to substance use disorders while being responsible for the evaluation and daily management of assigned patients.

Clinical Rotations
UF Consultation-Liaison Shands Hospital Rotation: This rotation provides experience in evaluating psychological problems occurring in medical patients, understanding the consultation process, and following medically ill patients with psychiatric problems over time. Recommend reviewing the ADMSEP CSI module on “Capacity Evaluations” prior to rotation.

• UF Health Shands Psychiatric Hospital (Vista) Rotations:
  Vista: 4101 NW 89th Blvd Gainesville, FL 32606. Shands Vista will be the first building on the right. The Vista Visitor Parking on the right across from the soccer field. Check-in with the receptionist.
  
  The Vista Adult teams (North and East) treat a variety of psychiatric conditions. Students witness many of the acute presentations of psychopathology, particularly thought disorders like Schizophrenia, and Mood Disorders such as Bipolar Disorder and Major Depression. Vista Adult Inpatient Addiction Psychiatry (Vista West): Students are exposed to patients with dual diagnoses-i.e., psychiatric and addictive disorders. The treatment approach is comprehensive, including both medications for detoxification and relapse prevention, as well as psychosocial approaches.
  
  Vista Child and Adolescent Psychiatry (Vista South): Students are exposed to child and adolescent patients with a variety of psychiatric conditions.
  
• Malcom Randall VA Psychiatry Rotations: Each of the VA Hospital treatment teams provides experience with a broad range of psychopathology. Particular emphasis is placed on interviewing and diagnostic skills, and psychopharmacology. During the admissions process, students are encouraged to conduct the interview, under the direction of house staff, and discuss differential diagnostic considerations.
  
• The Psychiatric Consultation and Liaison Service at VA Hospital: This rotation provides an experience in evaluating psychological problems occurring in medical patients, understanding the consultation process, and following medically ill patients with psychiatric problems over time. Recommend reviewing the ADMSEP CSI module on “Capacity Evaluations” prior to rotation.
  

OFF SITE PSYCHIATRY ROTATIONS:

• Jacksonville Consultation and Liaison Service: excellent experience in evaluating psychological problems occurring in medical patients, understanding the consultation process, and following medically ill patients with psychiatric problems over time. Recommend reviewing the ADMSEP CSI module on “Capacity Evaluations” prior to rotation.
  Jacksonville Consultation-Liaison: 580 West 8th Street, Tower 2, Suite 6005, Jacksonville, FL 32209
  
• Sulzbacher Center – Jacksonville Community Psychiatry: excellent experience in community and street psychiatry. Evaluating and treating individual with severe mental illness and/or substance use disorders.
  Arrive at 8:30am
  Our address is 611 E. Adams Street, the employee parking lot is in the back at the intersection of N. Catherine and E Monroe St. (put that intersection into GPS otherwise it takes you to the front). Just call/text when you park as our MHOP office is difficult to get to, 850-445-6501. Attire is typical clinic attire, but Monday is scrubs plus shoes that can get dirty (be sure to pack an umbrella or raincoat just in case).
  
• UF Health Florida Recovery Center (FRC): Students are exposed to patients with dual diagnoses- i.e., psychiatric and addictive disorders. The treatment approach is comprehensive, including both medications for detoxification and relapse prevention, as well as psychosocial approaches. 3939 SW 13th Street (FRC is on the corner of Williston Road and 13th Street).
  
• Meridian Behavioral Healthcare: has been providing treatment for psychiatric and substance use disorders in North Central Florida for over 40 years. The majority of the patient population is indigent and underserved, and as a result, frequently present with challenging psychiatric, medical and addiction problems which have been present for years with little or no treatment. Students participating in this rotation will have the opportunity to assist the attending physician and the UF Addiction Medicine fellow in all aspects of evaluation, detoxification (when necessary) and treatment planning of a diverse patient population with various substance use disorders as well as frequent psychiatric and medical comorbidities. The clinics will also demonstrate the transition from the detox unit, to the Meridian Methadone, Suboxone and Vivitrol clinic where outpatients are treated for Opiate Use Disorders and Alcohol Use Disorders.
  The Detox building is 4300 SW 13th Street Gainesville Florida. See Map below.
  

Learning Objectives:
The Department’s expectations of clerkship performance are linked with the College of Medicine’s competency-based curriculum and institutional learning outcomes.

• Professionalism (P)
• Patient Care (PC)
• Medical Knowledge (MK)
• Interpersonal Relationships and Communication Skills (ICS)
• Practice-Based Learning and Improvement (PBL)
• Systems based practice (SBP)

Table 1: Clerkship Objectives and relationship to College of Medicine Institutional learning Objectives

Required Textbooks and Resources
Quick Reference to DSM-5-TR. Provided by the clerkship at orientation. This is an abbreviated edition of the APA’s manual for psychiatric nomenclature. You can also find free access to the complete edition on the UF Library website. You should be familiar with its contents. You should also gain familiarity with multi-axial psychiatric diagnosis.

PsychiatryOnline DSM-5. Online access to DSM 5-TR provided through Health Science Center Libraries under P under A-Z Databases. https://guides.uflib.ufl.edu/az.php

Short computer modules on many psychiatric subjects can be found on the ADMSEP (Association of Directors of Medical Student Education in Psychiatry) https://www.admsep.org/csi-emodules.php?c=taskforce

Recommended Textbooks and Resources

General Psychiatry
The primary texts recommended for this rotation are:
Kaplan & Sadock’s Concise Textbook of Clinical Psychiatry (available through the library)

Introductory Textbook of Psychiatry by Donald W Black and Nancy C Andreasen

First Aid for the Psychiatry Clerkship Sixth Edition

Rating Scales

• Depression: PHQ-9, MADRS, Beck’s Depression Inventory, Hamilton Depression Rating Scale
• Postpartum Depression: Edinburgh Postnatal Depression Scale
• Anxiety: GAD-7; SCARED (Screen for Child Anxiety related Disorders)
• Social Anxiety Disorder: Liebowitz Social Anxiety Scale
• OCD: Y-BOCS, Family Accommodation Scale
• PTSD: PCL-5
• Catatonia: Bush-Francis Catatonia Rating Scale
• Cognition: MOCA, SLUMS, MMSE
• Alcohol Withdrawal: CIWA
• Opioid Withdrawal: COWS
• Tardive Dyskinesia: AIMS

Computer Requirement

Personal Laptops
Personal laptops can be utilized in clinical spaces and should meet the computer requirements laid out by the College of Medicine (https://osa.med.ufl.edu/support/policies-procedures/computer-requirement/). Desktops are available on all clinical rotation sites. You are not required to bring personal Laptops. If you bring a personal laptop they can be stored in the shared, rotation designated, locked work room.

Shelf Exam: Students who recently completed the rotation recommend the following study guides to prepare:

• First Aid for Psychiatry (Very high yield material)
• UWorld
• AMBOSS
• Psychiatry Blue Prints
• Appleton and Lange’s Psychiatry Board Review Questions

Case Files– by Eugene C. Toy, Eugene Toy, Debra Klamen; publisher: Lange Medical; 4th edition (does a good job with developing clinical reasoning needed for the exam) The Psychiatric Interview: A Practical Guide- Carlat, Daniel J.

Addictions Psychiatry
The standard reference text for the addictions portion of the course is: Substance Abuse a Comprehensive Textbook, (3rd edition). Lowinson JH, Ruiz, P, Millman, RB. Williams and
Wilkins

An excellent resource and available in the HSC library:
The American Society of Addiction Medicine’s Principles of Addiction Medicine

A good reference text for understanding the underlying pathophysiology and mechanisms of many psychopharmacologic agents:
The Biochemical Basis of Neuropharmacology, Cooper, Bloom and Roth, published by Oxford Press

Mid-clerkship Formative Feedback
Students are required to obtain written formative feedback from at least one faculty member and submit at the end of the rotation. Students are STRONGLY encouraged to obtain written formative feedback from all supervisors with whom they have significant contact.

Informal Feedback: Informal feedback is provided in all settings and usually takes the form of verbal comments from the attendings, fellows, and residents regarding a student’s behavior, answers to questions, and the ability to perform required clinical activities. It will rarely be labeled as feedback but should be recognized as such and should be utilized to improve performance. Students should ask for clarification when comments are unclear.

Mid-Point Formative Feedback: Students must complete 2 written self-assessments of their progress at roughly the midpoint of each 3-week (inpatient or consult-liaison service) and 2-week rotations (inpatient or consult-liaison service). When obtaining formative feedback from faculty or house staff you should print out the formative feedback evaluation form APPENDIX), reflect on your performance and how it aligns with the anchors for each competency, and rate yourself (physically circle numbers). Next, for areas you feel you are
struggling brainstorm 1-2 ways you might be able to improve your performance in these areas. If faculty/resident ratings don’t align with your evaluation this is a natural time to ask the faculty/resident, why the score they gave was lower (or higher!) and how you can improve performance.

Mid-Point Formative Feedback: The Details

1. Complete the Mid-Point Formative Self Evaluation Form (copy provided on Canvas). The student should critique strengths and weaknesses and include a few brief narrative comments. The student should place a check mark in the appropriate box under each competency heading.
2. Schedule a “midpoint” meeting with either the primary resident or supervising attending on the service during the time period being assessed. (Students are responsible for scheduling the meeting).
   • While meeting with the supervising psychiatry attending or resident, the student’s formative self-evaluation form will be reviewed. The attending/resident will circle the rating (from 1-9) which is most reflective of the student’s performance in each competency and provide feedback (verbal and written).
     • and positive feedback and encouragement are beneficial, weaknesses and deficiencies will be stressed more than strengths. Formative feedback does not influence the student’s final Summative Evaluation, unless the student does not turn it in on time.
3. Students must turn-in the first Formative Self Evaluation form by uploading it to Canvas no later than 5PM on the fourth Monday of the rotation, and the second no later than 5 PM on the 6th Friday of the rotation.
   • The Formative Self Evaluation form should include
     • Ratings checked by the student,
     • The student’s supervisor’s circled ratings
     • Both the student and the student’s supervisor’s comments.

Students concerned about their feedback should contact the Clerkship Directors.

1. If the feedback is too general, then you should ask for more specifics. For example, in response to “your interview should be more comprehensive,” you could ask what type of questions you should be asking or what sections did you leave out.
2. If a clinic assignment is ending and you have not yet received any feedback, you should approach the attending/resident and request it. You are most likely to get useful feedback if your request is specific. In a response to a question like “how am I doing?” you are likely to get a bland, general response like “just fine.” If instead, you ask which area you should pay the most attention to improving, you are much more likely to get useful feedback.

Student Evaluations – Major rotation supervisors (faculty and house staff) will submit an assessment of each student at the conclusion of the clerkship.

Your Feedback Is Very Important
Drs. Schmidt, Lewis, Carr, and the grading committee would like to address any issues if the student’s learning experience is not progressing as it was intended. Please keep them informed of any issues. Additionally, at the conclusion of the rotation, students are required to submit an online evaluation of the clerkship. The narrative comments are extremely helpful. Student should complete all online feedback forms including:

1. Overall Psychiatry Clerkship Evaluation
2. Faculty Evaluations
3. Resident/Fellow Evaluations

ASSESSMENT
Student performances are assessed and evaluated upon the degree of mastery of UF COM graduation competencies. Competency levels are secondarily correlated with overall performance ratings/grades. Competency assessments will be based, in large part, on direct observation by supervising faculty, fellows and residents during clinical experiences. Additional assessment tools include written examinations, participation in the didactic curriculum, and satisfactory completion of course requirements.

Internal Measures of Student Knowledge, Skills and Attitudes:

1. Direct observations of supervising faculty/house staff during clinical rotations
2. H&P Writeup and EBM Paper
3. Satisfactory completion of mandatory course requirements

External Measures of Student Knowledge and Skills:
At the conclusion of the clerkship, all students take the NBME subject (“shelf”) examination in Psychiatry. “Raw” scores on the examination are adjusted according to national guidelines from the NBME. The examination score is an equated percent correct score. A low score on the shelf will impact your overall grade.

Professionalism Mini Evaluation Exercise (P-MEX)
The Professionalism Mini Evaluation Exercise (P-MEX) is an instrument used to assess professionalism in clinical training. The evaluator rates the trainee on 24 different directly observable items of medical professionalism over four different skill areas: doctor-patient relationship skills, reflective skills, time management, and interprofessional relationship skills.
You will be required to obtain the following over the course of the rotation:

• 2 to be completed by a faculty or resident with whom you closely work. You will solicit these on demand, which will be aimed at providing real-time formative assessment
• Up to 1 from the clerkship coordinator. The administrative team will assign these such that you receive two over the course of the year.
• Available on Canvas (hard copy) and through New Innovations On Demand

Grade Committee and Evaluation Process
The numerical cutoffs that create the grade distribution are determined by the performance on the Psychiatry Clerkship by the medical students from the last academic year and not from your current clerkship group. A grade committee determines your final grade based on clinical evaluations, examination scores, and required assignments as outlined in the grade explanation. “Coaching up” faculty (telling them that certain numeric scores on their evaluation correlate to the grade) is misleading, unfair to the majority of students who do not
do this and is considered unprofessional behavior. Engaging in this behavior will result in a lower professionalism evaluation and could affect your grade and the comments submitted for the MSPE. As a reminder, the Department of Psychiatry utilizes a grade committee to determine all final scores and grades. This holistic and varied committee is comprised of clerkship directors, and invited faculty in educational roles, that represent both Gainesville and Jacksonville campuses. The grades are reviewed at the end of the year by the UF COM Phase 2 leadership team and the letter grades may be adjusted to fit the recommended clerkship grade distribution (40% A / 45% B+ / 15% B‑or‑below).

Should you have questions about your final grade, or wish to discuss your performance further, please follow the COM policy on the 3rd year CANVAS page, under Assessment, to formally request a meeting with two of the clerkship directors. All questions and concerns regarding numerical grades, letter grades, and MSPE comments must be brought to our attention by requesting a formal meeting within 30 days of the grades being released.

Required Activities
MANDATORY EXPECTATIONS: As some of the experiences below will pull you from your primary rotation site (inpatient/consult/etc.), it is REQUIRED that you clearly communicate to your primary service ATTENDING AND FELLOWS/RESIDENTS when you will be gone for such activities. Please notify them as early as possible so they will not expect you on service during these times. Required activities to complete include:

1. Students will attend one ambulatory/outpatient half-day. This sampling of outpatient psychiatric experiences provides students with exposure to psychopathology in a different setting, the outpatient clinic. Inherent to this setting is often higher functioning individuals with a more robust treatment response. Outpatient experiences are available in child & adolescent psychiatry in Gainesville and at the Sulzbacher Center in Jacksonville. If you want to do an additional afternoon outpatient experience in the adult clinic, you may schedule it yourself directly with a resident. You are STRONGLY encouraged to contact the resident you would like to work with in adult outpatient clinic (via email and/or in person) EARLY in the rotation, so that they have adequate time to arrange for the required day in clinic. Students SHOULD NOT schedule any ambulatory/outpatient psychiatry clinic days during their addiction medicine week.
2. Each student is required to observe and actively participate in one Electroconvulsive Therapy (ECT) session. The clerkship coordinator will schedule a date for your ECT session. NOTE: Please remember this is a serious procedure. As in any clinical setting, be careful what you say around the patients. Comments can be damaging which are inadvertently made to and around patients who are already anxious about undergoing ECT. ECT does NOT count towards your outpatient experience requirement.
3. Every student will interview at least one psychiatric patient and receive non-graded feedback from this interview on the CLEX form (available on Canvas). There is no formal grade received from this patient interview. The interview consists of interviewing a new patient (25-minute interview and 15-30 minutes for discussion) and presentation of their assessment and diagnosis of the patient with either a psychiatry attending or psychiatry fellow/resident. The student is responsible for scheduling this oral exam with their psychiatry attending or resident. Many students choose to schedule their CLEX during the 3rd or 4th week they are rotating on a psychiatry service, but you may do it at any time as long as it is done with a psychiatry resident or psychiatry attending. The student should bring a copy of the CLEX form with them for the attending or resident to fill out (on canvas).
4. Each student is required to observe and be present at any Grand Rounds lectures given on a Friday during the rotation. The clerkship coordinator will notify you of the date, time, and place if attendance is required.
5. Two self-evaluation Formative Feedback forms should be completed as outlined in the Feedback section.
6. One Ethics Case Conference will be attended currently by Zoom as outlined in APPENDIX.
7. Optional: 8-Hour MOUD Education Options. Trainings found at the link below satisfy the DEA training requirements. Save your certificates for record when applying for individual DEA. https://pcssnow.org/medications-for-opioid-use-disorder/8-hour-moud-education-options/
8. Students will complete two simulated patient cases in person at the Simulation Center. These OSCEs are designed to be low-risk exercises to practice psychiatric interviewing and developing an assessment and plan. Sessions will be held to debrief the encounter with both standardized patients and psychiatry faculty.
9. Professionalism includes following attendance policies/timeliness to rotations and clinics, following syllabus procedures, participation in lectures, timely submission of assignments, etc. Attendance is taken at lectures and YOU MUST HAVE YOUR VIDEO ON DURING THE LECTURE if the lecture is done over zoom. If you have a
   medical appointment, are sick that day, or have an emergency, etc., you must notify Shelly Flanagan of your inability to attend, and your absence will be excused. Your final grade may be impacted by professionalism lapses. Further information can be found at: https://osa.med.ufl.edu/policies-procedures/professionalbehavior/
10. Written assignments – DUE by 5 pm on the last Friday of the Psychiatry Clerkship H&P: Typed patient write-up should include all bold headings below. We want you to use the template provided below. Should be completed on a patient with whom you worked with while on the inpatient psychiatry service or the psychiatry consult-liaison service. All HIPPA information should be removed from the write up.

H&P headings should include/contain:

• Chief complaint – this should be in the “patient’s words.”
• History of Presenting Illness – the first few sentences should set the scene of who the patient is (age, past psychiatric or medical conditions, NO HIPPA information), symptom presentation, where they are presenting (medical Hx, ED, Psychiatric Hx, detox, etc), and how (EMS, Baker Act, Voluntary, Self, etc). The HPI is where symptoms and changes should be detailed. For patients being evaluated by the psychiatry consultation-liaison team, the question being asked by the consulting team should be clearly indicated. The HPI is where applicable timelines (medical hospital course, new psychosocial stressors leading to symptoms, events since the last discharge) should be presented. The HPI is also a good place to include applicable collateral from EMS, police, family or friends. For HIPPA purposes, please do not include actual dates of admission, discharge or hospitalization.
• Past psychiatric history – should comment on past psychiatric hospitalizations, past suicide attempts, past self-harm, past violence, past diagnoses, outpatient care (past or current), past medication trials (may also include TMS, ECT, Esketamine, therapy, other treatment). Negative history of the above is important to include.
• Full ROS for psychiatric disorders – should cover negatives/positives of major psychiatric categories like depression and other mood disorders, personality disorders,
  anxiety disorders, somatic disorders, eating disorders, trauma and stress related disorders, psychotic disorders, cognitive disorders, and substance use disorders.
• Current and past medical history
• Full Medical ROS – pertinent positives and negatives should be presented. “ROS Negative or Otherwise negative” is not acceptable for full credit.
• Current medications – (both psychiatric and medical; don’t forget inpatient medications)
• Substance use history – indicate what specific substances were screened, do not forget tobacco, nicotine, cannabis, caffeine. If applicable, should include details listing first use, last use, age first use, amount, etc of alcohol and each drug, treatment history, withdrawal history. “Denies all substance use” will not receive full credit, indicate
  substances specifically screened for.
• Family history, particularly psychiatric issues – diagnoses, treatments, completed suicide, substance use history
• Personal/social history including legal history and trauma/abuse history (do not include any details about the trauma or abuse, simple yes or no will suffice). Should
  include relationship history, educational history, vocational history, etc.
• Physical exam components including vitals and BMI Complete mental status exam
• Pertinent labs/Urine tests/Assessments
• Differential diagnosis according to DSM-5-TR format and criteria (ok to list) – don’t forget contributing medical conditions or substance use disorders.
• Assessment and discussion of any differential diagnosis you possibly would consider if seeing the patient long-term. Does not need to be long. Should make evident what
  diagnoses are most likely on your differential and why.
• Treatment plan – Can be in description or bullets. The plan should cover treatment plan for admission (medications with dosages, labs, therapy, Baker Act, Etc), safety
  assessment, and discharge planning (follow-up). For patients evaluated by the consultliaison psychiatry service, please include a plan as if you are the primary team, do not provide only “Recommendations.”

Psychiatry is a very collaborative specialty that values discussions about how to evaluate patients. Please feel free to talk with your attending/resident or email Drs. Schmidt, Carr, or Lewis with your questions about the H&P. It is ok to ask for feedback to incorporate as you are learning. However, use the template above for this assignment, and do not use a template provided by attending or resident on rotations.

11. Evidence-Based Paper – Psychiatry PICO question. You are to answer this question in a maximum of 5 double spaced pages (not including references) and have a typed addendum to your write-up listing at least 2 current references from the literature that you used in the paper. Does not need to be directly related to a patient you saw on the psychiatry rotation.
    Suggested Format:
    • Introduction to PICO Questions
    • Rational on how articles were chosen and why deemed appropriate for PICO
    • Analysis of first article (see rubric)
    • Analysis of second article (see rubric)
    • Summary

Any make-up work that needs to be completed after the clerkship, will result in a hold grade until the clerkship requirements are completed and you are able to receive your final letter grade.

Grading

*Students are evaluated on the following professionalism domains:

• Respectfulness
• Work Ethics and Dependability
• Motivation and Excellence
• Honesty

Required clinical presentations, skills, and procedures
The clerkship is designed to expose you to the following core presentations, skills, and/or procedures, which are graduation requirements. If you have difficulty meeting any of these, an alternate method is listed in the table below.

Failure to meet the graduation requirements, clerkship requirements, or to log completed requirements through New Innovations will result in a deduction of 1% from the final clerkship grade.
Video instructions on how to complete case logs in New Innovation are on the Phase 2 Canvas Page.

Policy on Student Evaluations

• Each student must complete at least 75% of all assigned faculty, resident, and small group leader
  evaluation forms associated with a course/clerkship in each year of enrollment. There is an
  expectation of 100% completion on overall course and clerkship evaluations.
• Every student is expected to respond in a professional manner to each item which she/he feels
  qualified to answer.
• Strict confidentiality of responses is assured. Evaluation data (numerical ratings and student
  comments) is de-identified. However, the completion of evaluations will be tracked.

On-Demand Evaluations
Clerkships now offer on-demand evaluations in New Innovations, giving you the ability to request evaluations directly from the faculty and residents you work with. You’ll be able to choose who evaluates you, generate the evaluation request yourself, and New Innovations will immediately send them a prompt to complete it. (On the faculty/resident side, the evaluation form will look the same—it will just arrive sooner.)
This system is designed to help you receive more timely and meaningful feedback, since you can request an evaluation shortly after working with someone, rather than relying on evaluations submitted at the end of the rotation, often weeks later.
Each clerkship will provide guidance on how many evaluations you are expected to initiate and when you should submit these requests. Clerkships may also continue to initiate evaluations on your behalf when needed.
If you have questions or concerns, please reach out to your course administrator. For technical issues with New Innovations evaluations, contact Michael Bruce.

ADA Accommodations
The University of Florida is committed to providing academic accommodations for students with disabilities. Students requesting accommodations must first register with the Disability Resource Center (DRC) (352-392-8565) https://disability.ufl.edu/students/get-started/ by providing appropriate documentation. Once registered, students should present their accommodation letter to the College of Medicine’s ADA Representative, Mr. Jim Gorske, who will distribute the accommodation letter to appropriate course and/or clerkship directors, as needed, as well as the testing center. The University encourages students to register with the DRC as soon as they begin medical school or upon the verification of a disability.

COLLEGE OF MEDICINE POLICIES AND PROCEDURES HANDBOOK

The following topics are covered in the College of Medicine Policies and Procedures Handbook