Long commutes || Psych Rotation
I’m exhausted! Two more rotations and I’ll be done with third year. Two more rotations and I’ll have to face Step 2 and all the residency application things. I wish I had a Spring break.
Since I started my psychiatry rotation so for a very long 6 months, I’ll be commuting 3 to 4 hours a day. Southern California traffic is no joke! It’s been brutal. My back hurts. I definitely feel like I’m in my late 20’s. Luckily, my attendings encourage exam preparation so most of my shifts have been in the afternoon.
I usually avoid the Los Angeles area because of all the traffic and I’ve done my stent in cities. I can’t deny how beautiful it is to see the skyline on the way in. We can see the sunset in the location I’m in and it’s breathtaking.
New hobbies
I continue to find new hyperfixations or we can call them hobbies. With open mornings, I have loved trying Brazilian jiu-jitsu. Nothing like channeling my study frustration into rolling or really getting tossed around like a toddler.
I’ve also become absolutely obsessed with Hogwarts Legacy. I’m a proud Hufflepuff. I’ll make a name for us out there at Hogwarts! I love open-world games where you can explore and dive into a new universe. It’s a great stress reliever.
Exploring
Though of the time after my commutes, I just want to melt into my bed. I’ve gotten o explore some great food spots. This is my celebration Japanese pancakes for passing my psychiatric rotation! I think I want to try baking, but Mr. Warmly is not a dessert person and I am 100% a “there’s always room for dessert” person.
My Psychiatry Rotation
The psychiatry core at SGU is 6 weeks long. Like all the other cores, the experience completely depends on the hospital or clinic and the staff. Some people have a primarily inpatient experience and others have primarily outpatient experience. Some people meet with the attending(s) daily and others are more connected to the residents.
During my rotation, I rotated with 3-4 students from other medical schools. We met our attending in one of two locations after he did rounds. We’d see patients together and then he’d give us lectures on some psychiatric topics.
I graduated with a Psychology degree and my mom is a therapist so I knew psychiatry wasn’t exactly for me. It is absolutely fascinating, but I don’t think I’m made of the stuff that can withstand the burden. Also, I felt like I was too inclined to start some internal investigation into what disorders I might diagnose myself with.
In the outpatient setting, we helped with mostly depression and ADHD. It was mostly the management of medication. With the national shortage of Adderall, we learned quite a bit about the pharmacology and different regimens offered. In the inpatient settings, we learned about the role of psychiatrists in psych holds and even witnessed some court hearings. We heard some shocking stories, but also stories that just stuck with me like one about sandwiches being thrown at priests. In the inpatient settings, we would see the patient as an admit and determine the best course of treatment for the length of the hold they had. It was intriguing to witness how some patients would change throughout their hold when responding to medication. We helped many people with bipolar, substance-abuse disorders, and severe depression. In the books and exams, the patients are very this disorder or that disorder. In real life, we had a lot of discussions trying to parse out diagnoses and what treatments they would more likely benefit from.
An average rotation day
My attending is an absolute amazing business role model. There is no way to avoid that medicine comes with business. The benefit of their efficiency was that they were able to serve many people, especially with the help of telehealth. My attending rounded in the hospitals in the morning. Then in the afternoon, we’d see clinic patients or telehealth into other inpatient hospitals. Most of the time, we’d start in the afternoon. From what I heard, many psychiatric rotations have more morning or afternoon schedules. We’d see patients together, pretty much back to back because of the loaded schedule. There is a huge demand for mental health services in my area.
SGU requirements
Weekly Requirements
This section is pretty much the same as other core blogs, but just in case you came here first here’s the deal. I’ve underlined the unique requirements for Psychiatry.
Firecracker
SGU requires you to sign-up for this website. It attempts to pace out the topics you need to learn. You’re supposed to mark 10 topics a day and review topics through their flashcards and questions. Participation counts towards professionalism. I definitely will never be able to follow this. It is required to fo 10-20 questions a day.
Quizzes: The quizzes are done online through Firecracker. They are released on Fridays and are due on Mondays. They are usually 20-25 questions.
Patient Encounter Log (PEL): You can find this google form-esque log on the SGU clinical site. Before the end of the rotation, you need to submit all 11 required encounters. It’s optional to submit a SOAP note in the comment, but the school mentions you can print this log and show it to your preceptor for the final rotation evaluation. My advice, submit a couple of encounters every week so it’s not a rush at the end but I still did it all at the end.
Observed Encounter: You can print the rubric from the Sakai site. Multiple residents/attendings can sign off competencies. My advice, it all depends on who you ask. Play smarter, not harder. Since this is a 6-week rotation, 1 form is required.
1 Case write-up & 2 focused SOAP notes. I wrote about 1-2 pages for each. A big bulk was the SOAP note itself. So far my evaluations have been fine so I wouldn’t spend an exuberant amount of time on this.
2 Communication Modules
Ethics Quiz
150 Uworld questions
Psych Shelf Exam
Signing Up
Since this rotation is 6 weeks long, I got an email with the scheduling permit to schedule my Shelf exam around 3-4 weeks in. I have to drive around 40 minutes to the nearest testing center. In SGU’s current policy we get the day of the exam and the day before off. However, some attendings have different policies allowing you to have more time to study.
Grading
Grading for SGU is honors, high pass, pass, and fail. To pass the shelf, you need a 75 percentile. This is much higher than other shelf exams.
How I studied For The Psychiatric Shelf Exam
The Psychiatry Shelf is touted to be one of the easier Shelf Exams, but I mean are any of them actually easy? The magnitude of content is much more constricted. The high-yield concepts (IMO)
Child diagnosis: ADHD vs. Autism vs. Conduct vs Oppositional
Schizophrenia spectrum
Depression spectrum
Personality Disorders
Intoxication/Withdrawal Syndromes
Medication
Neuro
Some tips:
Details matter! Timing, age,
Honestly, I think you’ll be fine! Uworld and NBMEs seem to be sufficient
What I actually used to study
Inputs: Onlinemeded
Qbanks: Uworld > Amboss + NBME
Anki: Doing the Shelf tagged cards would probably be really helpful. I was really burnt out during this rotation from all the driving so I ended up making a filtered deck with concepts I got wrong in my practice questions.
Anking Step 2 deck: The Speed Focus Add-on saved my behind for sure!
OME notes: These are the PDF summaries of the videos and helpful because they have charts and diagrams.
Ninja on Fleek Pharm sheets - what a throwback!
For cumulative review, I loved these video series:
I watched or listened to them in my car and then more seriously closer to the Shelf.
Divine Intervention: I watched this halfway through as a guide to topics I might need to spend time on. I watched it the day before the shelf and it made way more sense. Definitely saved me at least 3 questions!
First Aid Psychiatry
Podcasts for the commute:
Psychology in Seattle for a little more casual listen
Qbanks:
Uworld: 372 questions
Amboss: 321 questions for Psych
Times are tough! There is an Amboss Scholarship Program you can apply for. At the very least, they usually give you 1-2 weeks free if they don’t give you a scholarship.
4 NBME practice tests are available for purchase. I took the first one as the mid-core exam. The rest I started taking these about 3-4 weeks before my exam.
Lange Psychiatry for practice questions
Warmly, Rainee
We did it y’all! We’re onto the last rotation of third year. Can’t wait to celebrate with y’all.