PS507M.23

Women's Mental Health

Sites: BWH, Brigham Psychiatric Specialties Center for Women and Newborns, Brigham and Women's Hospital Fish Center for Women's Health Faulkner Hospital
Director(s): Erik Alexander, Fremonta Meyer, Polina Teslyar
Prerequisites: HMS Principal Clinical Experience (Core Clinical Clerkships including Psychiatry) or equivalent
Offered: Full time in January, February, March, April, May, June, September, October, November
Location: BWH - Brigham and Women's Hospital (23)
Open to Exclerks: Yes (may be restricted for international students)
Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Fremonta Meyer, flmeyer@partners.org, for approval to enroll. This elective is designed to increase students’ knowledge of the influence of sex, gender and reproductive cycle events on psychopathology and psychiatric care, and to augment their skills in assessing and treating psychiatric disorders related to gender and reproduction. It includes concentrated clinical experience with patients with premenstrual, perinatal and perimenopausal psychiatric disorders, as well as patients with infertility, pregnancy loss, and breast and gynecologic cancers. Students also learn how to do preconception planning with patients at risk for perinatal psychiatric problems, and about trauma-informed care for women who have experienced sexual trauma. Students see patients within Women’s Mental Health clinical services at Brigham and Women’s Hospital (BWH) and the Fish Center for Women’s Health. This includes both outpatient and inpatient consultation settings. Students are supervised by faculty within the BWH Women’s Mental Health Division. Students work closely with senior residents and a women’s mental health fellow, and attend biweekly multidisciplinary rounds with attendings, residents and a women’s mental health fellow. Students also do a scholarly project, consisting of either a written case report, a written literature review, or a presentation to the Women’s Mental Health Division. Students participant in relevant lectures, symposia and Grand Rounds. There is no call.
Incorporation of Basic Science Content and Evidence-Based Medicine:
Discussion of findings from relevant basic science and clinical studies are incorporated into biweekly rounds. For selected cases, students review relevant articles and summarize them in rounds. Basic science topics that are covered include brain sexual dimorphism, epigenetic fetal programming, activational effects of hormonal fluctuations, and hormone-neurotransmitter interactions. Understanding the evidence base for risks of untreated psychiatric symptoms during pregnancy, and risks of psychotropic medications during pregnancy, is a particular focus among the clinical studies reviewed. Students are expected to write up at least one full consultation style H&P note on a patient every week, this should incorporate relevant data from the scientific literature to support recommendations made.
Grade Criteria:
Honors with Distinction: Student demonstrates all the competencies listed for an "honors" grade. In addition, student shows an exceptional capacity for empathy, communication, diagnostic acumen, clinical judgment and treatment planning. Student consistently acquires substantial evidence-based background information relevant to clinical cases seen, and asks questions that indicate an in-depth analysis of this information and of the case. Student's scholarly project reflects original thought, including an ability to figure out next steps for research about the chosen topic.
Honors: Student demonstrates all the competencies listed for a "satisfactory" grade. In addition, student's evaluations of patients include thorough, detailed, nuanced histories and accurate, descriptive mental status examinations. Student can develop comprehensive differential diagnoses and biopsychosocial formulations. Student proactively finds relevant evidence-based information and shares it with the treatment team. Student communicates with patients in a nuanced, empathic way that is matched with patients' varied communication styles and capabilities. Student's scholarly project is well organized and effectively delivered, and reflects an accurate, up to date synopsis of the evidence base for the chosen topic.
Satisfactory: Student's evaluations of patients consistently include key elements of history, mental status examination, risk assessment, and multiaxial diagnosis or differential diagnosis. Student demonstrates ability to form a treatment plan that has defined goals and treatment modalities and is consistent with clinically effective and cost-effective care. Student demonstrates ability to explain risks and benefits of recommended treatments to patients. Student demonstrates ability to find evidence-based information and apply it to clinical situations. Student communicates effectively with patients, family members, other clinicians and supervisors. Student performs assigned tasks, consistently exhibits professional behavior, and works effectively as part of a health care team. Student completes a scholarly project.
Unsatisfactory: Student does not demonstrate one or more of the competencies listed for a "satisfactory" grade.