A six-week, six-credit-hour required clerkship in the third year which consists of a three-week assignment to an inpatient psychiatric unit and a three-week assignment in an outpatient/sub-specialty psychiatric setting. The overall goal of the clerkship is to provide a “hands-on” approach to learning psychiatry applicable to the general practice of medicine. While building on the first- and second-year knowledge of psychiatric/development concepts, the rotation emphasizes the ability to perform the various tasks necessary for evaluation, referral and treatment of psychiatric problems. Skills and knowledge in psychopharmacology, differential diagnosis, treatment planning, and the doctor/patient relationship are developed. A variety of clinical rotation sites is available. Required clerkship components include attendance at an Alcoholics Anonymous meeting and a faculty-reviewed videotaped interview. Primary methods of instruction include lecture, case-based discussion/presentation with individual tutors, clinical preceptorship, conferences, small-group discussion, and teaching rounds. Modes of assessment include the Psychiatry NBME subject examination, clinical evaluations, and an Objective Structured Clinical Examination (OSCE). Demonstration of mastery of a prescribed set of clinical skills, included on the Clinical Skills Attainment Document, is required for successful completion of this clerkship. Note: Restricted to medical students.

A four-week, four-credit hour required clerkship in the fourth year. The AI emphasizes basic generalist competencies, is predominantly an inpatient experience, and includes night call or night call equivalent. Acting interns are essential members of the ward teams, although students’ patient loads can be adjusted according to their aptitude. Some of the selectives also provide a minor amount of ambulatory clinical learning. The student has primary and direct responsibility for the continuing care of patients in the community or in one of the University of South Carolina School of Medicine programs at Palmetto Health Richland and the Dorn Veterans Affairs Medical Center in Columbia, the McLeod Regional Medical Center and the Carolina Hospital System in Florence, or the Grand Strand Regional Medical Center in Myrtle Beach. Alternatively, a student may elect to complete the AI as an extramural rotation but must have prior approval for this rotation from the USCSM AI director. The primary mode of instruction is clinical preceptorship. Other educational material may be presented via attending rounds, didactic lectures, subspecialty lectures, weekly grand rounds, resident case presentations, rounds with residents, clinical pathologic conferences, etc., and is dependent upon the specific rotation. Assessment will focus on core clinical skills, including, but not limited to, history and physical examinations, clinical decision making, case presentation, communication with patients, test selection and interpretation, and therapeutic decision making. Note: Restricted to medical students.

Students will acquire basic knowledge in child development and childhood psychopathology. Students will be exposed to clinical interviewing, diagnosis, and short-term treatment interventions in a variety of child and adolescent patients. This elective provides supervised clinical educational experiences in child and adolescent psychiatry with the focus on an out-patient setting. The student will be involved in diagnostic evaluations and for treatment of outpatients. Learning activities may include student participation in the following areas: Child and Adolescent Intake/Outpatient Clinic, Medication Management Clinic, DJJ, Substance Abuse, Peds Consultation Liaison, and didactics. Clinical experiences will be individualized based on the interests of each student when possible. Case conferences, didactic teaching and individual study will be used to supplement the experience.

William S. Hall Psychiatric Institute (WSHPI) is a treatment facility which provides acute treatment services for children and adolescents and also a program for adolescents with substance abuse disorders. WSHPI is licensed by South Carolina Department of Environmental Control (DHEC), accredited by The Joint Commission (TJC), and certified by Centers for Medicare/Medicaid Services (CMS). Substance abuse treatment uses a therapeutic community approach which stresses individual responsibility and the effect on the community (unit). Psycho-education, relapse prevention, and skills development are an important part of treatment. The program is designed to average 45-90 days, though can be longer in duration, and addresses psychiatric and behavioral problems. The Child and Adolescent Inpatient Addictions unit includes 18 beds for adolescent boys and girls, ages 13-18, with dual diagnosis. Students at WSHPI will evaluate and treat patients with a board certified child and adolescent psychiatrist. Students will gain experience in the diagnosis and management of substance use disorders. They will gain experience with psychiatric interviewing and with taking a thorough substance use history. Students will attend treatment teams, assist with admissions, follow patients, and complete progress notes.

This elective provides a supervised clinical experience in the evaluation and treatment of psychiatric patients in the emergency department at Prisma Health Richland. -The primary emphasis will be upon teaching via supervised psychiatric interviews and discussion of treatment options. -The student will acquire basic knowledge in psychopathology and psychopharmacology as it pertains to patients seen in the emergency room setting. -The student will participate in clinical interviewing, diagnosis, and short-term treatment of psychiatric patients presenting in the emergency department. -The student will be actively involved in the acute and short-term care of patients with a range of psychiatric illnesses from psychotic disorders to substance use disorders. -The student will work with the integrated multidisciplinary team to become efficient in systems based practice. -Individualized didactic teaching and independently study will be pursued to supplement the experience; this includes Grand Rounds and Chairman’s Rounds.

This elective will build on knowledge and skills gained in the core psychiatry clerkship in the third year. Students will become part of the consult-liaison team and will be responsible for assisting in psychiatric evaluations of medical and surgical patients throughout Prisma Health Richland. Students will round daily with the consult-liaison team and be responsible for the evaluation and follow-up of new consults. Particularly useful for students entering primary care fields, this elective allows the student the opportunity to assess and provide treatment recommendations for the psychiatric disorders most commonly found in hospitalized medical and surgical patients. By the end of the elective the student should: Be comfortable in performing a focused psychiatric interview on hospitalized medical and surgical patients. Be able to recognize common psychiatric complications and disorders in medical and surgical patients. Be able to formulate treatment recommendations and communicate them effectively to the requesting physician.

Earle E. Morris Jr. Alcohol and Drug Addiction Treatment Center (Morris Village) Morris Village is a 140 residential addiction treatment facility in SCDMH. Students at Morris Village will evaluate and treat patients with a board certified psychiatrist. Goals and Objectives: Students will gain experience in the diagnosis and management of substance use disorders, and in the diagnosis and treatment of co-morbid psychiatric disorders. Students will see consults on primary addiction units and specialty dual diagnosis units. They will gain experience with psychiatric interviewing, and with taking a thorough substance use history. There will also be a focus on the role of the non-addiction specialist physician in the recognition (through history and specific instruments like CAGE) to appropriately manage patients with substance use issues in a primary care setting. Students will also gain exposure to clinical research methods and procedures in the addiction setting. Students will become familiar with utilization of state databanks for refinement of treatment outcome measures.

The general goal of this elective is to provide supervised clinical education experiences in forensic psychiatry evaluations. The student will acquire basic knowledge in forensic psychiatry and how this knowledge is used for developing opinions in criminal court cases. This will include familiarity with psychiatry and the legal system, the concept of competency to stand trial and criminal responsibility, the concept of capacity to conform behavior, the diagnoses frequently evaluated in the forensic setting, and the various tests for criminal responsibility, including the test used in South Carolina. The student will be involved in outpatient forensic evaluations with the course director and/or forensic psychiatry fellows for competency to stand trial and criminal responsibility along with accompanying the course director when testimony is provided in court. The student may also accompany the psychiatrist to a civil forensic clinic one-half day a week and to a psychiatry clinic at the South Carolina Department of Corrections where treatment is provided to inmates with severe and persistent mental illness. Reading assignments with tutorial discussions will supplement clinical experience. The primary emphasis will be upon teaching via supervised psychiatric interviews and observation. Case conferences, individualized didactic teaching, and independent study will be used if needed to supplement the experience.

Inpatient setting is a general adult unit serving patients with a variety of mental illness and presentations. Rotation will allow students to improve interviewing skills and history gathering, learn management of acutely ill patients and acute exacerbations of mental illness while allowing students to follow patients closely over the course of their acute stabilization. Students will learn the role of medication management, therapies, and family support system. Additional education will be provided through patient case discussions and reading material.

Geriatric Psychiatry is a one or four-week elective that can be tailored to the interest of the student. Arrangements can be made to spend time at Senior Primary Care (Geriatric Psychiatry out-patient experience) or the Prisma Health Baptist Geriatric Psychiatry service. Supervision will be built in on all components and learning objectives will focus on assessment, utilization of multiple services for the elderly and psychotropic medication management in the elderly. Additional Objectives include: Multidisciplinary assessment of the elderly patient, including medical, social and family history Assessment of cognitive function using the screening tools such as MMSE, SLUMS, MoCA, and neuropsychological testing. Use of psychotropic medications and evaluation of poly-pharmacy in the elderly. Evaluation and management of older patients with Alzheimer's disease and other causes of Dementia, affective disorders and late life psychoses. Evaluation of the elderly patient's family and the determination of their roles in the treatment of the older patient.

The telepsychiatry/telemental health elective offers medical students an opportunity to gain clinical exposure to video-conferencing technology as a means of health care delivery. Students will work with attendings who perform telepsychiatry evaluations spanning adolescent, adult, and geriatric age ranges. Students will become familiar with telepsychiatry consultation and mental healthcare delivery to clinical settings including primary care (ICARED), forensics/ Department of Juvenile Justice (DJJ), state mental health center and geriatric PACE (Program for All Inclusive Care of the Elderly) sites. This elective will include assigned readings on the scope and effectiveness of telepsychiatry applications from the extant literature.