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Discipline of Psychiatry
Level 4, Eleanor Harrald Building
Royal Adelaide Hospital
The University of Adelaide
SA 5005

Year 4

Course Co-Ordinators:   Dr Scott Clark and Dr Oliver Schubert

Objectives of the 4th Year Clinical Rotation in Psychiatry

Our aim is to provide you with the opportunity to learn about the principles and clinical practice of psychiatry. By establishing a core knowledge and clinical skills base, our aim is that you will be able to develop your professional attitude so as to use this knowledge and these clinical skills competently and safely at the primary care level.

Attitude and professional behaviour
To understand, as a young clinician, your professional responsibilities to:

  • attend throughout your clinical attachment
  • show that you can be relied on by your patients and colleagues
  • maintain an attitude of respect towards:
    • your patients
    • your colleagues

Clinical skills

To develop the clinical skills that will enable you to:

  • converse with patients
  • listen to patients
  • take a full psychiatric history
  • perform a mental state examination and a relevant physical examination
  • summarise your findings
  • present these findings verbally to your colleagues
  • contribute to clinical discussions about your patients
  • write relevant clinical notes

Clinical knowledge

To develop the clinical knowledge that will enable you to:

  • ask relevant questions while taking a history
  • look for relevant signs while performing a mental state and physical examination
  • integrate theoretical knowledge with the clinical data you have elicited
  • formulate an assessment by answering the following question: 'Why has this patient presented in this manner at this time in the context of his or her life?'
  • develop an appropriately prioritised problem list
  • develop an appropriate management plan by answering the following question: 'What is the best setting in which to treat this patient, so that I can best ensure his or her safety, while giving the best treatment, but at the same time, maintaining the highest level of comfort and dignity, and doing the least harm?'

In order to do the above you will need to:

  • understand the concept of mental health.
  • understand the nature of mental illness.
  • understand how mental illness may arise, by learning about the factors that influence its development such as:
    • genetic factors.
    • developmental factors.
    • environmental factors.
    • socio-cultural factors.
  • understand how these factors influence personality development and the development of psychological defence mechanisms.
  • understand how these factors together with personality development may affect the clinical presentation of the psychiatrically and medically ill patient.
  • understand how mental illness may present so that you can:
    • be aware of medical conditions that may present as psychiatric conditions.
    • be aware of medical conditions that may complicate psychiatric conditions.
    • be familiar with the definitions and clinical manifestations of the common psychiatric illnesses, namely the psychoses, mood disorders, anxiety disorders, eating disorders, somatoform disorders, personality disorders and disorders of cognitive abilities such as delirium and dementia.
  • understand the nature of human relationships and interactions so that you can:
    • establish a safe doctor patient relationship appropriate to that patient.
    • be aware of the emotional response of that patient towards you.
    • be aware of your own emotional response to that patient.
  • be aware of mental health legislation as it applies to South Australia.
  • be familiar with the types of treatments used in psychiatry:
    • psychiatric medications.
    • other somatic therapies.
    • psychotherapies.

This should enable you to:

  • be competent in managing common psychiatric illnesses in the primary care setting.
  • be competent in the safe use of commonly prescribed psychiatric medications.
  • be competent in the safe use of basic counselling skills.
  • be competent in managing psychiatric emergencies in the form of the:
    • suicidal patient.
    • aggressive patient.
    • acutely confused patient.
    • acutely anxious patient.
  • be competent in knowing when and how to use the relevant mental health legislation.
  • be competent in knowing whom you can manage on your own, and when to refer a patient for specialist psychiatric care.