Understanding the Role of Psychiatric Principles in Patient Care: An Important Goal of the Medical Student Clerkship in Psychiatry

MEDiCAL STUDEnT CLERKSHip in pSYCHiATRY The significance of the psychiatry clerkship in medical student education is broadly and internationally recognized (1). In the United States, all 126 allopathic medical schools oblige their students to complete a clinical clerkship in psychiatry (2). In medical schools in the United States, the length of this clerkship is 4–6 weeks (3–5). According to the " A Position Statement on the Length of the Psychiatry Clerkship " published in 2006 by the Association of Directors of Medical Student Education in Psychiatry, " the psychiatry clerkship must be at least 6 weeks in length or longer " (6). In some non-U.S. Medical Schools, the duration of the psychiatry clerkship is 8–10 weeks (7, 8). The medical student psychiatry clerkship has taken an increased importance as the clinical practice of medicine evolves. Clinical training in psychiatry is a necessary part of a general medical education (9). Medical educators suggest that " any physician … must be able to diagnose, treat, manage, and refer patients with psychiatric disorders " (10). However, most physicians receive little training in interacting with patients with major mental illness and can feel uncomfortable or ineffective communicating with them, even about physical complaints (11–13). Students should understand that the knowledge of psychiatric principles is important for non-psychiatric physicians. Studies have demonstrated that about 20–40% of patients in primary care settings have a diagnosable psychiatric illness (14–18). The annual prevalence of all psychiatric disorders , including substance use disorder, is about 30% in the United States (19). The lifetime prevalence of any psychiatric disorder in the United States is >45% (20). Despite this, there is underrecognition of psychiatric conditions in the primary care setting (17, 21, 22). To understand psychiatric principles in patient care, students should obtain a foundation of knowledge concerning the psychological and humanistic aspects of the practice of medicine based on the study of the behavioral sciences and clinical psychiatry; learn interpersonal skills related to the management of patients with medical and/or psychiatric diseases; and follow attitudes and values that enhance the professional roles of physicians (23, 24). Suicide and intentional self-harm are major health-care issues. A research report suggests that patients hospitalized in a general hospital have an eight times higher risk of committing suicide compared to the general population (25). Many physicians who work with medical or surgical patients do not have adequate training in suicide assessment techniques and treatment …