For my first rotation, I had the opportunity to be in Psychiatry at Queens Hospital Center. At first, I was nervous because the patients are able to freely walk around and a few of the patients tend to get violent; however, the staff there did a great job of making the students feel safe. Eventually, I got used to the patients in the psychiatric unit, and I learned that there is an art to speaking with the patients so that you connect with them as much as you can to conduct an appropriate interview. For instance, you never want to dismiss the patient. As a provider in psychiatry, the most important tool you have is listening and observing the patient to be able to assess them. Most of the patients tend to lie about their situation, especially drug users, but it was important to take their story into account while also confirming their story by obtaining collateral information from friends or family members. Obtaining collateral information was new to me, but it is an essential part of the H&P for psychiatric patients. 

Some of the other patients that I got to speak with the most were those who were suffering from depression and suicidal ideation. It was with these patients that I learned how to execute a depression screening using the PHQ-9 which is a standard depression screening tool. I also learned that it is required to fill out a safety plan with each patient that had complaints of suicidal thoughts. A safety plan required me to ask the patient about their triggers, coping mechanisms, support system, hopes for the future, and what the patient plans to do to help themselves when they have suicidal thoughts in the future.

One of the most memorable patients I interviewed was actually a pediatric patient who presented for depression and anxiety. Interviewing pediatric patients was a little challenging for me at first because you really have to get them to open up to you without sounding like you’re following a script. Eventually I was able to just casually talk to patients by asking about activities they found interesting or about their favorite music, while also eliciting important information. What made this particular patient difficult for me was that during the interview, the patient disclosed that she self-harms by using scissors and knives. It made me very sad and emotional, but I kept my composure. In the end, I was able to convince the patient into trying therapy to talk about her depression and anxiety. 

My time in psychiatry was a very eye-opening experience and I really learned a lot, especially about myself. I learned that I really do better with hands on learning. We took the psychiatry course almost a year ago, but the information didn’t really stick since we don’t really look at those types of cases throughout the didactic year. However, being in psychiatry really helped solidify what we had already learned. I also found that I was very knowledgeable about the medications used in the field. While I garnered a lot of knowledge and experience, I definitely think there’s a lot more to learn and ways to improve as a clinician. My plan is to apply my interviewing skills to patients I see in future rotations and to compare and contrast my H&Ps from my first rotation to my new ones. My hope is that I can become more comfortable interviewing my patients, so that I can conduct an appropriate and thorough interview and improve my H&Ps.