My psychiatry site evaluator was Dr. Saint Martin. I submitted three H&Ps, pharm cards and a journal article with a summary. This was the first site evaluation in a group for me, so it was both different and beneficial to listen to others present on patients and provide insight into cases. During the first evaluation, I presented one H&P on a patient with persecutory delusions. We discussed the importance of social history in psychiatric patients as well as other modes of therapy, other than antipsychotics, that may be beneficial for this patient. Specifically, we discussed psychotherapy for this patient, as it would not remove the delusions, but would rather focus on living a functional life with the delusions still present. In addition, it was helpful to write and explain why I included the differentials that I did in my H&P. This allowed me to go through the criteria for certain disorders and also helped me think about what I believe is the most likely diagnosis for the patient. On my second evaluation, we discussed another one of my H&Ps and my journal article. We discussed the best medications for alcohol-induced seizures as well as the importance of not prescribing benzodiazepines long-term for anxiety. Additionally, we spoke about drug-seeking behavior and the characteristics of borderline personality disorder and how to be careful of these patients as they can easily influence the provider. I enjoyed being able to discuss my cases and explore my differentials with my site evaluator.

During my second group evaluation, I presented a journal article on different psychotherapies available for borderline personality disorder and whether they are effective in reducing symptoms. I wanted to learn more about different treatments and their efficacy for borderline personality disorder after a psychiatrist I was working with suggested a patient with borderline personality disorder enroll in dialectical behavioral therapy. I never heard of this type of therapy prior to the psychiatrist mentioning it, so I was interested in reading about the treatments currently available and their ability to provide some relief to patients with this diagnosis.

The psychiatry site evaluations helped me identify the importance of including all information, especially collateral information, in a psychiatric note. Being able to listen to my colleagues H&Ps further solidified this knowledge and aided in my understanding of these notes, as they are different from standard medical H&Ps. I plan to continue to work on providing an extensive treatment plan, as it is important to convey what should be done for the patient in a detailed and coherent fashion. Additionally, writing why each part of the treatment plan can be beneficial, in that it reminds me what I am looking to rule out or provide relief for.