Combining selegeline patch with other psychiatric medications
I've read differing information on this. What are thoughts on using selegeline patch with buproprion and/or stimulants? My understanding was there should not be an issue as it wouldn't not lead to serotonin syndrome nor would it cause hypertensive crisis. Any one able to weigh in? (Source: Student Doctor Network)
Source: Student Doctor Network - September 16, 2023 Category: Universities & Medical Training Authors: Psychresy Tags: Psychiatry Source Type: forums
Managing the seriously mentally ill while inpatient
A common issue I run into is I will get a patient who is just out of their minds psychotic with a history of low to moderate baseline. Perhaps they've been trialed on a few antipsychotics in the past with middling success. These are not patients who will have the support or clear up enough to become dependable for regular labs so clozapine is out.
I'll start them on risperdal for example, maybe they'll get 20% better. Of course I am faced with the ever pressing silent push to move the meat...
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Source: Student Doctor Network - September 16, 2023 Category: Universities & Medical Training Authors: BiscoDisco Tags: Psychiatry Source Type: forums
Do you sign off on medical LOA or accommodation forms?
I'm getting a steady stream of patients recently from a specific employer. Many of these patients are asking me to sign paperwork for psychiatric LOA or accommodations forms. I'm wondering what the general consensus is from other outpatient psychiatrists. Do you guys sign these forms? During residency, the rule of thumb we had was that if your symptoms are severe enough to need a leave of absence from work or school, they're severe enough that you need to be in an IOP or PHP at least. And...
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Source: Student Doctor Network - September 16, 2023 Category: Universities & Medical Training Authors: Atreides Tags: Psychiatry Source Type: forums
Therapy training during residency.
Do most residency programs today offer basic training in CBT, etc or for those of you who practice therapy did you have to secure training on the side? Did you have to pay for the training/supervision? (Source: Student Doctor Network)
Source: Student Doctor Network - September 16, 2023 Category: Universities & Medical Training Authors: psychma Tags: Psychiatry Source Type: forums
What do you recommend for an MS1 interested in psychiatry?
My son currently has plans to go into psychiatry. He thinks he would like to do inpatient work. He’s early in the process and things could change. I’ve told him to keep an open mind. This is his dream though. Helicopter mom here, what should he be doing to position himself to get into a good residency? He has an sdn account but quit using it when everyone told him he wouldn’t get into medical school. He did. (Source: Student Doctor Network)
Source: Student Doctor Network - September 16, 2023 Category: Universities & Medical Training Authors: psychma Tags: Psychiatry Source Type: forums
The challenge of managing chronically depressed patients
I have a few patients, usually females in their 40s or 50s, whom I inherited from past psychiatrists with a history of persistant and VERY impactful depressive symptoms (HAMD usually >30), with chronic suicidal ideation and almost no functionality in the real world.
The way I'm trying to approach these cases is:
1) Review the diagnosis, looking for secondary causes that may have been missed, and other psychiatric diagnosis such as personality disorders, OCD, PTSD, etc...no luck thus far...
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Source: Student Doctor Network - September 15, 2023 Category: Universities & Medical Training Authors: thelastpsych Tags: Psychiatry Source Type: forums
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case closed (Source: Student Doctor Network)
Source: Student Doctor Network - September 15, 2023 Category: Universities & Medical Training Authors: psychma Tags: Psychiatry Source Type: forums
LOR's needed for triple board program
I'm curious for the triple board psych/childpsych/peds program what kind of letters you would need to send to a program type like this. A letter from a psychiatrist, child psychiatrist and pediatrician? Would the letter writer have to write about your interest in the triple board or just how you'd be a good fit to their respective field? (Source: Student Doctor Network)
Source: Student Doctor Network - September 15, 2023 Category: Universities & Medical Training Authors: DO_or_Die Tags: Psychiatry Source Type: forums
An update to the dopamine hypothesis...
So this article from Wired came across my newsfeed a couple of days ago and caught my attention. Seemed like kind of a "look at this research" pop-psych type of title and article at first, but reading through it there's more depth than I expected. It's basically arguing that dysregulation of D1 receptors and not D2 receptors is primarily responsible for psychotic symptoms and that our drugs that are effective for psychosis primarily work on D1, whether directly or indirectly. I haven't read...
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Source: Student Doctor Network - September 15, 2023 Category: Universities & Medical Training Authors: Stagg737 Tags: Psychiatry Source Type: forums
Managing a difficult psych attending
I’ve gotten helpful responses before, so I thought I’d try again.
Client is mid-fourties’ and female. She was diagnosed 15 years ago by her psychiatrist as having bipolar 1, ocd, and ptsd. This client has taken medication for bipolar for 15 years with significant weight gain and sexual side effects as well as hair loss. Client was recently discharged for depression with suicidal ideation and intent after staying a week on the inpatient unit. This is when I began seeing her.
At the client’s...
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Source: Student Doctor Network - September 14, 2023 Category: Universities & Medical Training Authors: psychma Tags: Psychiatry Source Type: forums
What is a “reasonable” psychiatric expert hourly consultant fee (not for court testimony)?
Hi, everyone! I recently received an inquiry from a federal agency to potentially assist an investigation that would utilize my psychiatry subspecialty training and expertise (I am going to keep some of the details vague). There would be no court appearance or litigation. Rather, I would assist in interviewing patients (involves traveling to different states), developing protocol to properly assess the issue, reviewing records, and writing up an internal report. This work could involve...
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Source: Student Doctor Network - September 14, 2023 Category: Universities & Medical Training Authors: geripsyched Tags: Psychiatry Source Type: forums
Multi-part question: what do psych attendings do all day?
So I've read on here about how you can maximize your income by working at a bunch of places and I never understood it until I got into my psych rotation.
So basically, my attendings are there for 3 hours in the morning and then leave. Sometimes they have ECT before that. Sometimes they have to go to court afterwards.
So for those of you incomemaxxing, do you just round at a bunch of hospitals, spend 2-4 hours there each? Or what do you do? (Source: Student Doctor Network)
Source: Student Doctor Network - September 13, 2023 Category: Universities & Medical Training Authors: executivewaffle Tags: Psychiatry Source Type: forums
Expert witness conflict check-large health system
Many on the forum know that in forensic cases it's imperative to complete a conflict check before agreeing to take a case. Basically, it's no good to get retained in a case where you know the parties involved or have some other potential bias. I was contact about a malpractice case recently by plaintiff attorney. I do not know the defendant physicians, but it involves a major health system that spans are large geographic region. My residency hospital was actually purchased by this health...
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Source: Student Doctor Network - September 12, 2023 Category: Universities & Medical Training Authors: nexus73 Tags: Psychiatry Source Type: forums
Re: Valerie Cowie: influential psychiatrist and geneticist
(Source: BMJ Comments)
Source: BMJ Comments - September 12, 2023 Category: General Medicine Source Type: forums
PGY-1 FM Transfer to Psychiatry
Hello all! I am currently a PGY-1 in Family Medicine.
I am an IMG, old grad YOG: 2016, have ALL Step scores, including Step 3 and prior work experience in psychiatry in my home country (not residency) and psych rotations here in USA.
I want to transfer to Psychiatry, as that is the speciality I enjoy the most and I am the most passionate about and see myself being happiest long term in.
I am currently in my psychiatric rotation inpatient at CSU And also outpatient and I TRULY...
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Source: Student Doctor Network - September 12, 2023 Category: Universities & Medical Training Authors: smileybabi06 Tags: Internship, Residency and Fellowship Positions Source Type: forums
