Outcomes

MD PSYCHIATRY OUTCOMES (4-Year Program)

Source: MD Psychiatry PROSPECTUS.pdf and MD Psychiatry.pdf (UHS)

1. Knowledge and Scientific Inquiry Outcomes

• Access and apply relevant knowledge to clinical practice.
• Maintain currency of knowledge.
• Apply scientific knowledge in practice appropriate to patient need and context.
• Critically evaluate new technology.
• Recognize the clinical features, accurately diagnose, and manage psychiatric problems.
• Formulate a well-reasoned provisional diagnosis and management plan based on thorough history and examination.
• Formulate a differential diagnosis based on investigative findings.
• Recognize disorders of the nervous system and differentiate those amenable to psychiatric treatment.
• Accurately identify the benefits, risks, and mechanisms of action of current and evolving treatment modalities.
• Manage complexity and uncertainty.

2. Clinical and Procedural Skills Outcomes

• Safely and effectively perform appropriate clinical skills and procedures.
• Consistently demonstrate sound clinical skills.
• Demonstrate procedural knowledge and technical skill at a level appropriate to training.
• Demonstrate manual dexterity required to carry out procedures.
• Adapt skills in the context of each patient and procedure.
• Maintain and acquire new skills.
• Approach and carry out procedures with due attention to safety of patient, self, and others.
• Critically analyze own clinical performance for continuous improvement.
• Organize diagnostic testing, imaging, and consultation as needed.
• Select medically appropriate investigative tools and monitoring techniques in a cost-effective and useful manner.
• Appraise and interpret appropriate diagnostic imaging and investigations according to patients’ needs.
• Independently perform procedures including: Venepuncture, Cannula insertion, Arterial blood gas sampling, Lumbar Puncture, Pleural tap, Ascitic tap, Central venous cannulation, Cardiopulmonary resuscitation, Nasogastric tube placement, ECG.

3. Patient Management and Therapeutic Outcomes

• Manage patients in ways that demonstrate sensitivity to their physical, social, cultural, and psychological needs.
• Effectively recognize and manage complications.
• Identify and assess risk.
• Assess and implement a risk management plan.
• Critically evaluate and integrate new technologies and techniques.
• Develop a comprehensive treatment plan including acute stabilization, medication management, psychosocial interventions, group and individual therapy, psycho-education, and discharge planning.
• Use pharmacological regimens, including concurrent use of medications and psychotherapy.
• Understand the indications and uses of physical treatments such as ECT and monitor side-effects.
• Evaluate and treat psychological and interpersonal problems, including providing psychotherapy and counseling.
• Apply supportive, psychodynamic, cognitive-behavioral, family, couples, and group psychotherapies.

4. Psychotherapy-Specific Outcomes

• Supportive Therapy: Establish and maintain a therapeutic alliance; establish treatment goals; provide reassurance; provide education and advice about psychiatric conditions.
• Cognitive Behavioral Therapy (CBT): Elicit data and conceptualize patients using the cognitive conceptualization framework; educate patients about the cognitive model; utilize activity scheduling, exposure and response prevention, relaxation training; employ dysfunctional thought records.
• Psychodynamic Psychotherapy: Understand concepts of unconscious, defense, resistance, transference, and countertransference; evaluate patient capacity for psychodynamic therapy; utilize clarification, confrontation, and interpretation; write a psychodynamic formulation.

5. Psychopharmacology Outcomes

• Demonstrate knowledge of pharmacokinetics, pharmacodynamics, and drug interactions.
• Demonstrate knowledge of specific pharmacologic agents: Antidepressants (Tricyclics, MAOIs, SSRIs, SNRIs, NDRIs), Mood stabilizers (Lithium, Anticonvulsants), Antianxiety agents, Antipsychotics (Typical and Atypical), Psychostimulants, Hypnotics and sedatives.
• Apply pharmacotherapy in special situations: Renal disease, Pregnancy, Breast feeding.

6. Research and Scholarly Outcomes

• Complete an academic outcomes-based research project during training.
• Compile research in the form of a thesis submitted for evaluation.
• Acquire skills to lead a multidisciplinary team.
• Participate in journal clubs to teach critical appraisal of literature.
• Demonstrate acquisition and refinement of research skills including: evaluation and clinical care of research subjects, development of research protocols, performance of clinical and/or laboratory research, preparation and presentation of study results.
• Demonstrate knowledge of research methodology: Health Economics in Clinical Research, Genetic Analysis of Human Diseases, Questionnaire Design and Psychometrics, Responsible Conduct of Research, Genome Technologies.

7. Leadership, Management, and Teamwork Outcomes

• Act as a consultant to primary care physicians.
• Be an effective leader of a multidisciplinary mental health team (psychologists, social workers, psychiatric nursing professionals).
• Participate in psychiatric administration and leadership of interdisciplinary teams.
• Gain supervised experience in quality assurance and performance improvement.
• Provide psychiatric care to patients receiving treatment from non-medical therapists and coordinate such treatment.
• Effective use of resources to balance patient care and system resources.
• Identify and differentiate between system resources and patient needs.
• Prioritize needs and demands dealing with limited system resources.
• Manage and lead clinical teams.
• Maintain clinically relevant and accurate contemporaneous records.

8. Forensic and Legal Outcomes

• Deal with the legal aspects of psychiatric illness.
• Understand the relationship between crime and mental disorders.
• Assess fitness to plead, criminal responsibility, diminished responsibility.
• Prepare court evidence and reports.
• Understand administrative and legal aspects of compulsory detention and treatment due to mental disorder.
• Assess dangerousness and testamentary capacity.
• Understand civil law as it relates to marriage, divorce, custody of children, and management of property.

9. Community and Public Health Outcomes

• Be informed of mental health programs, policies, mental health care infrastructure, and issues in community care of mentally ill in the country.
• Promote health maintenance of patients.
• Advocate for appropriate health resource allocation.
• Promote health maintenance of colleagues and self.
• Work in community-based settings (community mental health centers, public hospitals).
• Consult with and use community resources and services in planning patient care.
• Consult and work collaboratively with case managers, crisis teams, and other mental health professionals.

10. Specialty Rotation-Specific Outcomes

• Neurology: Perform a thorough neurological examination; diagnose and manage common neurological disorders (Bell’s palsy, cerebral embolism, Parkinson’s disease, epilepsy); perform lumbar puncture; interpret EEG, CT, MRI.
• Inpatient Psychiatry: Assess for dangerousness; use precautions; formulate treatment plans; document comprehensive discharge summaries.
• Outpatient Psychiatry: Comprehensive history taking; psychiatric formulation; ECT administration; identify psychiatric emergencies.
• Child and Adolescent Psychiatry: Understand normative child development; diagnose and manage ADHD, Conduct Disorder, Autism Spectrum Disorders, Learning Disabilities; use play therapy and behavior modification techniques.
• Geriatric Psychiatry: Distinguish between dementia and delirium; evaluate decisional capacity; use age-appropriate dosing strategies; manage behavioral complications of dementia.
• Addiction Psychiatry: Conduct thorough interviews with substance abusing patients; manage detoxification and overdose; use motivational interviewing; apply CAGE, AUDIT, DAST screening tools.
• Consultation/Liaison Psychiatry: Adapt interview style for medically ill patients; assess cognitive capacity using MMSE; evaluate for competency; address medico-legal risks.
• Emergency Psychiatry: Crisis evaluation and management; triage of psychiatric patients; assess suicide and homicide risk.
• Forensic Psychiatry: Evaluate forensic issues (competency to stand trial, criminal responsibility); write forensic reports.
• Community Psychiatry: Work with persistently and chronically-ill patients in the public sector; use community resources.

11. Educational and Teaching Outcomes

• Assume the role of a postgraduate or undergraduate teacher.
• Prepare and present seminars and case conferences.
• Distribute summaries and bibliographies for presentations.
• Participate in journal clubs and core curriculum meetings.
• Conduct clinical case conferences monthly.

12. Professionalism and Ethical Outcomes

• Employ a critically reflective approach to psychiatry.
• Adhere to current regulations concerning workplace harassment.
• Regularly carry out self and peer-reviewed audit.
• Acknowledge and have insight into own limitations.
• Acknowledge and learn from mistakes.
• Recognize and appropriately respond to family violence (child, partner, elder physical, emotional, and sexual abuse and neglect).
• Demonstrate understanding of core ethical principles: confidentiality, consent, restraint, responsibility to others.
• Apply ethical reasoning and decision-making frameworks.
• Demonstrate understanding of research ethics.

13. Continuous Professional Development Outcomes

• Foster the habit and principles of self-education and reflection.
• Constantly update and refresh knowledge and skills.
• Demonstrate commitment to continuing education.
• Use self-assessment and peer assessment for growth.
• Provide and receive constructive feedback.
• Develop a personal development plan and comply with it.

INTERMEDIATE MODULE (IMM) PSYCHIATRY OUTCOMES (End of Year 2)

Source: Inter Mod Psy 2012 + WPBA

1. Knowledge Outcomes

• Distinguish Normality from Abnormality in the light of the concept of mental health.
• Discuss anthropological, social, and psychological determinants of normal development.
• Relate the interplay of biological factors with psychosocial factors in the genesis of mental illness.
• Discuss clinical features in phenomenological terms.
• Classify clinical presentations into current ICD and DSM categories.
• Use neurobiological, psychological, and social theories in clinical assessment and management.
• Identify common neurological and medical disorders relevant to psychiatric practice.
• Apply evidence-based guidelines to manage clinical situations in emergency, outdoor, and indoor settings.

2. Clinical Skills Outcomes

• Write comprehensive history and mental state examination.
• Formulate a diagnosis for professional communication.
• Write management plans, discharge summaries, and referral notes.
• Perform accurate physical and mental state examination in complex clinical problems.
• Prioritize clinical problems for the start of interventions.
• Independently undertake counseling and informational care sessions.
• Independently conduct supportive psychotherapy, group therapy, and behavior therapy.
• Independently use electroconvulsive therapy (ECT) and other evidence-based physical methods of treatment.

3. Research Skills Outcomes

• Undertake literature search and collect evidence base and standard guidelines.
• Develop a synopsis or a research proposal using CPSP guidelines.
• Interpret, summarize, and use research articles in clinical practice.

4. Administrative and Managerial Outcomes

• Acquire administrative and managerial skills to assist in running a Psychiatry unit/institution.
• Organize educational, training, and research activities.

5. Professionalism and Attitudinal Outcomes

• Establish an ethical and therapeutic relationship with all patients.
• Demonstrate commitment to the bio-psycho-social model in assessment and management.
• Demonstrate sensitivity, empathy, and understanding while performing examinations.
• Show consideration of the interests of the patient and the community paramount and above personal interest.
• Exhibit integrity, compassion, honor, altruism, excellence, and humanism.
• Demonstrate respect for time, punctuality, conscientiousness, and professional attire.
• Demonstrate integrity in reporting patients’ findings.
• Recognize stress in self and others and support colleagues.