MCG Consult/Liaison

[Betsy]

This was posted by agucwa from the Class of 2006 Forum.

Hours:
3 weeks in the C/L office from 9:00 - 5:00, but depends on resident. Sometimes they will call you when they need you othertimes they will want you there at nine. Busiest times are before lunch when patients are first admitted and you are covering the ER. Lots of depression.

3 weeks in ER from 1:00 - 9:00. You will see a lot of suicide attempts and detox. Get ready!

Call:
3-4 nights per six weeks, random nights. I think they give the C/L team more call because they do less.

Attendings:
My attendings were Dr. Albritton and Dr. Shevitz, but you have very little contact with them. We probably had rounds 1-2 x week for a total of 30 minutes. You will not have contact with them when you are working in the ER. They write your evaluation, so heads up.

[Betsy]

Here is my personal experience with Consult and Liaison.

Consult/Liaison is a great rotation with very interesting patients. However, you have to work a lot more than your MCG colleagues. You get to see almost every diagnosis in psychiatry (good for when the shelf comes around). Unlike the floors, these patients are usually untreated, so you get to see a lot of pathology.

Basically on C/L, there are 3 students for the 6 week rotation. You spend 4 weeks on consult with one other student, and the other 2 weeks by yourself doing ER call.

Consult: Day starts at 8:30am, ends around 4-5pm. I did stay until 6:30 a couple times. Get ready to be eating lunch, when the students on the Adult Ward (3 south) are going home for the day. On the consult service, you get psych consults from the hospital and clinics all day. Also, you get the ER consults from 8:30-11:30am. Its really hit or miss, some days are TOTALLY crazy, and you barely have time to eat lunch, and other days you sit in the consult room staring at the walls all day. Bring stuff to study! On the floors, its interesting because you get to see what other physicians believe psychiatry is. Its frustrating because there is a lot of bogus consults (Ex: we actually got consulted to evaluate if a mother can care for a newborn….ummmm…can we say social work?). Lots of depression, bipolar, anxiety disorders, and suicide attempts. Fair share of schizophrenia, dementia, delirium, and substance abuse.

ER Call: The other 2 weeks you will be taking ER call from 11:30am – 7:30pm. And yes, you do get to take call from home. Most days I wouldn’t start until 4-5 and work until 7:30. But there were a few days when I worked then entire time. And yes, even a couple where I didn’t get paged in at all. ;D It sounds sweet, but its hard to do anything because you have to be ready to leave on the pager. ER call totally depends on your resident. I worked with 2 residents, and one paged me every day for even one patient, and the other paged me in only during high patient loads. In the ER, you take call from the adult and peds ER, so you do get to see a good number of childhood disorders like oppositional defiant, conduct disorder, ADHD, etc. Adult is mostly untreated schizophrenia, detox, and suicidal ideation.

Psych H&P:[/u] The psych H&Ps are on pre-printed forms, so you don’t have to remember anything, its right there. Make sure and write good HPIs because the residents love that. A lot of the time, they have to recopy your H&P (since if the patient is admitted, the H&P must be by the resident). So the less work they have to do, the more they like you.

**HEADS UP** During the entire rotation, I saw an attending on 3 occasions. Basically the C/L and ER psych service is run by residents. You are working with the 2nd year pysch residents, and the 3 that I worked with (Bahmiller, Carr, and Ellis) are all really cool. I don’t know about the others. The attendings write one of your letters, so make sure to impress when you do get to see one! Dr. Shevitz is the attendings for consult on Thursday and Fridays. He likes to have the students do an informal presentation about a topic on Friday, so there is your chance to shine.

Psych call in general: You are on call if you are in the Augusta area (VA, MCG, GA Regional) about 4 times during the rotation, with one day being a weekend. It totally depends on your resident, as to if you get called in. I was on call 4 times, and got called in once. That one time I was called in from 5:30pm to midnight. I know people who never got called in, and I know others that had to stay until 3:30am. Totally up to the resident. So, if you know a resident that pages students in *cough, Dr. Earwood, cough*, you may want to try and switch it up with another student.

Bottom line: Long hours for consult, sweet for the 2 weeks in the ER. Bring a book to study because the patient load is unpredictable. Hope for good residents, and impress the attendings when you do see them. Write a good HPI for the resident. Don’t get upset when you see your classmates leave at noon, and you have another 5 hours. Hope you don’t go psychotic, because I think I almost did. And have fun because this is only of the few rotations where you have time do actually do things for yourself! And did I mention the first aid book is only 150 pages!

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