2007

Dear GENP !v Student

Welcome to the Division of Psychiatry. The Division has a commitment to the
education and training of medical students. An understanding of human
behaviour, behavioural manifestations of illness and psychopathology is
considered to be an essential component in the education of all physicians,
regardless of future specialty or practice plans.

Psychiatry is a six week block comprising adult and child psychiatry at
Chris Hani Bara Adult and Child 8 Family Units
Tara Adult and Child 8 Family Units l
Johannesburg Adult and Child 8 Family Unit at TN!
Helen Joseph Hospital Child and Family unit at TN!

The co-ordinators at the different sites are:
Tara Hospital - Dr Fernandes - meet at out-patients department
Chris Hani Bara Hospital - Dr Duncan -meet at Psych department
Johannesburg Hospital - Dr Pillay - meet in ward +87
Helen Joseph Hospital - Dr Bracken meet in ward 2

At the clinical sites students are expected to work closely with the nursing and
medical staff.

OBJECTIVES
LEARNING OBJECTIVES
1) Able to recognize:
Body dysmorphic disorder
Somatisation disorder
Dissociative fugue
Depersonalisation disorder
Dissociative identity disorder
Paraphilia
Gender identity disorder
!ntermittent explosive disorder
Pathological gambling
Trichotillomania

Learning Disorders
Tic Disorders: Chronic Notor or vocal Tic Disorder
Transient Tic Disorder
Tourette's Disorder
Pica




2) Able to cope with clinically:
Hypochondriasis
Factitious Disorder
Ethical issues
Teratogenicity of psychiatric drugs
Premenstrual dysphoric disorder

PDD: Aspergers Disorder
Pervasive Developmental Disorder NOS
Sleep disorders: Nightmare disorder
Sleep terror disorder
Breathing related sleep disorder
Adjustment Disorders
Relationship problems: Parent - Child
Sibling
Relational Problem NOS
Selective Nutism
Attachment Disorder

3) Able to cope with clinically and make the diagnosis personally:
Anorexia Nervosa
Bulimia Nervosa
Eating disorder NOS
Conversion disorder
Nalingering

Elimination disorders: Encopresis
PDD: Autistic Disorder
Conduct: Conduct Disorder
Oppositional Defiant Disorder
Abuse: Physical Abuse
Sexual Abuse
Neglect of Child
Anxiety: Separation Anxiety
School refusal
Schizophrenia
Depression

+) Able to treat:
Psychiatric medication side effects - EPSE
- anticholinergic SE
NNS
Post partum psychosis
Post partum mood disorder

Nental Retardation
Attention Deficit Hyperactivity Disorder
Elimination disorders: Enuresis
SKILLS OBJECTIVES
Refer to "History Taking and Assessment" document on the Orientation
page on the GEMP website

1) Taking a psychiatric history
from patient: biographical details, general, past, habits and social
from a third person

2) Doing a psychiatric assessment
administering Nini Nental State Exam
assessing consciousness, actions,
assessing basic cognition: intelligence, memory, orientation
assessing mood, affect
assessing perception, thought (form and content)
assessing risk: suicide, homicide

3) Naking a diagnosis according to classification systems
+) Providing psychiatric therapy
5) Consulting the multidisciplinary team
6) Recognising an indication for psychiatric hospitalisation
7) Conducting psychoeducation

DELIVERIES FOR MEETING LEARNING AND SKILLS OBJECTIVES

1) LEARNING TOPICS:
LT: +.01. Somatoform disorders
LT: +.02. Dissociative, sexual and impulse control disorders
LT: +.03. Ethical issues: consent
LT: +.0+. Eating Disorders
LT: +.05. Women related mental health problems
LT: +.06. Developmental disorders in children
LT: +.07. Sleep and tic disorders in children
LT: +.08. Adjustment disorders in children
LT: +.09. Relationship problems
LT: +.10. Anxiety disorders in children
LT: +.11. Attachment disorder
LT: +.12. Childhood Elimination disorders
LT: +.13. Behaviour disorders
LT: +.1+. Problems related to Abuse
LT: +.15. ADHD
LT: +.16. Nood disorders in children
LT: +.17. Psychotic disorders in children
LT: +.18. Childhood Epilepsy
LT: +.19. Conversion disorders in children
LT: +.20. Psychotropic medication in children


2) TUTORIALS

TUT: +.01. Eating disorders
TUT: +.02. Personality disorders
TUT: +.03. Delirium 8 dementia
TUT: +.0+. Psychiatric emergencies
TUT: +.05. Nental health care act and forensic psychiatry
TUT: +.06. Psychotherapy
TUT: +.07. OT and Social services
TUT: +.08. Childhood Elimination disorders
TUT: +.09. Psychotic disorders in children
TUT: +.10. Relationship problems in children
TUT: +.11. Adjustment disorders in children
TUT: +.12. Psychotropic medication in children

3) Presentation of psychiatric interviews
4) Presentation of management of patients

ASSESSMENT

Performance in the course will be assessed as follows.

THE `YEAR NARK'
This is a mark (20 marks) for work done during the clinical block and is made
up of:
completenessf attendance and accuracy of the logbook,
participation in tutorials and
aspects of performance in the ward, which are not covered by the logbook
(include areas such as `comportment' and `attitude to staff)

The year mark contributes to the final mark.

THE `END-OF-BLOCK' EXAN!NAT!ON NARK

Comprises:
a written examination of: (which will take place on the last
Wednesday morning at the end of each 6-week rotation at Nedical
School)
NCQs - `A' and `X' types (20 marks) and
Nodified essay and short answer questions (20 marks)

A clinical examination: (which will take place on the last Thursday
morning (10H00) at the end of each 6-week rotation at Tara
Hospital)
presentation of a psychiatric interview (30 marks) and
structured oral examination (10 marks).
Passing and failing the block

A student fails a block if:
Herf his year mark is less than 50. !n such a case sfhe is not admitted
to the final examination.
Herf his clinical examination mark is less than 60.
Herf his final combined (year mark and end of block examination) mark is
less than 60.


We trust that you will find the experience beneficial and educational, not only
for exam purposes, but also to equip you for ethical and good clinical practice
as doctors. Nental illness will be one of the top three causes of disability in
the coming century and presents commonly to primary care health workers.
You should be comfortable with diagnosing and managing these conditions
when you finish this block.

Thank you.