Psychiatry thread

“Psychiatry and neurology are inextricably linked. Psychiatry is neurology that we just don’t know yet.” -- Dr. Filley

The psychiatry thread started last semester during the CVPR block (cardiovascular, pulmonary, renal) and consisted of three brief lectures spaced throughout the block. Each lecture was then followed by an interview with a psychiatric patient. We split up into groups of eight students, each group led by a couple psychiatrists and/or psychologists who facilitated the interview and learning experience. One of the eight students then conducted the patient interview in front of everyone else.

At our level of training and experience (i.e. none), interviewing a patient by itself is enough to get the adrenaline flowing. But being observed and evaluated by both professors and our fellow classmates makes the experience that much more anxiety-provoking. I conducted an interview last semester with a patient who suffered from anxiety and depression related to a serious cardiovascular illness.

The psychiatry thread has continued into the neuroscience block. Each week, we cover a different condition or disorder. So far, we have interviewed patients with PTSD, autism, Parkinson's disease, chronic pain, bipolar disorder, and schizophrenia. Next week we're interviewing someone who is dealing with a substance use disorder.


I'm having a lot of fun with psychiatry. I have always been interested in the brain - how it works, and also what exactly goes wrong when it's not working so well. Learning about neurologic and psychiatric disorders in the classroom is good and all, but I really value this more clinically-oriented exposure to psychiatry. First, application of knowledge is always rewarding. Second, this psychiatry thread has encouraged me to appreciate on a personal level the impact that these diseases or disorders have on the individual.

I may or may not become a psychiatrist, but I have heard several times that every physician - regardless of specialty - practices psychiatry on some level.

Second year so far: Neuroscience block

So far, the second year of medical school has turned out to be remarkably like the first year: lots of lectures and didactic teaching. That's no surprise and is in fact quite the norm in medical education. We're currently in our neuroscience block, which I'm particularly enjoying. Just like last year when we had laboratory sessions coupled with hematology and microbiology coursework, the neuroscience block has offered some reprieve from the lecture hall with hands-on laboratory sessions to better learn neuroanatomy and synaptic transmission.

The neuroanatomy lab consisted of examining a whole brain, a hemisected brain (cut down the midline), and a brainstem+cerebellum, in order to identify important neuroanatomical structures. I was somewhat taken aback that this 3 hour session was the extent of our wet lab neuroanatomy exposure. Incidentally, a classmate of mine sent out the link to a website that uses magnetic resonance imaging (MRI) to teach neuroanatomy. It's pretty fun to play around with, and you can find it at www.headneckbrainspine.com.

The synaptic transmission lab made use of frog leg muscle fibers (connected to their motor neurons) and different drugs (curare, neostigmine) to demonstrate manipulations of signal transduction at the neuromuscular junction. When the motor neuron is electrically stimulated, you can record electrical responses from the frog muscle fiber - and even make it twitch, if the electrical stimulation is strong enough. Application of curare blocks the neurotransmitter acetylcholine, which is the means of communication between the motor neuron and muscle fiber. Neostigmine has the opposite effect, stimulating synaptic transmission by making acetylcholine more available at the junction between the motor neuron and muscle fiber.

I learn well by doing and by putting information in context, so I found these laboratory sessions fun and particularly helpful.