Thursday Born

The everyday life of a psychiatry resident (who was born on a Thursday).

Archive for December 5th, 2010

So what I’m hearing is…

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Our Practice of Medicine class is so much better this year! The first year version often felt a bit… wishy-washy, but lately it’s felt a lot more relevant and useful.

We learned about Motivational Interviewing on Thursday, and I had a blast. We had a half hour introduction to the concept, and then we split into small groups. Each group had one doctor (we got a psychiatrist; not sure if all the others were too) and one Standardized Patient. What I didn’t realize going into this, was that we were all going to practice on the SP in front of the entire group! So the doctor started the interview, and we rotated in.

Our SP actually was an ex-smoker, and she had built her persona off of her own experience. She was tough! And she did a really great job of making it seem real (which makes sense, because it was real). I was really nervous about my turn, but I did just fine. I was a bit miffed because I was heading in a certain direction, and right as I was about to take the conversation there, the doctor interrupted (he interrupted everyone with tips) and suggested that I do that. So it seemed like I was just doing what he told me, but I swear I’d already thought of it! I struggled a bit once that was done though, and I started to rush her too much. It felt weird doing what felt like a therapy session during a scenario of someone coming in to see a primary care provider for a quick check-up, and I let that influence my pacing. I’ve noticed that I do that in general, when I’m being watched. I feel like I need to be quicker, because people are waiting on me. But it’s okay, and I’m supposed to take my time.

The SP gave us some good advice about what it feels like to be a smoker, and how all smokers have thought about quitting, and how she hated being asked if she had. She also talked about how she didn’t want to try to quit, because what if she fails? So now I know a few key things not to bring up when trying to counsel a patient to stop smoking.

I kind of wish we’d gotten to do other scenarios though. I know counseling smokers is going to be common, but there’s so many other applications to Motivational Interviewing, like counseling people to exercise or eat better, and I feel like people know how to be more PC about smoking, but not so much with other issues. I guess we’ll learn on the job, though.

So yeah, it was fun! And it affirms a bit that I really want to talk to my patients in whatever specialty it is that I end up in. I’m pretty sure the doctor leading my group was the one who really made me think about Psychiatry again when I went to the Psychiatry career talk. I’m not so sure it’s at the top of my list, mostly because I don’t have much experience with the psychiatric population, but I think I’m leaning more and more toward some sort of primary care. Every now and then I half-wish I’d done Clinical Psychology or gone some other route so I could be a therapist, but I still believe I can find what I’m looking for in medicine. I’m feeling a lot better after this experience and after my hospital session. :)

Written by Aba

December 5, 2010 at 1:08 pm

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