Professor’s Rounds
Medical students (except for the first week of each rotation) and residents on the C/L service and outpatient service take turns (approximately in a 1:1 ratio) presenting a case once per week to a faculty member. The case is to be written up by the presenter and given to the faculty member the day before, along with an article from the literature related to the presented case. As long as the article is scientifically interesting, it can be at some intellectual remove and still be a well-chosen article. A photocopy of the article is also given to the a professor the day before the rounds.
At the rounds, photocopies of the case history and the article are given out to everyone. The medical student or resident presents the case for about 10 minutes, and the scientific topic is discussed by the presenter for about 10 minutes. Nursing and Social Work services present brief summaries of their perspective on this patient, and then the patient is interviewed by the a professor for about 10 minutes.  The patient will almost always be a current consult service patient (generally on the third Wednesday of each month). The faculty member discusses the case with the presenter and the audience, and the attending psychiatrist also discusses the case.
These rounds have been very stimulating exercises for the most part, and have improved the learning experience for the presenters and the audience. Like many other learning opportunities in medicine, what people gain from the rounds is very much a function of what they put into it. Writing up the case and thinking about its scientific relatedness has been very useful to the presenters and to the audience. The challenge to the faculty member has also proved useful to him and to the people at the rounds. The patient routinely benefits from the amount of thought devoted to his or her case and life situation.

Helpful Hints for the Medical Student and Residents
1. professor’s rounds have these goals:
a. Help the student or resident formulate a patient’s case in a succinct and focused manner.

b. Relate the case to one or two pertinent literature articles.

c. Give a demonstration of one interview style.

d. Give a multidisciplinary perspective on the case.

e. Explore different opinions and ideas about a given case.

2. They do not have these goals:
a. Intimidate or frighten the student or resident.

b. Delay lunch.

3. Questions that will routinely come up in the rounds:
a. Why me?  This will be asked by the patient as well as by the presenter.  It is left to the ingenuity of each participant to work out the answer, but the best answer is when patient, presenter, and the faculty see this as a cooperative venture.

b. Diagnostic criteria will routinely be asked for.  If you are presenting, be prepared to discuss the criteria for the diagnosis you favor and for the diagnoses in the differential.

c. The raw clinical observations will also be asked for. 

i. Be ready to describe the components of mental status that you have observed in the presented patient.  If you say the patient is depressed, be prepared to describe the mood in other words, how pervasive it is, whether it is present day and night or has diurnal variation, and to describe the other symptoms of depression.  If you say a patient is in catatonia, you will be asked to describe specific observations describing the statement.

ii. It is important to gather as much pertinent history as possible.  Old records are extremely valuable.

d. Pharmacology questions often come up.  Typical questions have to do with receptors and reuptake sites involved with different antidepressants and antipsychotic medications.  Steve Stahl’s textbook, Essential Psychopharmacology, has more than you need to know.

e. If imaging studies have been done, you will be asked about the anatomical aspects of the case.  Think of it as educating whomever is attending the rounds.

4. Can one fail professor’s rounds?
a. Not if you have prepared a written summary and a reasonable article.  This has to be done before the morning of the rounds.

b. Don’t feel badly about questions you can’t answer.  The faculty member can’t answer all questions either.  You are sometimes asked just so we know the limits of an excellent student’s or resident’s knowledge.

c. It helps to catch the faculty member or whoever is the faculty person conducting the rounds a day before, to get some feedback on the case and the article you have picked.