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Organizing the History of Present Illness

American Physician Institute recently completed another Psychiatry Oral Board prep course. Although this is my 78th course, I continue to discover new approaches to conducting interviews and presenting cases. At this course the number one reason I would have failed candidates was due to weakness in the HPI. Let me explain why the HPI is frequently underassessed.

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The Good and The Bad of Substance Use

At the recent Psychiatry Oral Board Prep Course I was again reminded that it takes some nuance to get patients to open up about the nature of their drug use and the associated consquences of the use. Interestingly, in the interviews I observed, the patients were even less eager to talk about the bad consequences of their drug use than about the amount and type of substances they used. To counter this reticence, here is an interview approach I’d like to share with you.

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Notes on Oral Board Note-Taking

The way you take notes on your oral board exam makes a large and direct impact on your performance – for both good and bad. If your note-taking works for you, you gain confidence as you proceed through the interview and presentation. If your note-taking does not work well for you, you can become flustered and disorganized. Today I present some tips on taking notes on the live patient interview.

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Guardians, Conservators, Payees, Powers of Attorney

The ABPN Part 2 exam format includes the “4 vignettes in one hour” section. This number of vignettes provides examiners a lot of opportunity to test your knowledge and skills across several very different cases.
 
One area of knowledge that has become a particular focus is the area of Medical-Legal issues. I kindly received an email from a candidate who took her Part 2 boards recently. On one of her cases the discussion focused on the patient’s possible need of a “conservator.” What the heck is that, you ask? Here’s the answer and more.

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Many Assessments for Violence Risk are Inadequate

Today’s post is a must read. Frequently – including at our last Beat The Boards! Psychiatry Oral Board Prep Course – candidates do not differentiate between the presence of violent thoughts and / or intentions AND the risk of violence. In short, risk of violence requires a much broader assessment than simply querying thoughts, plans, and intentions. Below I clarify our understanding of this crucial psychiatry oral board topic.

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