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.
When Interviewing, Let the End Decide the Beginning
I concluded another Beat The Boards! course last week and was struck by how subtle is the difference between a great interview and one that misses the mark. Learn this simple concept to avoid becoming examiner road-kill.
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.
At the last Child & Adolescent Psychiatry Oral Board Prep Course, I heard 12 out of the 21 kids I observed being interviewed talk about fighting. Too often the exam candidate did not enquire as to the meaning of “fighting.” This is why this lack of clarification is a problem.
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.
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.
The Trap of Positive Counter-transference
It’s nice to have a positive professional regard for our patients. But when your positive feelings grow too strong, you can become blind to your patient’s true needs and end up doing them harm. Here are some real-life examples of how positive counter-transference went bad!