My site evaluator for this rotation was Dr. Saint Martin.

For my mid-rotation evaluation I presented an H&P on a 58 year old female presenting with worsening depression and suicidal ideation. The patient had significant past medical history of hypothyroidism and hyperlipidemia, and significant past psychiatric history of major depressive disorder with 2 prior psychiatric hospitalizations. Her history of MDD was long-standing with her first in-patient admission x17 years ago. Dr. Saint Martin stated that I developed a good treatment plan, and provided informative critique with emphasis on proper placement of information within my writeup. For example, he noted that I had made reference to aspects of the patient’s mental status exam in my HPI, however it should have been saved exclusively on its own for later. Additionally, he addressed placing the alcohol and substance use in past medical history instead of the social history as I had done.

For my final evaluation I presented another H&P, this time featuring a 46 year old female who was disruptive and disorganized at a community pool prompting the staff to call EMS. She had PMH of obesity, HLD, HTN and significant past psychiatric history for Bipolar I disorder with multiple inpatient admissions. Dr. Saint Martin recognized that I developed a proper assessment and treatment plan for this patient. It was brought to my attention that Lithium would have been ideal first line for treatment of the mania seen in this patient. However, I explained to Dr. Saint Martin that the patient herself asked for Depakote instead of Lithium, and therefore the attending provider complied with her request.