Instruction in psychiatry is given during the second, third and fourth years of the medical curriculum. Emphasis is on the teaching of psychiatry as a medical discipline, including the biological, social and psychological mechanisms and manifestations of psychiatric illness, as well as psychological reactions to other illnesses. Psychiatric disorders are common and disabling illnesses. An explosion of knowledge resulting from research in neuroscience, genetics and epidemiology is leading to exciting advances in understanding and treating these disorders. Our department is heavily involved in this research, and our didactic curriculum integrates current clinical information with research advances to help students develop the knowledge, skills and attitudes to recognize these illnesses and understand the basic principles of treatment.
William Greenleaf Eliot Division of Child & Adolescent Psychiatry
The Division of Child & Adolescent Psychiatry offers a varied teaching program for medical students, residents in psychiatry, and fellows at St. Louis Children's Hospital and the Child Psychiatry Center. The center provides outpatient services to children with an array of mental disorders. Trainees are assigned to these various services, where they participate in diagnostic evaluations and see patients in treatment, under the supervision of a fellow and the attending physician.
Although the Department of Psychiatry does not offer its own degree, some of the department's courses are open to students in the MD and MSTP (MD/PhD) programs. Further information about the MD and MSTP degrees can be found in the Degrees & Programs section of this Bulletin.
Note to Students: There are always a number of research projects in the Department of Psychiatry. For additional information, contact Dr. Rubin at 314-362-2462.
Andrey Anokhin, PhD
Genetics of the Brain, Behavior and Psychopathology
Central Institute for the Deaf (CID) Building
660 S. Euclid Ave., Suite 1
This research elective is intended for students interested in cognitive neuroscience, biological psychology, psychophysiology and behavior genetics. Dr. Anokhin's laboratory is investigating the relationships between genes, the brain and behavior in order to better understand the complex etiology of mental disorders. Our main focus is on "externalizing" the spectrum of psychopathology characterized by deficits in inhibitory self-regulation, including ADHD, conduct disorder and addictive behaviors. We are particularly interested in the intermediate phenotypes or endophenotypes mediating genetic risk for addiction, such as impulsivity, risk taking, and abnormal affective processing of social-emotional information. In our laboratory-based studies with human volunteers, including twins, we investigate individual differences in brain activity using the recording of brain oscillations (event-related brain potentials) and functional magnetic resonance imaging (fMRI). For example, an ongoing longitudinal study of adolescent twins explores the developmental and genetic determinants of brain activity related to reward and punishment processing, inhibitory control of behavior, and risk taking to identify prospective predictors of substance abuse and associated behavioral problems. Another fMRI study using repeated assessments of the same individuals over time is focused on the identification of stable individual differences in brain activation related to inhibitory control, error monitoring and reward processing that can be used as reliable phenotypes in genetic analyses. We are now starting a study that will examine twins who are discordant for adolescent marijuana use in order to identify the consequences of drug abuse for the brain, cognition and emotion and distinguish them from pre-existing risk factors. Interested students will be able to learn a variety of methods used in these studies, such as the recording and analysis of brain oscillations, event-related neural dynamics, startle response, autonomic measures, the administration of neuropsychological and behavioral tests, and the statistical analysis of data. The format of this research elective may include the following: (1) directed reading; (2) participation in laboratory experiments involving human subjects; (3) analysis of existing data from various research projects; and (4) designing and piloting new behavioral experiments. Qualifications include reliability and responsibility, the ability to commit a specified amount of time per week and to work a schedule that can be negotiated on an individual basis, and good computer skills.
Deanna M. Barch, PhD
Cognitive and Affective Neuroscience of Schizophrenia and Depression
4525 Scott Avenue, Suite 1153K
Students may participate in the conduct of clinical studies of schizophrenia and depression. Involvement in clinical studies can include training and experience in interviewing psychiatric patients, or it may involve gaining experience in the techniques of assessing cognitive and emotional function using behavioral and brain imaging methods.
Laura Jean Bierut, MD
This research elective will focus on analyzing data from high-risk studies of smoking and other addictions. Students will have the opportunity to examine genetic and environmental factors that place some individuals at risk for developing nicotine, alcohol and other substance dependence and that protect others from the development of these disorders.
Kevin J. Black, MD
4525 Scott Ave., Room 2205
Students will participate in ongoing studies of brain imaging, movement disorders or neuropsychiatric illnesses. Degree of participation will relate to the student's available research time, skills and interest. Visit the laboratory's webpage for examples of past research.
Ginger E. Nicol, MD
Taylor Avenue Building, Suite 121
Clinical research concerning metabolism and the regulation of weight and body composition in persons with mental illness, particularly during exposure to psychotropic medications, is the focus of this lab. Projects include the following: (1) participation in the interpretation of results from clinical trials testing the effectiveness of behavioral weight loss in mentally ill individuals; (2) participation in clinical studies testing the effectiveness of psychotropic medications in mentally ill youth and adults; (3) the use of administrative data to characterize and examine provider behaviors, including prescribing practices and adherence to standard of care monitoring practices in mentally ill youth and adults; (4) participation in the development and use of mobile health interventions to collect data and to promote health behavior change in mentally ill individuals; and (5) participation in the development, implementation and effectiveness testing of patient safety and quality improvement (PSQI) interventions in mentally ill obese patients in Washington University outpatient psychiatry clinic settings. This elective offers the student a broad exposure to clinical research protocols, including protocols in adults and children. Students will have an opportunity to focus on a particular project of interest.
Rumi Kato Price, PhD, MPE
Central Institute for the Deaf (CID) Building
4560 Clayton Rd.
Medical and graduate students as well as postdoctoral and clinical fellows will work closely with Dr. Price and her collaborators on ongoing research projects in psychological trauma, substance abuse, psychiatric epidemiology, and prevention in the community research context. Current projects include the following: (1) the implementation of a sensor- and smartphone-based technology to monitor and manage post-traumatic stress disorder and anxiety disorder symptoms; and (2) epidemiology and clinical studies of human trafficking in the St. Louis region as well as in global context. We work closely with the Institute for Public Health, and we collaborate with multidisciplinary researchers as well as community leaders.
Psychiatric and Behavioral Health Sciences Concentration
Rumi Kato Price, PhD, MPE (concentration program director); Arpana Agrawal, PhD; Li-Shiun Chen, MD; Rick Grucza, PhD, MPE
Taylor Avenue Building (TAB)
660 S. Taylor Ave.
Courses are held at the Institute for Public Health TAB building. The Psychiatric and Behavioral Sciences concentration is an integral component of the Master of Population Health Sciences (MPHS). It is accredited in the School of Medicine and taught by psychiatry faculty members. The concentration provides clinician-researchers, postdoctoral fellows, and advanced medical and other graduate students with strong conceptual and methodological skills required for the design, advanced analysis and interpretation of epidemiological and treatment-effectiveness studies. Didactic training focuses on in-depth understanding of disease phenotypes and developmental trajectories; understanding the underlying biological and environmental factors and their interactions; understanding the role of psychiatric epidemiology in disease prevention and intervention locally and globally; and evaluating psychiatric clinical treatment and management programs of psychopathology. A fellow/student has an option of applying for an MPHS degree program or taking appropriate courses as part of their training or academic program.
Current available courses include the following:
- M19 PHS 562 Addictions and Addictive Behaviors (Course director: R. Grucza, PhD; 3 credits): This course provides an overview of the principles of substance-related addictions and the processes and mechanisms that underlie addiction.
- M19 PHS 5656 Global Burden of Diseases: Methods and Applications / S55 MPH 4003 (Course director: R.K. Price, PhD; 3 credits): This course provides an overview of the current methods for studying the global burden of medical and psychiatric diseases from a multidisciplinary perspective.
- M19 PHS 561 Psychiatric and Behavioral Assessment in the Digital Age (2 credits; not offered in Fall 2019): The first segment of this course introduces psychiatric disorder nosology and diagnostic assessment and screeners. The second segment will provide didactic and student-initiated digital applications of evidence-based prevention and intervention examples coupled with implementation frameworks of such digital applications.
Visit online course listings to view offerings for M85 Psych.
M85 Psych 676A Diseases of the Nervous System: Psychiatry
This course will emphasize the diagnosis of major psychiatric illnesses in adults and children. Psychiatric diseases will be described in terms of epidemiology, clinical presentations, natural history, genetics, differential diagnosis and clinical management. Biological and psychological influences on these diseases will be presented. Interviewing techniques and performance of the mental status exam will be demonstrated by patient interviews.
Credit 44 units.
M85 Psych 770 Psychiatry Clerkship
Students spend three weeks on the inpatient psychiatry service of Barnes-Jewish Hospital at the main campus unit. Students evaluate and treat patients under the supervision of house staff and an attending physician, and they attend teaching conferences, including small-group sessions with WUSM clinical faculty and upper-level psychiatry residents. Students are also assigned for one week at either an ambulatory treatment site or an inpatient consult-liaison service. There is also an opportunity for students to gain exposure to emergency psychiatric services in the Barnes-Jewish Hospital emergency department. Students are responsible for completing learning exercises and other assignments.
Credit 154 units.
M85 Psych 771 Ambulatory Clerkship: Psychiatry for Generalists
Up to two students may elect to pursue their ambulatory medicine selective through the psychiatry department. Students participate in clinical duties depending on assigned locations, which can include the BJH adult psychiatry clinic, a community mental health center, the Washington University child and adolescent psychiatry clinic, and both the adult and child psychiatry consultation services. Students will also submit a written review of a relevant clinical topic of their choice. There are no call obligations at any clinical site.
Credit 154 units.
M85 Psych 805 Psychiatry Consult Subinternship
Students spend four weeks on the psychiatry consult service at Barnes-Jewish Hospital. Under the supervision of house staff and attending physicians, students participate in the evaluation and collaborative management of inpatients on medical and surgical units for a broad range of psychiatric and behavioral concerns. They learn about the intersection between psychiatry and other medical specialties as well as important skills for collaborative patient care. Students attend departmental conferences and other educational sessions, and they also prepare and present a clinical topical review of their choice
M85 Psych 810 Outpatient Community Psychiatry
This elective will provide the student with a significant outpatient experience in psychiatry. Students will be paired with a resident physician and have exposure to two adult clinics and one child clinic over the course of the rotation. Students will observe and assist in the diagnosis and treatment of patients in the clinic setting. Students will also attend scheduled lectures and conferences over the course of the rotation that are relevant to outpatient psychiatry. During the elective, the student will learn about the outpatient presentations of psychiatric disorders, a variety of treatment techniques (psychotherapy and psychopharmacology), and general principles of outpatient clinical management.
M85 Psych 836 Inpatient Psychiatry Subinternship
This is a senior rotation that provides the students with an opportunity to expand their knowledge of inpatient clinical psychiatry by functioning as interns. Students attend all staffing and teaching conferences given to first-year psychiatry residents, take patients in rotation, and share night call with first-year residents approximately every fifth night. Immediate supervision is provided by the inpatient attending, and additional supervision can be arranged as desired. Teaching emphasis is directed toward psychiatric diagnosis, appropriate use of psychopharmacologic agents, psychotherapeutic intervention, use of community resources, and pursuit of the psychiatric scientific literature. The student will write a paper on a self-selected clinical topic relevant to the treatment and management of psychiatric inpatients.
M85 Psych 840 Child Psychiatry
This elective in child psychiatry utilizes the Child Psychiatry Outpatient Clinic and the consult-liaison service at St. Louis Children's Hospital. It provides experience in age-appropriate diagnostic and treatment methods in children and adolescents. A paper on a topic of the student's choosing is required.
M85 Psych 844 Forensic Psychiatry
The medical student will be actively involved in many aspects of forensic psychiatry, including civil litigation, worker's compensation, malpractice, civil commitment, and guardianship. There may be opportunities to be involved in criminal forensic issues. The student will work with several instructors within the Department of Psychiatry but will primarily meet with the Course Director a minimum of two hours per week. They will also work with the BJH Manager of Case Management and the City of St Louis Probate Court. The student will be assigned readings of landmark cases, textbooks, psychiatric expert opinions, and legal filings with the probate court and will attend civil hearings. The student will learn relevant criminal statutes regarding competency and civil commitment, causation in civil litigation, the concept of medical malpractice, and risk assessment for violence and suicide. There may be the opportunity to witness sexually violent predator evaluations and/or treatment. The student will be required to research and write an opinion on a specific approved topic in forensic psychiatry. The objectives will be measured by attendance and by formal evaluation of the student's participation and knowledge during the supervision discussion. It will also be determined by the originality, thoroughness, and quality of the research paper.
M85 Psych 855 Introduction to Eating Disorders
Students will learn the basics of assessment, participate in groups that focus on family education, gain experience in interdisciplinary psychiatric team work, attend case discussions with psychiatrists, and participate in treatment planning. Students will be able to describe core symptoms, recommend treatment options, and discuss the medical, nutritional, and psychiatric components of treatment.
M85 Psych 880 Schizophrenia Precursors & Prodomal States
This is an opportunity for trainees to gain experience in the evaluation of children and adolescents who may be at high risk for schizophrenia. The rotation would center around the "First Contact Assessment Service," which evaluates patients who show characteristics suggestive of prodromal schizophrenia (e.g., new-onset attenuated psychotic symptoms along with recent deterioration in functioning) and/or early life characteristics that may indicate risk for developing schizophrenia later in life (e.g., nonspecific social/emotional/behavioral symptoms in a child/adolescent with a strong family history of schizophrenia). Since the full symptoms of schizophrenia are often preceded by a wide range of childhood behavioral and developmental abnormalities, this rotation would also help trainees integrate information regarding the continuity between childhood development and adult psychopathology. The trainee would observe all aspects of First Contact evaluations (including semi-structured diagnostic interviews and examination of subtle neurological signs), participate in case discussions, and observe follow-up consultations involving patients with psychotic and/or complex neurodevelopmental disorders. The trainee would also be required to write a literature review on a topic relevant to the rotation.
M85 Psych 889 Interventional Psychiatry
Interventional Psychiatry involves the application of electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), and vagus nerve stimulation (VNS) in the treatment of medication-resistant psychiatric illness. The student will participate in the evaluations of patients referred to the Treatment Resistant Depression Clinic supervised by Dr. Charles Conway. The student will be involved in the neuropsychiatric assessment of patients referred for ECT. In addition, the student will receive training in the application of ECT and in the clinical management of patients receiving inpatient and outpatient ECT. As cases become available, the student will be involved in rTMS and VNS evaluations and treatment. The student will be encouraged to review appropriate literature and to make clinically relevant case-oriented presentations. The student will be expected to write a review of a self-selected clinic topic relevant to interventional psychiatry. As advances in the field occur, the rotation may also involve exposure to individuals receiving other modalities of intervention, including deep brain stimulation (DBS) and magnetic seizure therapy (MST).
M85 Psych 900 Research Elective — Psychiatry
Research opportunities may be available. If interested, please contact the Department of Psychiatry.