Water, water, everywhere. That’s what lithium-induced nephrogenic diabetes insipidus makes me think of. I see the problem only occasionally and needed a refresher to bring me up to date on the basic physiology and what to do about it. So that led to yet another outstanding Clinical Problems in Consultation Psychiatry (CPCP) presentation the other day.This was an excellent review by one of our best junior residents, Dr. Burgundy Kimm, and reminded me of the importance of a systematic method of keeping up with medical knowledge and clinical skills relevant to my practice.
Because I’m basically a psychiatric hospitalist, about the only time I see patients on lithium is if they’re admitted to the general hospital with toxicity from this mood stabilizer, which is historically the linchpin of medication management for patients diagnosed with bipolar affective disorder.
That’s why the CPCP is the best method for me to learn and relearn what is most relevant to my daily practice as a consulting psychiatrist in the general hospital. I was reminded of this when I read an article about “boot camps” for medical interns, a sort of crash course for new residents typically run for a couple of days in July to get them ready to take care of patients. Probably the best known program is the one run by Northwestern University in Chicago.
These are practical and are mostly simulations revolving around doing medical procedures except for a very important exercise in fostering communication skills–giving bad news to patients.
I think a different kind of boot camp could be both practical and popular for new residents in psychiatry as well as medicine and surgery. Certainly they could include teaching them how to assess and manage delirium. They could also include exercises covering topics like the one in this excellent CPCP.
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