Psychiatry Rotation Reflection

Something New

During this psychiatry rotation, I was exposed to new interviewing techniques and treatments that were specific to the CPEP setting, which differs significantly from outpatient or inpatient psychiatry. I learned how quickly decisions must be made regarding patient safety, disposition and medical clearance, often with limited initial information. One of the most important lessons I learned was understanding that patients may present with impaired insight, judgement, or impulse control, making collateral information essential. Family members, people who live with the patient, witnesses, EMS, prior records and chart review often provided critical details that shaped clinical decision-making. I also learned that psychiatric patients are often some of the smartest patients you will meet, and it is important to never underestimate their understanding, resilience or lived experience.

Skills, Challenges, and Action Plan

This rotation challenged me to grow in both interpersonal and interprofessional communication. Working closely with attendings, residents, PAs, social workers, nurses and security highlighted the important of clear, respectful communication in high-stress situations, involving multiple rounds with all team members throughout the day. One personal challenge I identified was delivering information with confidence, especially during presentations and when speaking directly with patients. I learned that I need to speak louder, show confidence and trust my clinical knowledge, even when I feel uncertain internally. While I became more comfortable over time, this remains an area for continued improvement. Moving forward, I want to continue practicing concise oral presentations, seek direct feedback from preceptors, and observe how experience providers communicate difficult information calmly and clearly, such as the news a patient may have to stay in CPEP holding for observation or that they will be moved to inpatient admission.

Challenging Patients and Growth

Some of the most challenging patients for me included those with psychosis, aggressive tendencies, oppositional behaviors and intellectual disabilities. These encounters taught me the importance of patience, emotional regulation, and adaptability. I learned that a patient’s behavior is often rooted in past trauma, social circumstances, or untreated illness, rather than intentional hostility. An unexpected strength I discovered was that my identity and how I present myself often helped patients feel more comfortable and willing to engage, due to being a woman, a Muslim, or a person of their culture. This reinforced the value of authenticity and cultural awareness in building rapport. I also learned how difficult breaking bad news of a patients condition or treatment can be and how important it is to balance empathy with safety.

Memorable Experiences

One of the most memorable aspects of this rotation was working in a setting that served a largely underserved population. I saw firsthand how psychiatric emergencies can affect anyone, regardless of background, and how access to care plays a major role in outcomes. CPEP’s fast-paced nature emphasized how important it is to be thoughtful about which patients require admission, as beds and resources are limited. This experience will be applicable across all future rotations, as it reinforced the importance of holistic patient care, medical clearance, and considering psychosocial factors alongside clinical symptoms. I genuinely loved working in CPEP and felt I was making a meaningful difference, even during brief patient encounters.

Overall Reflection and Perspective

Over the course of this five-week rotation, I learned that I am capable of adapting to high-acuity environments while still being able to focus on individualized patient care. My perspective on psychiatry has deepened and I now better understand that mental illness can develop unexpectedly and affect anyone, even me, and that every patient deserved dignity and care regardless of how they present. One thing I would want my preceptors and colleagues to notice about my work is my willingness to learn and my effort to integrate feedback into my clinical growth. This rotation affirmed my interest in psychiatry and strengthened my confidence in caring for vulnerable populations, while also clearly identifying areas for improvement as I move forward in my training.