Student Survival Guide: CMC-Randolph Psychiatry
Site Director: Linda Mundle, MD
The Basics
You will spend 3 weeks in the Emergency Department and S weeks in a combination of
inpatient and outpatient services.
You will also meet during the week with Dr. Mundle for interview skill building, ongoing
feedback, setting up additional clinical experiences, and more.
You may also be assigned some classic psychiatry reading such as The Quiet Room by
Lori Schiller and An Unquiet Mind by Kaye Redfield Jamison.
 If you need anything logistics-wise (problems with your login, badge, whatever),
Megan Hartwig can help you! (704) 358-2722
megan.hartwig@carolinashealthcare.org
 If you need anything else (problems on the rotation, questions regarding the
meaning of life, to discuss the greatest show in the history of television, gun
control questions, whatever) talk to Dr. Mundle!
Emergency Department: 3 weeks
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When they tell you to be proactive as an MS3, this rotation is what they were
talking about.
You set your own hours!
o Week 1: come in around 9:00 a.m. The mornings are usually slow, so you
can use this week to figure out the flow and what you are supposed to be
doing.
o After week 1: vary your shifts (for example, come in for noon lecture then
work in the ED in the afternoon/early evening). The pace picks up
considerably in the afternoon so you will get to see more patients.
Day 1: find the triage nurse, have her show you where to find the following
things: completed triage form folder (patients that need assessments),
assessment forms, MMSE forms, release-of-information forms, progress notes
Ask how to read the “board” (LCD screens with list of patients currently in the
ED) and access it on the computer (WebApps  FirstNet aka H Clinician tab)
Shadow a nurse doing a full triage and assessment to get an idea of what you are
supposed to do.
Med students work in the secure lobbies only (both adult and pediatric).
Panic buttons: ask the triage nurse to show you where they are, put a sticky note
on the panic button computer with the button’s number and “your name,
medical student” (ex. Temp123, Rolicious, med student), wear it while you are
assessing patients, make sure to take it off before you leave.
Kelly Esposito, Middleton Chang and Ronnie Milam, MS3’s October 2011
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The med student’s job is to do the assessment, present the patient to the doctor,
and follow the doctor through the rest of the encounter.
Flow in the ED: patient arrives, talks to receptionist who decides whether they
go to the secure or outer lobby, nurse triages them, then assessment (nurses
usually do this, but this the med student’s job when we are there), the
completed assessment is placed in the wood slots by the doctors’ desks, the
doctor picks it up and goes to see the patient
Put a sticky note on your completed assessments so the doctors know to come
find you.
Physicians work shifts, so you will not be working with the same person all the
time. Try and present a few times to the same doctor for consistency, but the
variety is one of the strengths of this half of the rotation.
Try to work with the child/adolescent doctor at least once (Drs. Shannon and
Livingston)
The rotation is very flexible. If you have an interesting patient in the ED who gets
admitted, you should continue seeing and following them on your own, and
make sure to let your fellow students know so they can see them too.
Outpatient/Inpatient: 3 weeks
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This half of the rotation is very dependent on your attending. Work with them to
set your schedule and expectations.
To get information about patients on Cerner: the best way to learn is to play with
it, but some helpful places to look (left-hand menu):
o Documents: dictations, admit notes, behavioral health assessments (you
can organize this by type, date, etc.)
o DocViewer and Power: nursing flowsheets chronologically
o Flowsheets: vitals, labs, imaging, lots of other important stuff
o MAR and MAR summary: meds! Whether they received them, when, and
pay attention to PRNs
o How to print a progress note: Task  Reports  Gen Prog Note
The rotation is very flexible. If you have an interesting patient in the ED who gets
admitted, you should continue seeing and following them on your own, and
make sure to let your fellow students know so they can see them too.
Don’t be afraid to pull patients aside/out of group to talk to them whenever you
want.
Kelly Esposito, Middleton Chang and Ronnie Milam, MS3’s October 2011