Psychiatry Miniboard

Each rotation culminates in an NBME (National Board of Medical Examiners) miniboard exam, so that we can be somewhat standardized (you know, so people can't open up their own Billy Bob's School of Medicine and start churning out inadequate doctors.)

This is a useful outline that the NBME provides to help you figure out how much weight each subject carries on the exam for each discipline, and includes a few sample questions. Here's the psych miniboard outline:

• General Principles - 5-10%
• Promoting Health and Health Maintenance - 1-5%
• Understanding Mechanisms of Disease - 10-15%
• Mental disorders usually first diagnosed in infancy, childhood, or adolescence - 5-10%
• Substance-related disorders - 5-10%
• Schizophrenia and other psychotic disorders - 5-10%
• Mood disorders - 5-10%
• Anxiety disorders - 5-10%
• Somatoform disorders - 1-5%
• Other disorders/conditions - 5-10% (this probably includes personality disorders, because there was some of that)
• Applying Principles of Management - 20-25%
• Diseases of the Nervous System and Special Senses - 10-15%

The NBME also exists to be the bane of medical students' existence (I picture them all to look like Mr. Burns from the Simpsons - sitting around being animated, rubbing their palms together and going, "Yesssssss ...") The psychiatry miniboard, incidentally, wasn't bad at all. Other than reading a little throughout the rotation for our every-other-week quizzes, and doing further reading about a few major patients that I wrote up, I only studied hard(ish) for a day or two. I am a compulsive book-buyer, and I used Lange Psychiatry Q&A 9th edition, Blueprints Psychiatry, and First Aid for the Psychiatry Clerkship. I don't think there was anything that I couldn't answer by using these books, had I studied a little more (I looked up items that I didn't know later. As Christy says, I may be the only person on earth who studies more AFTER the exam that I do before it. Heh.)

Most rotations require a score at the 11th percentile to pass the exam (except OBGYN, which I think is 22nd percentile, and Family Medicine, which is somewhere around the 5th percentile because it includes surgery and OB questions, which are separate rotations that the student may or may not have had yet. The Family Medicine department gives its own exam in addition to the NBME one.)

So, I really liked psychiatry. Not just because the hours were really good or because the material wasn't beat-your-head-against-the-wall hard, but because it was interesting. I had a great group of fellow students to work with, too. I'm going to miss them when I start Internal Medicine tomorrow! I'm thinking of doing some time in psych as an elective next year, because no matter what your specialty is, you're going to deal with psychiatric patients and psychopharmacology. I would like to actually have a little extra training (seeing how I'm planning on a primary care residency) instead of just giving my patients whatever antidepressant that is written on my ink pen! (Not that primary care providers do that - I'm not insinuating that.)