The first site evaluation was very beneficial to my understanding of psychiatry and the general approach to psychiatric conditions. I presented my first history and physical on a young schizophrenic patient. I learned through the evaluation how to better interpret patient behavior, the statements they make, and how previous trauma can affect current presentation. The patients auditory hallucinations and reactive, agitated behavior correlated with collateral information about the patients past violent trauma. This allowed me to expand my thinking of differential diagnoses and question patients about a broader range of topics in subsequent interviews. I implemented this advice into my second history and physical, making sure to focus more on social history and how it impacted the patients current hospitalization. The second history and physical I wrote up was about a patient with a complicated psychiatric history, including major depressive disorder, borderline personality disorder, and history of anorexia nervosa for 30 years. The patients interpersonal relationships, psychiatric history, and lack of social support contributed to her current hospitalization. These were both interesting and complicated cases and I learned a lot from presenting both.

The site evaluation also included pharmacology cards for which I chose to write up the medications I most often saw used on the inpatient psychiatric unit. It was interesting to hear feedback about which medications are more commonly used, which are more effective, and which are not as widely utilized anymore due to side effects or inconvenient monitoring. Lastly, I presented an article that related to the history and physical presented during my second evaluation. The article evaluated Olanzapine use in patients with anorexia nervosa, aiming to increase weight gain and decrease obsessive and anxious symptoms contributing to the disorder.

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