This site visit was a little different than the previous one because both of my site evaluations were done via Skype and not in person. Despite some technical difficulties and connection problems, both site evaluations were very helpful and I received great feedback from Dr. Martin.

For my first site visit, I presented Mr. TK who was a 31-year-old African American male with past psych history of schizophrenia who was brought in by EMS, activated by his grandmother because patient was non-compliant with his medication and acting bizarre. After careful monitoring and evaluation, Mr. TK was placed back on medication and appointment with his outpatient psychiatrist was made. My site-evaluator suggested to work on my assessment and plan a bit more. Originally I suggested to place my patient on IM haloperidol decanoate 2mg for long term care, however based on my patient’s history and social circumstances, my site-evaluator said that might not be the best option and suggested for me to explore a different medication. For my second and third H&P, we mostly discussed differential diagnosis and I had to justify the reason why I selected each one of them to my site- evaluator. It was a great conversation and very educational.

The article I selected to present to my site-evaluator was a meta-analysis which was published in 2009 with the title “Antipsychotic combinations vs monotherapy in schizophrenia: a meta-analysis of randomized controlled trials”. I selected this article because it had the highest level of evidence being a meta-analysis with a total population size of 1229 patients. This article was also very relevant to not only my psychiatric rotation but also relevant to my first H&P that I presented to Dr. Martin. I discussed the method and conclusion with my site-evaluator and we both agreed with the articles’ final conclusion that when it comes to comparing the effectiveness of antipsychotic monotherapy vs. cotreatment with antipsychotic, current data is limited and more research needs to be conducted.

For my 10 pharm cards, I tried to select all drugs that I saw the most during my psych rotation. Some of the drugs I presented were antipsychotics, antidepressants, mood stabilizers and benzodiazepines.

Overall, this was a great experience and I received very helpful tips and comments from my site-evaluator.

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