title: Medical decision-making by psychiatry residents.
abstract: OBJECTIVE
  Several conspiring factors have resulted in an increase in the level of medical burden in psychiatric patients. Psychiatry residents require increasing levels of medical sophistication. To assess the medical decision-making of psychiatry residents, the authors examined the outcome in subjects initially seen in the emergency psychiatric service and referred to the medical emergency department for medical evaluation and treatment.
  
  
  METHODS
  Psychiatry residents completed a survey sheet for every patient referred for medical evaluation from the emergency psychiatric service. The survey collected information on demographics, the level of subjective concern, and the anticipated level of medical intervention.
  
  
  RESULTS
  Twenty-seven medical referrals were made in the 6-week study period. Complete data were available for 23 (85.2%) subjects. Psychiatry residents accurately predicted the medical intervention 43.5% of the time. They overestimated the intervention 26.1% of the time and underestimated the intervention 30.4% of the time.
  
  
  CONCLUSIONS
  Psychiatry residents' medical decision-making can be improved. Additional research is required to determine whether additional medical training is needed or whether our findings are a consequence of the variability in how different physicians address medical problems.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY 40202, USA. rselma01@louisville.edu
authors.forename: Rif
authors.initials: R
authors.lastname: El-Mallakh
authors.forename: Jill
authors.initials: J
authors.lastname: Zinner
authors.forename: Amanda
authors.initials: A
authors.lastname: Mackey
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Tamas
authors.forename: Chanley M
authors.initials: CM
authors.lastname: Martin
authors.forename: Jerad
authors.initials: J
authors.lastname: Dalton
authors.forename: Nitu
authors.initials: N
authors.lastname: Dhaliwal
authors.forename: Nicole
authors.initials: N
authors.lastname: Luddington
authors.forename: Farhad U
authors.initials: FU
authors.lastname: Numan
authors.forename: Ross
authors.initials: R
authors.lastname: Nunes
authors.forename: Stephen
authors.initials: S
authors.lastname: Taylor
authors.forename: Lu
authors.initials: L
authors.lastname: Ye
mesh_terms: D002983:Clinical Competence; D015897:Comorbidity; D003479:Curriculum; D004636:Emergency Service, Hospital; D004637:Emergency Services, Psychiatric; D006301:Health Services Needs and Demand; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D007396:Internship and Residency; D008403:Mass Screening; D001523:Mental Disorders / Q000175:diagnosis*; D011570:Psychiatry / Q000193:education*; D012017:Referral and Consultation; D014481:United States; D019564:Unnecessary Procedures