Marcus Autism Institute, Emory University, Atlanta, Georgia / Saint Francis Memorial Hospital, San Francisco / Morgan Autism Centre, San Jose

I spent the entire eight weeks of my elective in America in the field of psychiatry as I am hoping to pursue a career in this field.  The aims of my elective were to gain exposure to different psychiatric settings (clinic, hospital, school and academic), see the range of services that are available, discover the similarities and differences within the subspecialties as well as comparing it to the UK and most importantly see a wide variety of patients!

I started in the Marcus Institute, a child outpatient clinic handling the age group 3-22 mainly with autism and attention deficit but also with anxiety, depression, post traumatic stress following sexual abuse. Consultations (typically 90 minutes) involved taking a thorough history from the parents to determine which diagnostic tests, medications or further services were necessary. There was a weekly telemedicine clinic with consultation by web camera from an outreach location for patients unable to come to the clinic and was a great way to provide psychiatric services to people who would not usually have access.

The Saint Francis Hospital has an adult psychiatry ward for 24 patients and a partial day programme.  Patients were admitted from accident and Emergency or by the police for three days for assessment and treatment. I sat in on consultations, group meetings, art therapy and multidisciplinary teams.  I also went to the ward judicial hearings for patients contesting their detention, and went to the local court for one of the cases. The patients presented mainly with acute psychosis or were suicidal, but the variety of presentations was very interesting and it was a fantastic opportunity to see patients who were acutely unwell with obvious psychiatric signs!

My last placement was at the Morgan Centre, which was established in 1969 and is a special education programme for children who cannot be served by the school district.  There are 65 students aged between 5 and 22 with autism, developmental delay, epilepsy, hearing impairments, Downs Syndrome and other chromosomal disorders.  They are taught in individual cubicles on a 1:1 basis. I was able to take the role of a staff member working with the children on their academics as well as helping during art, physical education, and meals.  There is also an adult programme with 35 clients and with a focus on independent living skills and vocational training.  It was a great opportunity to spend lots of time with the patients, get to know them and gain insight into the complexities of their conditions.

I volunteered at the 9th Annual Autism Conference at Santa Clara University which had 460 people in attendance and 40 exhibitors.  There were talks on the biological basis of autism, nutritional interventions and new methods of communication.  I was invited to the speakers’  dinner and prepared a poster about the Morgan Autism Centre, and also presented a poster on the Magnocellular Theory of Autism based on the work I had done supervised by Professor Baron Cohen in Cambridge.

The time I spent doing psychiatry was invaluable.  I learnt a lot, saw many more and a wider variety of patients with psychiatric disorders than ever before and definitely stimulated my interest in the subject even further.

I would like to thank the Jewish Medical Association for the bursary they gave me for my elective, which has given me a greater insight into the field and many great memories.

Abigail Martyn
Cambridge University / King’s College London

Published in General News, on June 22nd, 2017

 

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