RULES FOR VSMMC-CBS ROTATION (PSYCHIA)

1. CALL TIME: BEFORE 8:00 AM

BEYOND 8:00 AM, RESIDENT ON DUTY WILL DRAW A LINE (USUALLY DR. SY
WILL DRAW A LINE AFTER 8:00 AM) IF YOU ARRIVE AFTER 8:00 AM,
YOURE CONSIDERED LATE AND 3 CONSECUTIVE LATES IS EQUIVALENT TO
1 ABSENCE. IF YOU ARRIVE BEYOND 8:15 AM, YOU WILL IMMEDIATELY
HAVE AN EXTENSION.

2. SIGN IN IN THE BLUE LOGBOOK. WRITE THE INITIALS OF YOUR SCHOOL,

Write legibly your full name, time you arrived and signature
3. Dont sign for your co-interns!! (If masakpan mo, extension or repeat
rotation)
4. Usually the endorsements will start at 8:00 am and end at around 9 or 9:30
am
5. Those on duty will stay on the interns quarters and those on
Previous/Preduty 1 and 2 statuses will proceed to the OPD
6. Communicate with MHAM, CDU, CIM interns on how you will divide all the
patients (both male and female) in the wards. Acute and Chronic patients
must be divided equally. Each intern must have an acute and chronic patients.
Once you have an assigned patient/s, you have to write progress notes in
their charts
If its an acute patient, you have to write the SOAP everyday
For chronic patients, write it EVERY OTHER DAY (So when you started to
write on June 1, 2017, your next progress entry will be on June 3, 2017)
7. Dont forget to write the demographics on each sheet of progress note sheet.
This include Patients SURNAME, GIVEN NAME, HOSPITAL NUMBER, AGE,
SEX
Nurses tend to throw your progress note sheet if you forget or lack to fill
out the demographics data
REMEMBER: its back to back so dont forget to fill out the other side
8. DUTY
Schedule: 8:00 am to 8:00 am of the next day.
Communicate with MHAM or CIM interns on who will deck 1st, 2nd, 3rd, etc.
In our batch, we did it alphabetically.
If a patient arrives, go down to the CMU aka ER and find out if the patient
is an OLD or NEW patient
If the patient is NEW (meaning no previous records), then get a FIRST
CONTACT FORM from the nurses station
If its an OLD patient, then use the progress notes
Usually the nurse will give you a blotter form where you will write a brief
HPI and MSE for the patient. Dont forget to take the vital signs upon
arrival.
Follow the complete psychiatric history/report format in Kaplan as well
as the MSE
 Usually it will take you 1-2 hours to extract the history from the patient
You have to write a clinical formulation for that patient regardless if its an
old or a new patient
o Initial impression and explanation why it was your impression?
o 3 differential diagnosis (rule in and rule out)
o plan/management (Copy it from the blotter or what are the
medication written by the resident in charge in the blotter)
If the resident gave a cocktail (Haloperidol and diphenhydramine), dont
forget to monitor the vital signs EVERY 30 MINUTES FOR 2 HOURS!!!
This is an interns responsibility so dont expect for the nurse to get it for
you. Write the said vital signs legibly in the V/S monitoring sheet.
Dont forget to e-log the patient you decked. Once youre done with the
elog. The leader must compile and copy the e-logs on the residents
computer in the resident quarter.
Write the census for that day in the white board and the patients who
arrived beyond 5 pm regardless if its a new or an old patient.
Write the census, all the patients regardless if its consult or admission
and regardless if its beyond or before 5 pm.
The following day, its the residents or the consultant decision who will
endorse for that day.
Residents: Dr. Tampos (Chief Resident), Dr. BErtulfo, Dr. Cheung, Dr.
Calmerin, Dr. Villas, Dr. Sy
Consultants during the endorsements:
o Monday: Dr. Buot
o Tuesday: Dr. Obra
o Wednesday: ???
o Thursday: either endorsement or lecture by a resident
o Friday: Dr. Igot (Shes kinda strict and asks a lot of questions)
o Saturday and Sunday: No endorsements but Patients who arrived
between Friday to Sunday will be endorsed on Monday
9. PREVIOUS
Schedule: from 8:00 am to 12 noon of the same day! ()
For previous, dont forget to clean the interns quarter before leaving
the room. Throw the empty bottles, etc.
Tasks: You will be given a white folder with patients follow-up records
by the nurse, Call the patients name and let him/her sit in front of
you.
Your task is to check the color of the number card attached to the
folder
o If its WHITE, just write the S and O of SOAP
o If its YELLOW, it is usually a child, minor or elderlies: Also
write the S and O of SOAP
o If its a BLUE card, then you must write a prescription for the
patient
 You can get the prescription papers from Maam Awi
usually kept in her drawer. Ask for permission.
Separate prescription papers for injection via IM and
those taken orally
Usually the oral medications are given for 1 month
Check the medications from their record
o Aside from the SOAP, you may be asked to write a medical
abstract or a psychological evaluation form
o The usual reason for medical abstract is: financial assistance

PREDUTY
BREAKTIME SCHEDULE:
Pre-duty 1: 12:00 noon to 1:00 pm Dismissal time: 5:00 pm
Pre-duty 2: 11:00 am to 12:00 noon Dismissal time: 4:00 pm

Tasks: Youre usually given a new contact patient so that means you
have to get the informant/reliability, General data, Chief complaint,
HPI, past psychiatric/medical history, Substance History, Family
History, Complete Personal History or Anamnesis (The residents are
usually particular/meticulous with this part so as much as possible
extract a complete history..hehe)

!!!!!!sDuring Saturdays and Sundays, those who are on duty will ofcourse go on duty
but for previous, preduty 1 & 2 you still have to go for attendance in the logbook and
do the progress notes of your assigned patients.

IMPORTANT:
Every 15 days each intern is required to submit 1 case report individually
(ONLY NEW PATIENTS REGARDLESS IF IT WAS DURING YOUR DUTY OR
IN OPD). If its not possible you may submit the 2 case reports during the
last day of your rotation. (please check the attached sample case report.

Every 15 days, there will be case presentation so divide among yourselves

together with the MHAM/CDU/CIM iinterns. There must be 2 groups.
First group will present on the 15th day and 2nd group will present on any
days of last week of rotation.

Additional reminders:
S: subjective complaints of the patient (verbatim), sleeping difficulties,
appetite, substance use, hallucinations, delusions, suicidal ideations???
O: Mental Status Examination
A: the diagnosis
P: management/medications of the patient
YOU MAY ALSO BE REQUESTED TO DO THE FOLLOWING:
EXTRACT BLOOD FROM THE PATIENT, insert FBC, NGT, etc.
Transport the specimens (blood, urine, sputum) to VSMMC-Main
Laboratory
Always carry with you a specimen carrier
You may also be asked to transport the patient via ambulance to Sotto
main
Its not your job to restrain the patient..usually its done by the
security guard or the nurse

ENJOY YOUR ROTATION and sleep well..haha!!!