Traditionally, psychiatry education for medical students has relied on didactic lectures and observational learning during clerkships on inpatient psychiatric units. However, Inpatient settings no longer reflect how most psychiatric care is delivered, as the majority of care now occurs in primary care or outpatient settings.
Given the prevalence of mental health disorders worldwide, psychiatric education is essential to medical training. However, the inpatient-focused teaching model is increasingly recognized as insufficient for preparing students to address the psychiatric challenges they will encounter in real-world clinical practice. Most medical students pursue careers outside of psychiatry, entering specialties such as internal medicine, pediatrics, or surgery, and many of these physicians feel ill-prepared to manage the psychiatric conditions that complicate the care of medically ill patients.
Coupled with the time constraints of modern medical curricula, there is an urgent need for the adoption of a revised educational strategy for medical students — one that is more relevant, practical, and integrative. In a recent article, a group of consultation-liaison psychiatrists, including Jeong Hoo Lee, MD from Brigham and Women’s Hospital and Linda Herrera Santos, MD, PhD and Theodore Stern, MD from Mass General Hospital, advocate for the adoption of consultation-liaison (C-L) psychiatry as a core learning experience for medical students.
The Unique Value of Consultation-Liaison Psychiatry
Consultation-liaison psychiatry serves as the vital interface between medicine and psychiatry, making it an ideal setting for the medical student psychiatry clerkships. This interface exposes students to patients with both medical and psychiatric issues, a setting that mirrors the clinical complexity seen in the real world.
In this setting, clinician-educators are able to deliver apprentice-style teaching at the bedside. The authors note, “Care at the bedside represents the optimal location for trainees to observe, learn, and practice interviewing skills and techniques, as well as strategies for patient and family education, shared decision-making, approaches to the physical examination, bedside manners, and the use of rating scales and screening tools.”
In exposing medical students to psychiatry at the interface of medical and surgical care, C-L psychiatry demonstrates the importance of collaboration between specialties and allows students to work closely with nonpsychiatric colleagues and see models of interdisciplinary care in action.
What Medical Students Can Learn Through C-L Psychiatry
While the traditional psychiatry clerkship provides a foundation for understanding common psychiatric disorders—including their clinical presentation and treatment—a clerkship based in consultation-liaison psychiatry broadens the scope of learning beyond these boundaries. The authors argue that relocating the clerkship from the inpatient unit to the medical-surgical floors would not only teach medical students about psychiatric illness but could also play a fundamental role in their development as physicians.
The skills acquired in the C-L psychiatry setting are considered “essential for the practice of clinical medicine” and benefit practitioners across all specialties. This model creates unique opportunities for medical students to learn and master the following core competencies:
- The doctor-patient relationship and communication skills
- The mental status examination (MSE)
- Neuropsychiatric assessment, especially at the bedside
- Risk assessment for suicide and violence
- Evaluation and treatment of life-threatening causes of altered mental status
- Coping with medical illness
- Coping with the rigors of medical practice and building resiliency
By integrating C-L psychiatry into the clerkship, students gain both practical psychiatric skills and a more holistic view of patient care and physician well-being.
How Should Psychiatry Be Taught to Medical Students?
Medical education is increasingly adopting new teaching approaches grounded in adult learning principles, such as fostering self-directed learning, focusing on their readiness to learn, and emphasizing hands-on, real-world problem-solving. Teaching psychiatry in a medical or surgical setting encourages both horizontal and vertical models of learning.
- Horizontal learning refers to connecting topics that are being taught simultaneously. For example, when examining a patient with altered mental status, students can learn about possible causes related to different systems (e.g., neurologic, cardiac, and respiratory etiologies).
- Vertical learning involves exploring topics that may seem unrelated, like substance use problems and depression in a cancer patient. Even though these subjects are different, students can learn to look for recurring themes, such as considering the psychosocial factors during their assessment.
New educational tools and techniques, including the “flipped classroom” and “layered learning” can be customized to meet the unique needs and learning styles of individual students
Why the C-L Setting Is Optimal
Moving beyond the traditional inpatient-based psychiatry clerkship and integrating C-L psychiatry into the medical student curriculum provides relevance, breadth, and practical skills. When combined with modern instructional approaches like flipped classrooms and layered learning, this strategy is both feasible and acceptable for educating medical students.
The authors argue that C-L psychiatry clerkships expose students to scenarios that demand the integration of both medical and psychiatric thinking. A C-L based clerkship:
- Offers practical experience in communication and building rapport
- Fosters empathy by addressing psychosocial and medical factors simultaneously
- Provides basic skills for rapidly assessing mental status, competency, and risk for violence and suicide in a real-world medical setting
- Promotes the development of the skills necessary for collaborating with other providers within a multidisciplinary setting
- Reduces the stigma surrounding mental health, as trainees can “develop a nuanced understanding of psychiatric conditions beyond symptomatology”
A student interviewed in the article reflects, “We learned to approach patient care more systematically (covering biological, psychological, social, cultural, and existential factors), thereby ensuring that we would assess both basic and complex aspects of each patient’s condition.”
Read More
Lee JH, Rustad JK, Herrera Santos LJ, Ho P, Stern TA. Time-Limited Teaching of Psychiatry to Medical Students: Flipping the Classroom and Offering Layered Learning. Prim Care Companion CNS Disord. 2025 Jun 17;27(3):25f03944.
Rustad JK, Schlozman SC, Chen J, Stern TA. An Alternative Proposal for Teaching Medical Students About Psychiatry: Consultation-Liaison Psychiatry Rotations That Consult to Medical and Surgical Services. Acad Psychiatry. 2024 Feb;48(1):81-85.
