Prite 2017 Content Outline

PRITE 2017 CONTENT OUTLINE

The annotations and milestones listed below are suggestions to guide question writing; they are not the only options.

Since this exam is an cognitive assessment, in general, the MK milestones are the most appropriate. All items must have one milestone; please add others as appropriate.

A.  NEUROSCIENCES

(Emphasis on basic science, structure & processes, general, not related to specific disorders/pathology.) MK3 (all subheadings)

1.___Neurodevelopment (across the lifespan) also MK1

2.___Neuroanatomy

3.___Cells and circuits (Recognized circuits with clinical relevance.)

4.___Neurotransmitters and receptors

5.___Modulators (hormones, inflammatory responses)

6.___Neurobiological basis of basic behaviors (e.g. appetite, sleep, sex, aggression, attachment, attention, pain and pleasure) also MK1

7. Genetics

7.a___Methodologies for identifying genes

7.b___Types of genetic abnormalities (Mechanisms, not clinical syndromes, e.g. trinucleotide repeats, translocations, etc.)

7.c___Methods to identify genetic disorders

7.d___Epigenetics (Non-DNA factors including gene expression)

B.  CLINICAL NEUROLOGY

MK3, PC1 (all subheadings)

1. Diagnostic procedures

1.a___Neurological interview and examination (How to conduct a neuro interview and exam in general, e.g. how to assess for apraxia)

1.b___Neuroimaging (e.g. structural and functional)

1.c___Neurophysiological testing (EEG, evoked potentials, sleep studies)

2. Diagnostic and clinical evaluation of neurologic disorders/syndromes (also MK2)

2.a___Common neurological disorders/syndromes 2.b___Comorbid psychiatric disorders associated with neurological disorders or syndromes

3.___Management and treatment of neurological disorders/syndromes (also MK2, PC1, PC2, PC3, PC5)

C. CLINICAL PSYCHIATRY

C.1 Development & Maturation across the Lifespan

(Growth and development, relationship to functioning at various stages, changes and growth relevant to clinical assessment and treatment; clinical vignettes useful; avoid name that theory/name that age)

MK1 (all subheadings)

1.a___ Physical (other than neurodevelopmental) 1.b___Cognitive/Language

1.c___Psychological/Emotional/Personality 1.d___Social

1.e___Sexual

1.f___Environmental influences (ethnic, cultural, family, social, spiritual influences)

1.g___Life Transitions/Aging/Death

C.2. Behavioral & Social Sciences (May overlap with other areas) MK4 (all subheadings)

2.a Psychology

2.a.1___Behavioral psychology and cognitive psychology (Includes behavioral, cognitive and cognitive-behavioral theory)

2.a.2___Neuropsychology and learning theory

2.a.3___Psychoanalytic/psychodynamic theory (Avoid questions that simply match names with theories – should test for understanding of significance and meaning)

2.a.4___Social psychology (Includes social factors influencing attitudes and behaviors, e.g. bias and prejudice, as well as theories of group/family organization and dynamics); Sociology, Anthropology and Ethnology (incl. religion, spirituality, culture, includes cross-cultural factors important for clinical practice)

2.b___Other Behavioral/Social Sciences

C.3. Epidemiology

(Avoid questions where answer may vary over time such as prevalence of substance use. Epidemiology of specific disorders goes in C5. Focus on methodology and statistics essential to understanding research reports.) MK2 (all subheadings)

3.a___Core concepts and major research studies also PBL1

3.b___Prevention (Primary, secondary, tertiary; examples and clinical vignettes useful); Risk Factors (General risk factors rather than risk for a particular disorder); Resilience/ Protective factors (General protective factors rather than risk for a particular disorder)

3.c___Other Epidemiology

C.4. Diagnostic Procedures

(Where appropriate, ask questions specific to different age groups, e.g. children, adolescents, elderly or special populations) MK2, PC1 (all subheadings)

4.a___Interview also ICS1, PROF1

4.b___Mental Status (all aspects of formal MSE including differences for specific age groups and special populations)

4.c___Diagnostic assessments and rating scales (test for understanding clinical relevance of specific instruments)

4.d___Psychological/Neuropsychological testing (test for understanding and clinical relevance of specific tests)

4.e___Diagnostic/Laboratory Testing/Monitoring and Screening

4.f___ Imaging also MK3

4.g Neurophysiological testing (also MK3 all subheadings)

4.g.1___EEG

4.g.2___EMG

4.g.3___Sleep

4.h___Other Diagnostic Procedures

Continued on next page

C.5. Psychopathology & Associated Conditions Across the Lifespan

(Clinical vignettes useful, differential diagnosis, contributing factors and characteristics, comorbidity but not indicated treatment) MK2, PC1, PC2, PC3 (all subheadings)

5.a Disorders (includes substance-, medication-, medical condition – induced)

5.a.1___Neurodevelopmental

5.a.2___Schizophrenia spectrum/ other psychotic disorders

5.a.3___Bipolar and related disorders

5.a.4___Depressive disorders

5.a.5___Anxiety disorders

5.a.6___Obsessive-compulsive and related disorders

5.a.7___Trauma and stressor-related disorders 5.a.8___Dissociative disorders

5.a.9___Somatic symptom and related disorders (may include pain syndromes)

5.a.10___Feeding and eating disorders 5.a.11___Elimination disorders

5.a.12___Sleep-wake disorders

5.a.13___Sexual dysfunctions

5.a.14___Gender dysphoria

5.a.15___Disruptive, impulse control, conduct disorders

5.a.16___Substance-related and addictive disorders

5.a.17___Neurocognitive disorders 5.a.18___Personality disorders

5.a.19___Paraphilic disorders

5.a.20___Other mental disorders

5.b High Risk Behaviors (May overlap with other areas, especially psychopathology; identification and management of these types of behaviors; characteristics of affected individuals; significance of these behaviors for diagnosis, treatment response, outcome; lifespan and various patient populations; clinical vignettes useful) MK2, MK6, PC1, PC3, SBP1 (all subheadings)

5.b.1___Suicidality; Self-injurious behavior

5.b.2 ___Aggression; Interpersonal violence and homicide; Social aggression (gangs, terrorism, etc.)

5.c___Environmental – Risk/Protective Factors (e.g. Family/Social/ Education/ Employment/ Housing/ Financial/Legal/ Health; impact and relationship of environmental factors to functioning and

psychopathology; avoid listing of statistics; clinical vignettes useful) also SBP2

C.6. Treatment Across the Lifespan

(Should include questions relevant to specific age groups and special populations) MK 2 (all subheadings)

6.a___Patient Engagement: The Therapeutic Alliance and the Physician/Patient Relationship (MK6, ICS1, PC1, PROF1) (clinical vignettes preferred when possible, not ethical issues)

6.b___Case Formulation and Differential Diagnosis (Should focus on clinical reasoning and integration of data from multiple domains, e.g., the biopsychosocial formulation) also PC2; Treatment Planning (should focus on factors related to selecting specific treatment(s) based upon diagnostic formulation and other considerations, e.g., access to care, systems of care, cost-effectiveness) also MK6, PC3, SBP2

6.c___Management of difficult patients and non-adherence to treatment (preferable to use clinical vignettes) also MK2, PC3, PC2, PC1

6.d Somatic Therapies MK5, PC5 (all subheadings)

6.d.1. Psychopharmacology

6.d.1.a___Pharmacokinetics/pharmacodynamics (clinical vignettes encouraged)

6.d.1.b___Drug Interactions (clinical vignettes encouraged)

6.d.1.c___Age/Gender/Racial issues (Pharmacokinetic/dynamic factors specific to different age, gender and racial groups)

6.d.1.d___Pharmacogenomics

(For categories below, focus on mechanisms of action, indications, selection, side effects etc.; NOT differential dx. Use generic names of medications)

6.d.1.e___Antipsychotics

6.d.1.f___Antidepressants

6.d.1.g___Antianxiety, sedative-hypnotics

6.d.1.h___Mood stabilizers

6.d.1.i___Cognitive enhancers 6.d.1.j___Psychostimulants

6.d.1.k___Augmentation agents (Applies to all augmentation strategies for all medications and all diagnoses)

6.d.1.L___ Medications for side effects

6.d.1.m___ Adverse effects

6.d.1.n___Other psychopharmacology (e.g. medications for addiction)

6.e Other Somatic Therapies MK5, PC5 (all subheadings)

6.e.1___Neurophysiological; Neurostimulation (TMS etc.); Neurosurgical approaches

6.e.2___ECT

6.e.3___Biofeedback

6.e.4___Phototherapy/Chronotherapy

6.e.5___Complementary/Alternative medicine 6.e.6___Other somatic therapies

6.f Psychotherapy & Psychoeducational Interventions (Where appropriate, should cover full range of age groups and other special populations; should emphasize treatments that have evidence supporting effectiveness and efficacy, taking into account that a wide range of therapies are considered clinically relevant) MK4, PC4 (all subheadings)

6.f.1___Supportive

6.f.2___Behavioral and Dialectical Behavioral 6.f.3___Cognitive and Cognitive Behavioral 6.f.4___Interpersonal

6.f.5___Dyadic (includes couples tx. parent-child tx.)

6.f.6___Psychoeducation (including parenting) 6.f.7___Psychodynamic and psychoanalytic 6.f.8___Family

6.f.9___Group

6.f.10___Motivational Interviewing

6.f.11___Other psychotherapy and psychoeducational interventions/other therapies also SBP3

Continued on next page

6.g Psychosocial/Milieu Treatments (Indication for and management of treatment interventions; clinical vignettes useful; focus on patient/disorder characteristics for various interventions, unique aspects of interventions, role of psychiatrist; cover lifespan/different patient populations; should include rationale for selections of various interventions)

MK6, PC1, SBP3 (all subheadings)

6.g.1___Rehabilitation/Relapse prevention/Harm reduction; Self-Help/Peer Support Programs; Case Management

6.g.2___Inpatient/Residential; Partial/Day Rx;

In-home/Community-Based services

6.g.3___Outpatient

6.g.4___Emergency/Crisis Interventions also SBP1 Seclusion/Restraints

6.g.5___Other Psychosocial/Milieu Treatments

C.7. Consultation/Collaborative-Integrated Care

(Applies to patient care issues in consultative systems and models; does not cover questions of specific diagnoses (5a) or treatments including pain, medication, interactions (6d), etc.

Clinical vignettes useful; focus on the role of the psychiatrist in each setting) MK6 (all subheadings)

7.a___Medical (focus on the role of the psychiatrist in medical settings) also SBP4

7.b___Court/Justice system (Psychiatric consultation to the courts. Avoid name that case.) also SBP4

7.c___Community Mental Health Systems (community mental health based care) also SBP3

7.d___School (may include basic questions about educational law) also SBP4

7.e___Other Consultation (religious organizations, patient advocacy organizations, employment based services) also SBP4

C.8. Issues in practice (Understanding aspects of practice and research, avoid name that case.)

MK6 (all subheadings)

8.a___ Quality Assurance/Improvement, Patient Safety, Risk Management (Different QA approaches, etc. Hospital patient safety goals, etc.; Root cause analyses, when to notify, incident reporting, etc. Clinical vignettes useful) also PBL2, SBP1;

- Use of Technology (Refers to use by an individual in practice: does not include EMR, electronic billing, e-mailing, texting, internet, etc.; NOT professionalism concerns (see 8b); also ICS2, PC, SBP, PBL, PROF; - Teaching and education (Includes teaching patient/family groups as well as colleagues) also PBL3;

- Advocacy (Advocating on behalf of patients, organizations and the profession to insurances, other professionals, government, etc.) also PROF2, SBP4;

- Self-assessment and lifelong learning (Maintenance of certification, etc.) also PBL1

8.b___ Ethics/Professionalism (clinical examples useful) also PROF1, PROF2

- Clinical (Professionalism issues in practice, e.g. billing, CPT codes, working with insurance, etc.)

- Research/Scholarly Activity (The ethics of conducting research, writing up case reports, etc.)

- Organizational & Administrative (Ethical issues in systems of care, leadership, accrediting bodies, etc.)

8.c___Forensics and legal issues (As the apply to practice, e.g. mandated reporting requirements, landmark case precedents that impact clinical care. Avoid “name that case;” emphasize key content of important cases) PROF 1, PROF2, SBP4

8.d___History of psychiatry (Avoid name recognition questions; focus on landmark thinkers, specific contributions)

8.e ___ Other issues in practice

C.9. Research and Scholarship Literacy

MK6, PBL1 (all subheadings)

9.a___Research design/methods (study design)

9.b___Accessing and evaluating the evidence (validity, reliability, etc.)

9.c___Statistics (core concepts, e.g. NNT. Not picky)

9.d___Application of evidence to practice (Generalizability, etc.) also PC3

C.10. Administration and Systems

(Structures, organization, processes and policies that govern the delivery of psychiatric care in various settings, impact functioning of psychiatrically ill individuals, determine type and extent of services available, control/manage information collection and dissemination; should be relevant to psychiatry; cover

lifespan/different patient populations) MK6 (all subheadings) Also SBP

- Systems of care also ICS2 (e.g. Community, justice/legal, educational, other systems)

- Health Care Economics

- Public Policy

- Information Management and Electronic Medical Record also ICS2

- Organizational theory and structure

- Global

- Other Administration and Systems