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Psychiatry Psychiatry curriculum ======================= Conquer the Psychiatry Boards—Then Lead With Confidence Core Advanced Psychiatry Core Pathway ### Basic Neurosciences 1,428 questions #### Acute Psychiatry 125 Psychiatric emergencies, rapid stabilization, safe environments, rapid tranquilization, and short-te... - Acute agitation and aggression management - Agitation etiologies and targeted treatment 5 - Rapid tranquilization: medication selection principles 4 - Restraint and seclusion 5 - Verbal de-escalation and behavioral strategies 5 - Acute management of medication toxicities and medical complications - Anticholinergic toxidrome 3 - Clozapine emergencies 4 - Lithium toxicity 4 - TCA overdose and QT/QRS issues 4 - Acute psychosis and mania - Acute antipsychotic treatment strategies 4 - Acute mania management 4 - First-episode psychosis emergency workup 4 - Psychotic depression and severe agitation with psychosis 4 - Delirium, catatonia, and altered mental status emergencies - Catatonia recognition and benzodiazepine challenge 5 - Delirium management 4 - Differentiating NMS, serotonin syndrome, malignant hyperthermia 4 - Emergency psychiatry triage and initial stabilization - ABCDE approach and medical clearance principles 4 - Delirium screening and differentiation 4 - Immediate safety and environment 4 - Inpatient admission, disposition, and legal thresholds - Capacity in emergencies 4 - Criteria for involuntary detention/treatment (general principles) 4 - Discharge planning from ED/inpatient 5 - Substance intoxication and withdrawal emergencies - Alcohol withdrawal and delirium tremens 5 - Cannabis, hallucinogens, and novel psychoactives 3 - Opioid intoxication and withdrawal 3 - Sedative-hypnotic withdrawal 4 - Stimulant intoxication 4 - Suicidal and self-harm emergencies - Non-suicidal self-injury vs suicidal behavior 4 - Post-attempt medical/psychiatric management 5 - Safety planning vs hospitalization decision-making 4 - Suicide risk stratification in the acute setting 5 #### Behavioral Sciences 137 Psychological theories, development across lifespan, sociocultural psychiatry, and behavioral mechan... - Family systems and group behavior - Family systems concepts 4 - Group dynamics and leadership 4 - Parenting styles and child outcomes 5 - Psychological assessment constructs (non-diagnostic) - Intelligence, achievement, and adaptive functioning constructs 5 - Personality testing overview 5 - Symptom rating and outcome measurement principles 4 - Cognition, emotion, and social behavior - Attention, memory, and executive function 5 - Decision-making and behavioral economics 3 - Emotion theory and regulation 4 - Social cognition and attribution 3 - Human development across the lifespan - Cognitive development and milestones 5 - Developmental stages and tasks 6 - Moral development and behavior 4 - Neurodevelopmental vulnerability and resilience 5 - Learning theory and behavior change - Behavioral activation and contingency management 4 - Classical and operant conditioning 5 - Exposure-based learning principles 5 - Health behavior change frameworks 5 - Social learning and modeling 4 - Personality, temperament, and individual differences - Attachment theory and adult attachment patterns 5 - Defense mechanisms and coping 4 - Temperament models 4 - Trait models of personality 5 - Sociocultural psychiatry and social determinants of health - Culture, identity, and explanatory models 4 - Migration, refugees, and acculturation 4 - Religion/spirituality in clinical care 4 - Social determinants (housing, income, education) 5 - Stigma, discrimination, and minority stress 5 - Stress, trauma, and resilience science - Acute and chronic stress physiology 4 - Resilience and post-traumatic growth (critical appraisal) 4 - Trauma and developmental impacts 4 #### Cellular and molecular neuroscience 144 Neuronal signaling, synaptic plasticity, and molecular mechanisms underpinning psychopathology and t... - Apoptosis, neurotoxicity, and oxidative stress - Excitotoxicity and NMDA/glutamate 4 - Oxidative stress mechanisms 4 - Glia, neuroinflammation, and the blood-brain barrier - Astrocytes and glutamate homeostasis 4 - BBB integrity and CNS drug penetration 3 - Microglia and cytokine signaling 4 - Neurodevelopment, genetics, and epigenetics - Gene-environment interaction and epigenetics 4 - Neurodevelopmental processes 5 - Pharmacogenomics and clinical caveats 4 - Prenatal/perinatal exposures and neuropsychiatric risk 4 - Psychiatric genetics fundamentals 4 - Neurodiagnostics for psychiatry (overview) - EEG and seizure/delirium evaluation 4 - Functional imaging basics (PET/SPECT/fMRI) 4 - Sleep studies and circadian assessment 5 - Structural imaging principles (CT/MRI) 4 - Neuroendocrine systems and stress physiology - HPA axis and cortisol dynamics 4 - Reproductive hormones across lifespan 4 - Thyroid axis and mood/cognition 5 - Neuronal membrane physiology and action potentials - Channelopathies and neuropsychiatric relevance 5 - Ion channels and excitability 4 - Synaptic integration and firing patterns 3 - Neuropathology and neuroimmunology relevant to psychiatry - Autoimmune encephalitis and related syndromes 3 - Demyelinating and inflammatory disorders 4 - Infectious causes and mimics 4 - Metabolic/toxic neuropathology relevant to psychiatry 5 - Neurodegenerative diseases with psychiatric presentations 5 - Neurotransmitters, receptors, and psychopharmacology mechanisms - Acetylcholine and cognition/delirium 4 - Dopamine systems 4 - Endocannabinoid and opioid systems 4 - Glutamate and GABA balance 4 - Histamine, orexin, and appetite/sedation 5 - Norepinephrine systems 5 - Serotonin systems 4 - Synaptic plasticity and learning - Long-term potentiation/depression (LTP/LTD) 4 - Memory systems and reconsolidation 3 - Neurotrophins and stress 4 #### Clinical Psychopharmacology 167 Evidence-based prescribing principles, major psychotropic classes, monitoring, interactions, special... - Adverse drug reactions, toxidromes, and urgent syndromes - Hematologic, hepatic, and endocrine adverse effects 4 - Hyponatremia/SIADH 3 - QT prolongation and torsades risk 4 - Serotonin syndrome 4 - Withdrawal syndromes and rebound phenomena 5 - Antidepressants and augmentation strategies - Atypical antidepressants 5 - Augmentation options 4 - Rapid-acting antidepressant interventions (mechanisms/monitoring) 4 - SSRIs/SNRIs 5 - TCAs and MAOIs 5 - Antipsychotics (typical and atypical) - Adverse effects and monitoring 4 - Clozapine: indications and safety 5 - Long-acting injectables (LAIs) 4 - Mechanisms and receptor profiles 5 - NMS and other severe syndromes 4 - Anxiolytics, hypnotics, and related agents - Benzodiazepines 4 - Beta-blockers and adrenergic agents 5 - Buspirone and other non-sedative anxiolytics 4 - Non-benzodiazepine hypnotics and sedating agents 5 - Core prescribing principles (PK/PD, adherence, monitoring) - Adherence, shared decision-making, and deprescribing 4 - CYP450 and transporter interactions 4 - Pharmacodynamics fundamentals 4 - Pharmacokinetics fundamentals 5 - Therapeutic drug monitoring (psychiatry) 5 - Medications for substance use disorders (overview) - Alcohol use disorder pharmacotherapy 4 - Opioid use disorder medications 5 - Tobacco cessation pharmacotherapy 4 - Mood stabilizers and bipolar pharmacotherapy - Antipsychotics for bipolar disorder 4 - Carbamazepine/oxcarbazepine 4 - Lamotrigine 3 - Lithium 5 - Valproate 4 - Special populations in psychopharmacology - Children/adolescents 4 - Older adults 4 - Pregnancy and lactation 4 - Renal/hepatic impairment and medically ill patients 5 - Stimulants, non-stimulants, and cognitive enhancers - ADHD pharmacotherapy in adults and youth (principles) 4 - Atomoxetine, guanfacine, clonidine 4 - Wake-promoting agents 4 #### Ethics and Law 108 Professionalism, ethical practice, confidentiality, consent/capacity, boundaries, documentation, div... - Clinician wellbeing, impairment, and professionalism - Burnout, moral injury, and impairment 4 - Supervision, trainee responsibilities, and escalation 4 - Telepsychiatry ethics and legal considerations (principles) - Licensure, jurisdiction, and prescribing controlled substances (awareness) 3 - Privacy, consent, and identity verification 3 - Boundary management and professional conduct - Financial boundaries and conflicts of interest 5 - Gifts, self-disclosure, and social media 4 - Sexual misconduct and dual relationships 5 - Confidentiality, privacy, and information sharing - Confidentiality fundamentals and limits 4 - Documentation and patient access to records 4 - Sharing information with family/caregivers 4 - Consent and decision-making capacity - Capacity assessment components 4 - Informed consent for treatment 3 - Substitute decision-making and guardianship concepts 4 - Core ethical principles and decision-making - Autonomy, beneficence, nonmaleficence, justice 4 - Ethical reasoning frameworks 4 - Professional virtues and fiduciary duty 4 - Cultural safety, diversity, and anti-discrimination ethics - Cultural humility and bias mitigation 4 - Working with marginalized groups ethically 4 - Documentation, billing integrity, and medico-legal risk - Fitness for duty, disability, and work letters 5 - High-risk documentation (suicide/violence, capacity, involuntary) 5 - Standard of care and negligence basics 4 - Duty to protect, warn, and public safety - Firearms and lethal means counseling (ethics/legal interface) 5 - Threats of violence and duty frameworks 4 - Involuntary assessment and treatment (civil mental health law principles) - Criteria and thresholds (generalizable) 4 - Patients' rights under involuntary care 5 - Treatment over objection and emergency exceptions 5 #### Evidence-Based Practice 95 Critical appraisal, statistics, applying evidence to care, guidelines, quality improvement, and pati... - Research ethics and governance - Informed consent and vulnerable populations 4 - IRB/ethics committees and data protection 3 - Publication ethics 4 - Teaching, scholarship, and lifelong learning skills - Appraising and presenting evidence 3 - Learning plans and reflective practice 4 - Applying evidence to individual patients - Clinical reasoning under uncertainty 3 - Measurement-based care 3 - Shared decision-making and values-based care 5 - Biostatistics and interpreting results - Confidence intervals and clinical significance 4 - Effect sizes and standardized measures 3 - Hypothesis testing 4 - Measures of frequency and association 4 - Clinical epidemiology and study designs - Observational studies 3 - Pragmatic trials and real-world evidence 4 - Qualitative research methods (overview) 3 - Randomized controlled trials (RCTs) 4 - Diagnostic test evaluation - Likelihood ratios and Bayesian reasoning 3 - Reliability and validity of rating scales 3 - Sensitivity, specificity, predictive values 4 - Quality improvement (QI) and patient safety - Medication safety in psychiatry 4 - Patient safety principles 5 - QI methods and tools 2 - Reducing restrictive interventions 4 - Systematic reviews, meta-analyses, and guideline appraisal - Clinical practice guidelines 4 - Meta-analysis interpretation 4 - Systematic review methodology 4 #### Neuroanatomy, networks, and circuits 85 Structural and functional neuroanatomy most relevant to psychiatric symptoms, syndromes, and neurops... - Spinal cord, peripheral nervous system, and autonomic nervous system (ANS) - Neurogenic bladder/bowel and psychotropic side effects 4 - Somatic symptom overlap with neurologic disease 5 - Sympathetic/parasympathetic physiology relevant to anxiety and panic 4 - Functional neurocircuitry of major psychiatric domains - Cognitive control networks 4 - Default mode network and self-referential processing 3 - Fear, threat, and anxiety circuits 5 - Reward, reinforcement, and motivation circuits 4 - Social cognition networks 4 - Neuroanatomical organization and localization - Basal ganglia and cortico-striato-thalamo-cortical (CSTC) loops 4 - Cerebellum and cognition/affect 4 - Cortical lobes and key functions 4 - Lateralization and interhemispheric connectivity 4 - Limbic system and salience processing 4 - Thalamus, hypothalamus, and brainstem 5 - Neuroanatomy of sleep and circadian rhythms - Circadian biology and mood 3 - REM/NREM neurophysiology and psychiatric relevance 4 - Sleep-wake regulatory systems 4 - Neurologic lesions and neuropsychiatric syndromes - Basal ganglia disorders and behavior 4 - Frontal syndromes 5 - Parietal/occipital syndromes with psychiatric mimics 3 - Temporal lobe epilepsy and psychiatric presentations 4 #### Psychiatric Assessment 159 Interviewing, mental status exam, risk assessment, formulation, and diagnostic procedures including... - Psychological and neuropsychological testing - Common symptom rating scales (selection and pitfalls) 4 - Indications for neuropsychological evaluation 4 - Interpretation fundamentals 4 - Case formulation and documentation - Biopsychosocial and cultural formulation 4 - Documentation standards and risk documentation 5 - Problem list, differential, and treatment plan writing 4 - Collateral information and longitudinal data synthesis - Family/caregiver collateral 3 - Records review and coordination across systems 4 - School/workplace collateral (with consent) 5 - Imaging, EEG, and specialized studies (indications and interpretation basics) - EEG indications 5 - Lumbar puncture indications (psychiatric context) 4 - Neuroimaging indications in psychiatric presentations 4 - Sleep studies and actigraphy indications 4 - Laboratory testing, toxicology, and biomarkers - Baseline labs for psychotropics and differential diagnosis 5 - Infectious and autoimmune workup when indicated 5 - Therapeutic drug monitoring (TDM) basics 5 - Toxicology testing (urine/serum) 5 - Medical and neurologic assessment in psychiatry - Differential diagnosis of altered mental status 5 - Focused neurologic exam and red flags 5 - Medication-induced psychiatric syndromes 5 - Physical exam screening relevant to psychiatry 5 - Mental status examination (MSE) and cognitive screening - Appearance, behavior, and psychomotor activity 4 - Brief cognitive tests 4 - Insight and judgment 4 - Mood, affect, and emotional reactivity 4 - Perception and cognition 3 - Speech and language 3 - Thought process and content 4 - Psychiatric interview structure and communication skills - Difficult interviews and de-escalation communication 4 - Eliciting symptoms and timeline 4 - Engagement, rapport, and agenda setting 3 - Substance use, medications, and iatrogenic factors 5 - Trauma-informed interviewing 4 - Working with interpreters and communication barriers 3 - Risk assessment and management planning - Risk in psychosis/mania and substance use 3 - Safeguarding: child/elder abuse 2 - Self-neglect and vulnerability 3 - Suicide risk assessment 4 - Violence risk assessment 4 #### Psychiatric Diagnosis 197 DSM/ICD-based classification, phenomenology, differential diagnosis, comorbidity, and diagnostic rea... - Somatic symptom and dissociative disorders - Dissociative disorders 5 - Factitious disorder and malingering differentiation 5 - Functional neurological symptom disorder 4 - Somatic symptom disorder vs illness anxiety disorder 5 - Anxiety, obsessive-compulsive, and trauma-related disorders - Adjustment disorders 4 - Generalized anxiety disorder, panic disorder, agoraphobia 5 - Obsessive-compulsive and related disorders 4 - PTSD and acute stress disorder 4 - Social anxiety disorder and specific phobia 4 - Diagnostic systems and nosology (DSM/ICD principles) - Diagnostic bias and equity 4 - DSM-5-TR structure and diagnostic criteria use 4 - ICD principles and crosswalk concepts 3 - Reliability, validity, and limitations of categorical diagnosis 4 - Mood disorders (depressive and bipolar disorders) - Bipolar I/II and cyclothymic disorder 4 - Major depressive disorder and persistent depressive disorder 4 - Peripartum mood disorders (diagnostic aspects) 5 - Seasonal pattern and circadian-related mood presentations 5 - Suicidality and mood disorders (diagnostic implications) 4 - Neurocognitive, sleep-wake, and feeding/eating disorders - Delirium and major/mild neurocognitive disorders (diagnostic) 5 - Eating disorders and differential 4 - Impulse-control and disruptive behavior disorders (adult relevance) 5 - Sleep-wake disorders 6 - Neurodevelopmental disorders (core diagnostic principles) - ADHD, ASD, intellectual disability 5 - Specific learning disorders and language disorders 5 - Tic disorders and Tourette syndrome 4 - Personality disorders and related constructs - Antisocial personality disorder and psychopathy constructs 4 - Borderline personality disorder 4 - DSM personality disorder clusters and diagnostic approach 5 - Obsessive-compulsive personality disorder vs OCD 4 - Personality change due to another medical condition 4 - Psychopathology and descriptive phenomenology - Cognition, insight, and judgment 4 - Mood and affect 4 - Perceptual disturbances 6 - Self and identity disturbances 4 - Thought process and content abnormalities 5 - Schizophrenia spectrum and other psychotic disorders - Brief psychotic disorder and schizophreniform disorder 3 - Catatonia (as specifier/standalone) 4 - Delusional disorder and shared psychotic disorder concepts 4 - Psychosis differential diagnosis (medical/substance/neurologic) 4 - Schizoaffective vs mood disorder with psychotic features 5 - Schizophrenia core features and diagnosis 4 - Substance-related and addictive disorders (diagnostic) - Gambling and behavioral addictions (classification) 4 - Intoxication and withdrawal syndromes (overview) 5 - Substance use disorder criteria and severity 4 - Substance/medication-induced mental disorders 5 #### Psychotherapy Principles 124 Foundational psychotherapy competencies, modality selection, alliance, boundaries, and integration w... - Group, couples, and family therapy (foundations) - Couples/family therapy principles 5 - Group therapy indications and contraindications 4 - Therapeutic factors in groups 5 - Interpersonal psychotherapy (IPT) and related approaches - Communication analysis and interpersonal skills 4 - IPT problem areas and structure 4 - Psychodynamic psychotherapy fundamentals - Interpretation vs supportive-expressive balance 5 - Transference and countertransference basics 4 - Unconscious processes and conflict 5 - Cognitive-behavioral therapies (CBT/behavioral) - Behavioral interventions 5 - CBT model and case conceptualization 4 - Cognitive techniques 4 - Relapse prevention and maintenance planning 5 - Skills-based CBT variants 4 - Core psychotherapy skills and common factors - Boundaries and frame 5 - Confidentiality in psychotherapy 4 - Empathy, validation, and mentalizing stance 5 - Safety planning and risk in therapy 4 - Therapeutic alliance and engagement 5 - Crisis intervention and brief therapies - Brief solution-focused elements (overview) 3 - Crisis assessment and stabilization 4 - Grief counseling basics 4 - Integration of psychotherapy with pharmacotherapy and systems of care - Measurement-based care in psychotherapy 4 - Referral, coordination, and documentation 4 - Motivational interviewing (MI) - Managing ambivalence and resistance 3 - MI in substance use and adherence 4 - MI spirit and core skills 5 - Supportive psychotherapy - Indications and goals 4 - Strengthening defenses and functioning 4 - Techniques 4 #### Somatic Therapies 87 Nonpharmacologic somatic treatments including ECT and neuromodulation, plus light/chronotherapy and... - Biofeedback, relaxation, and neurofeedback (overview) - Biofeedback modalities 3 - Neurofeedback 4 - Chronotherapy and phototherapy - Bright light therapy 4 - Sleep phase interventions 3 - Wake therapy (sleep deprivation) (overview) 3 - Lifestyle and physical interventions as somatic adjuncts - Exercise and structured activity 4 - Mind-body and breathing interventions 4 - Other neuromodulation therapies - Deep brain stimulation (DBS) and lesioning procedures (overview) 4 - Transcranial direct current stimulation (tDCS) (overview) 3 - Vagus nerve stimulation (VNS) 3 - Electroconvulsive therapy (ECT) - Adverse effects and management 4 - Consent and capacity issues in ECT 4 - Continuation/maintenance ECT planning 4 - Contraindications and medical risk assessment 4 - Indications and patient selection 4 - Procedure basics and stimulus dosing concepts 4 - Informed consent, capacity, and safety systems for somatic treatments - Consent discussions and documentation 4 - Device and procedure adverse event response 5 - Interdisciplinary coordination (anesthesia/medicine) 4 - Repetitive transcranial magnetic stimulation (rTMS) - Adverse effects and monitoring 3 - Contraindications and precautions 5 - Indications and efficacy overview 4 - Protocol parameters (high-level) 3 Psychiatry Advanced Pathway ### Addiction Psychiatry 146 questions #### Assessment, diagnosis, and acute management 39 Comprehensive evaluation of substance-related and addictive disorders, intoxication/withdrawal manag... - Addiction assessment and formulation - Co-occurring psychiatric disorders 4 - Risk assessment 4 - Substance history and severity assessment 4 - Intoxication syndromes and emergency care - Alcohol intoxication and complications 3 - Opioid intoxication and naloxone 4 - Stimulant intoxication 4 - Withdrawal management across substances - Alcohol withdrawal 4 - Opioid withdrawal 4 - Sedative-hypnotic withdrawal 4 - Stimulant withdrawal 4 #### Dual diagnosis and special populations 31 Integrated care for co-occurring disorders and tailored approaches across settings and vulnerable po... - Adolescents and family involvement - Confidentiality and consent in minors (jurisdictional) 4 - School and peer influences 3 - Pain, chronic opioid therapy, and addiction interface - Assessing opioid misuse risk 4 - Nonopioid pain strategies and collaboration 6 - SUD in pregnancy and perinatal period - Alcohol and fetal alcohol spectrum risk counseling 3 - OUD in pregnancy (principles) 4 - SUD with severe mental illness (SMI) - Cannabis and psychosis risk counseling 4 - Integrated treatment models 3 #### Medication treatments and relapse prevention 51 MAT, pharmacotherapies for alcohol/tobacco and other SUDs, and long-term relapse prevention strategi... - Stimulant use disorder treatment (evidence-informed overview) - Contingency management and psychosocial treatments 4 - Medication trials and evidence limitations 4 - Alcohol use disorder (AUD) pharmacotherapy - Acamprosate 4 - Disulfiram 5 - Naltrexone 6 - Off-label agents (overview) 4 - Opioid use disorder (OUD) pharmacotherapy - Buprenorphine treatment principles 4 - Extended-release naltrexone 4 - Methadone treatment principles 5 - Overdose prevention and harm reduction 4 - Tobacco/nicotine use disorder treatment - NRT strategies 4 - Varenicline and bupropion 3 #### Systems of care, ethics, and public health in addiction 25 Harm reduction, policy, recovery supports, and ethical/legal issues in addiction treatment. - Ethical issues in addiction psychiatry - Coercion, mandated treatment, and autonomy 5 - Stigma reduction and language 4 - Harm reduction frameworks - Safer use counseling 4 - Syringe services and supervised consumption (overview) 3 - Recovery supports and continuing care - Mutual-help groups and alternatives 5 - Relapse prevention planning 4 ### Advanced Psychotherapies 78 questions #### Advanced psychodynamic and relational work 15 Transference/countertransference, enactments, ruptures, and supervision-focused competencies. - Interpretation, timing, and working through - Levels of interpretation and patient readiness 4 - Supervision and reflective practice - Using supervision to manage risk and countertransference 4 - Transference/countertransference management in high-intensity cases - Recognizing enactments and maintaining frame 4 - Rupture repair and alliance renegotiation 3 #### Complex trauma therapies and dissociation 21 Treatment planning for complex PTSD, dissociation, and trauma-related comorbidity with safety and pa... - Phase-oriented treatment and stabilization - Safety, grounding, and skills building 6 - Treatment of dissociation 4 - Trauma-focused CBT approaches (overview) - EMDR principles (overview) 3 - Prolonged exposure (PE) / cognitive processing therapy (CPT) principles 4 - Working with complex comorbidity (BPD, SUD, eating disorders) - Sequencing and integrated models 4 #### Group psychotherapy advanced skills 8 Managing complex group dynamics, risk, and therapeutic processes in groups. - Group stages and leadership interventions - Forming/storming/norming/performing (overview) 4 - Risk management in groups - Confidentiality, boundaries, and crisis handling 4 #### Integrative psychotherapy planning and outcomes 12 Selecting, sequencing, and combining modalities with medications and systems supports; measuring out... - Outcome measurement and feedback-informed therapy - Routine outcome monitoring 3 - Case formulation-driven modality selection - Managing nonresponse and dropout risk 4 - Matching problems to mechanisms 5 #### Therapy for personality pathology and chronic risk 22 Advanced modality selection and management of therapy-interfering behaviors, chronic suicidality, an... - Schema therapy (overview) - Modes and schemas 3 - Mentalization-based therapy (MBT) and transference-focused therapy (TFP) (overview) - MBT principles 4 - TFP principles 5 - Dialectical behavior therapy (DBT) advanced applications - DBT hierarchy and consultation team model 3 - Managing chronic suicidality ethically and effectively 4 - Skills generalization and behavioral chain analysis 3 ### Child Psychiatry 175 questions #### Developmentally informed assessment and formulation 42 Advanced child/adolescent assessment integrating development, family systems, school context, and sa... - Developmental history and milestones in psychiatric assessment - Attachment and caregiving environment assessment 4 - Multi-informant and multi-setting symptom synthesis 5 - Prenatal/perinatal and early development factors 4 - School functioning and learning assessment 3 - Risk assessment: self-harm, aggression, and vulnerability - Aggression and conduct risk assessment 5 - Substance use and exploitation risks 4 - Suicide/self-harm assessment in adolescents 5 - Safeguarding, abuse, and trauma in youth - Mandatory reporting and interagency work 4 - Recognizing abuse/neglect indicators 4 - Trauma-focused assessment and stabilization 4 #### Disruptive behavior disorders and youth forensic interfaces 32 ODD/CD management, aggression, and systems work with schools and juvenile justice. - School refusal and complex functional impairment - Anxiety-based vs depression vs environmental causes 4 - Reintegration planning 4 - Youth violence, threats, and risk management - Legal/ethical considerations in youth risk cases 5 - Threat assessment principles 5 - Oppositional defiant disorder and conduct disorder - Differential and comorbidity 5 - Evidence-based psychosocial treatments 5 - Medication for aggression (careful, targeted) 4 #### Eating disorders and other specialized youth presentations 23 High-risk pediatric syndromes requiring medical coordination and specialized interventions. - Somatic symptom and functional disorders in youth - School and family systems management 4 - ARFID and feeding problems - Differential and comorbidity 3 - Multidisciplinary management 4 - Anorexia nervosa and medical instability - Assessment of medical risk 4 - Family-based treatment principles (FBT) 4 - Pharmacotherapy caveats 4 #### Mood, anxiety, and psychotic disorders in youth 37 Age-specific diagnosis and treatment integration for internalizing and psychotic disorders. - Bipolar disorder and severe irritability differentials - DMDD vs bipolar disorder vs ADHD/ODD 4 - Mood stabilizers/antipsychotics in youth (principles) 3 - Early-onset psychosis - Assessment and medical workup 5 - Family psychoeducation and functional support 4 - Anxiety disorders and OCD in children - Exposure-based therapy with developmental adaptations 4 - SSRI use in pediatric anxiety/OCD 4 - Depression and suicidality in adolescents - Antidepressant use and monitoring 4 - Differential diagnosis and medical mimics 5 - Psychotherapy integration 4 #### Neurodevelopmental disorders and complex presentations 41 Advanced management of ADHD, ASD, intellectual disability, learning disorders, and comorbid psychiat... - Intellectual disability and developmental syndromes - Challenging behavior management 4 - Diagnostic overshadowing and communication adaptations 4 - Tic disorders and Tourette syndrome - Behavioral treatments 4 - Comorbid ADHD/OCD/anxiety 4 - ADHD across development and comorbidity - Behavioral/parent training and school accommodations 4 - Differential diagnosis and comorbidities 3 - Medication management and monitoring 5 - Autism spectrum disorder (ASD) with comorbid psychiatric symptoms - Assessment of irritability, anxiety, and depression in ASD 4 - Behavioral interventions and family support 5 - Pharmacotherapy for target symptoms 4 ### Community Psychiatry 69 questions #### Integrated and collaborative care models 18 Primary care integration, collaborative care, and population-based management of common mental disor... - Integrated care for SMI in primary care - Metabolic monitoring and preventive care coordination 4 - Telepsychiatry and digital mental health in community care - Access, equity, and safety 3 - Blended care models 3 - Collaborative care model (CoCM) fundamentals - Stepped care and consultation strategies 4 - Team roles and measurement-based care 4 #### Public mental health, prevention, and crisis systems 19 Population approaches, crisis response, and cross-sector collaboration including homelessness and di... - Disaster psychiatry and community trauma response - Psychological first aid and early interventions 3 - Crisis services continuum - Involuntary care in community context 4 - Mobile crisis, crisis lines, stabilization units 4 - Homelessness and serious mental illness - Engagement strategies 4 - Housing resources and interagency work 4 #### Recovery-oriented systems of care 24 Service organization, recovery models, rehabilitation, and multidisciplinary community-based practic... - Assertive community treatment and intensive case management - ACT/FACT model components 3 - Risk management in community settings 5 - Recovery principles and shared decision-making - Hope, agency, strengths-based approaches 5 - Peer support and lived experience roles 4 - Rehabilitation and supported housing - Supported employment/education 4 - Supported housing models 3 #### Resource stewardship and quality in community services 8 Managing demand, prioritization, quality improvement, and ethical distribution of care resources. - Quality improvement in community teams - Outcome measures and service metrics 4 - Waitlist management and triage ethics - Prioritization based on risk and need 4 ### Consultation-Liaison Psychiatry 135 questions #### Assessment of psychiatric symptoms in medically ill patients 41 Diagnostic reasoning and management when psychiatric symptoms arise in the context of medical illnes... - Delirium and acute encephalopathy in hospital settings - Evaluation and workup coordination 5 - Management strategies 4 - Risk factors and precipitants 4 - Depression, anxiety, and adjustment in medical illness - Brief psychotherapeutic interventions in hospital 4 - Differential: demoralization, grief, delirium, medication effects 5 - Pharmacotherapy in medically ill 5 - Psychosis and mania secondary to medical causes - Autoimmune/infectious etiologies 4 - Endocrine/metabolic causes 5 - Medication-induced psychosis/mania 5 #### Capacity, ethics, and behavior management in hospitals 36 Capacity evaluations, refusal of care, agitation, and complex ethical interfaces in general hospital... - Agitation management in medically ill and ICU - Medication strategies and medical safety 4 - Nonpharmacologic strategies 5 - Restraints ethics and safety 4 - Capacity evaluations and informed consent in medical settings - Refusal of treatment and AMA discharge 4 - Task-specific capacity in acute illness 3 - Liaison skills and consultation effectiveness - Consult note structure and recommendations 4 - Interprofessional communication and conflict management 4 - Somatic symptom, functional, and medically unexplained symptoms - Communication of diagnosis and alliance with teams 3 - Treatment approaches 5 #### Psychopharmacology in complex medical illness 35 Selecting and dosing psychotropics in organ dysfunction, drug interactions, QTc risk, and special me... - Neuropsychiatry in acute neurologic illness (interface) - Seizures, postictal states, and psychosis 5 - Stroke, TBI, and behavioral complications 4 - Transplant, oncology, and immunosuppression contexts - Drug interactions with calcineurin inhibitors/chemo agents (overview) 6 - Steroid neuropsychiatric effects 3 - Psychotropics in hepatic and renal impairment - Dose adjustment principles and monitoring 4 - Hepatic enzyme induction/inhibition in hospital 4 - QTc prolongation and cardiac safety - High-risk medications and additive risks 5 - Managing agitation in cardiac/respiratory disease 4 #### Specialty consultation scenarios 23 High-yield consultation scenarios often tested in advanced exams (perioperative, ICU, pregnancy in h... - Perioperative psychiatry and anesthesia interactions - Continuing vs holding psychotropics perioperatively 4 - Postoperative delirium prevention 4 - Psychiatric issues in ICU - Acute stress reactions and PTSD prevention (evidence limits) 4 - ICU delirium and sedation strategies (overview) 4 - Capacity and ethics in refusal of life-sustaining treatment - Consultant role boundaries 3 - Decisional capacity and values clarification 4 ### Forensic Psychiatry 118 questions #### Civil forensic evaluations 20 Common civil evaluations and medico-legal opinions in psychiatric practice. - Personal injury and PTSD claims (overview) - Causation and differential diagnosis 4 - Disability and functional impairment assessments - Functional assessment and causation issues 4 - Capacity evaluations (civil) - Financial capacity and undue influence 4 - Parenting capacity and child custody (overview) 4 - Treatment capacity and informed consent 4 #### Core forensic principles and the psychiatrist’s role 37 Foundations of forensic practice, objectivity, ethics, and legal standards relevant to psychiatric e... - Forensic ethics and dual-agency problems - Objectivity and bias mitigation 4 - Professional conduct and scope 4 - Treating vs evaluating roles 4 - Legal standards and psychiatric evidence - Civil commitment and risk thresholds (principles) 4 - Competence/fitness concepts (criminal) 4 - Criminal responsibility/insanity standards (overview) 4 - Report writing, testimony, and communication - Expert testimony skills 4 - Forensic report structure 5 - Record review and collateral standards 4 #### Criminal forensic evaluations and correctional psychiatry 20 Evaluations and treatment considerations in criminal justice settings. - Correctional mental health care - Medication management and diversion risk 4 - Standards of care and resource constraints 4 - Insanity/criminal responsibility evaluations - Mental state at time of offense reconstruction 3 - Fitness to stand trial / competency evaluations - Assessment of understanding and ability to assist counsel 5 - Restoration approaches (overview) 4 #### Malingering, deception, and symptom validity 13 Recognition and management of feigned symptoms in forensic and clinical contexts. - Symptom validity testing (overview) - Performance and response validity principles 4 - Malingering vs factitious disorder vs genuine illness - Interview strategies and collateral verification 5 - Motivation and context 4 #### Violence and risk assessment 28 Structured approaches to assessing and managing violence, sexual offending risk, and self-harm risk... - Sexual offending risk (overview) - Paraphilic disorders vs illegal behavior 4 - Risk management and treatment options (overview) 4 - Suicide risk in custody and secure settings - Documentation and communication with custodial staff 4 - High-risk periods and environmental risks 3 - Violence risk assessment methods - Actuarial tools (overview) 4 - Static and dynamic risk factors 5 - Structured professional judgment (SPJ) principles 4 ### General Adult Psychiatry 158 questions #### Complex anxiety, trauma, and somatic symptom presentations 31 Advanced formulation and treatment planning for comorbid, chronic, and refractory anxiety/trauma/som... - Somatic symptom, illness anxiety, and functional disorders in adult psychiatry - Collaborative formulation with medical teams 4 - Psychotherapy approaches 4 - Complex PTSD, dissociation, and comorbidity - Differential: BPD, psychosis, neurocognitive disorders 3 - Medication considerations in PTSD 4 - Phase-based trauma treatment planning 4 - Refractory OCD and related disorders - ERP optimization and adherence barriers 4 - Neuromodulation options (overview) 3 - Pharmacologic optimization 5 #### Complex mood disorders and treatment resistance 45 Advanced longitudinal management of depressive and bipolar disorders with comorbidity and nonrespons... - Complex grief and prolonged grief disorder - Differential with MDD/PTSD 4 - Evidence-based psychotherapy approaches (overview) 3 - Complex bipolar disorder management - Bipolar depression strategies 4 - Comorbid anxiety/substance use in bipolar disorder 3 - Peripartum bipolar risk management 5 - Rapid cycling and mixed features 3 - Treatment-resistant depression (TRD) strategies - Augmentation algorithms 3 - Defining TRD and pseudo-resistance 5 - Managing chronic suicidality in depression 5 - Neuromodulation and rapid-acting interventions 5 - Sequencing and switching strategies 5 #### Personality pathology and high-risk longitudinal care 29 Advanced management of personality disorders, chronic suicidality, and therapy-interfering behaviors... - Antisocial traits and violence risk in general adult practice - Assessment of violence risk and criminogenic needs (overview) 4 - Boundary setting and team splitting management 4 - Borderline personality disorder: high-risk care pathways - DBT-informed care principles (overview) 4 - Medication use and deprescribing in BPD 5 - Risk management without reinforcing crises 4 - Complex comorbidity and polypharmacy stewardship - Comorbidity patterns and prioritization 5 - Polypharmacy risk mitigation 3 #### Psychotic disorders, complexity, and recovery 35 Treatment-resistant psychosis, clozapine optimization, comorbidity, rehabilitation, and relapse prev... - Negative symptoms and cognitive impairment management - Differential of negative symptoms 3 - Psychosocial interventions for functional recovery 4 - First-episode psychosis (FEP) and early intervention models - Duration of untreated psychosis (DUP) reduction 3 - Stage-based care and recovery outcomes 3 - Psychosis with comorbid substance use - Differentiating substance-induced vs primary psychosis longitudinally 3 - Integrated dual diagnosis treatment 4 - Treatment-resistant schizophrenia and clozapine optimization - Clozapine augmentation (selective and cautious) 4 - Clozapine titration and side-effect management 4 - Identifying TRS and timing of clozapine 3 - Managing nonadherence and LAI strategies 4 #### Systems-based adult psychiatry and relapse prevention 18 Care planning across settings, rehabilitation, measurement, and multidisciplinary work. - Measurement-based care in complex adult cases - Selecting measures and tracking outcomes 5 - Rehabilitation and recovery-oriented practice - Social determinants interventions (housing, benefits) 3 - Supported employment/education 3 - Relapse prevention planning across disorders - Early warning signs and crisis plans 3 - Family involvement and psychoeducation 4 ### Leadership And Scholarship 131 questions #### Advocacy, policy, and professional identity 14 Advocacy for patients and populations, policy literacy, and maintaining professional wellbeing and s... - Mental health policy literacy (overview) - Financing, parity, and service design concepts 3 - Advocacy for mental health equity - Social determinants and structural stigma 3 - Professional wellbeing and sustaining a career - Burnout prevention and boundaries 4 - Ethics in leadership roles 4 #### Clinical leadership and service management 20 Leadership competencies for psychiatrists, including team management, change leadership, and resourc... - Change management and implementation - Implementation science basics 3 - Leadership styles and team dynamics - Interdisciplinary teamwork and delegation 5 - Situational leadership and psychological safety 3 - Quality, safety, and governance in mental health services - Clinical governance and incident review 5 - Risk management at service level 4 #### Education, supervision, and assessment 17 Teaching skills, curriculum design, supervision, and assessment aligned with competency frameworks. - Curriculum and exam blueprint literacy - Learning objectives and alignment 3 - Clinical teaching and feedback - Bedside/clinic teaching models 4 - Feedback and remediation 3 - Supervision and trainee assessment - Entrustment and graded responsibility 3 - Workplace-based assessments (overview) 4 #### Quality improvement, safety, and systems-based practice 60 QI methodology, patient safety event analysis, guideline implementation, stewardship, and leading te... - Research methods, teaching, and leadership - Ethics, IRB, and dissemination 3 - Feedback, coaching, and assessment 3 - Leadership in clinical teams 4 - Research design and statistics (advanced overview) 4 - Teaching skills and curriculum design 3 - Resource stewardship and guideline implementation - Antimicrobial stewardship programs (systems level) 2 - Choosing tests and treatments wisely (value-based care) 3 - Clinical pathways and standardization 2 - Health informatics and clinical decision support (overview) 4 - Implementation science basics (overview) 2 - Patient safety science and event analysis - High reliability organization principles 3 - Human factors and systems thinking 3 - Medication safety and diagnostic safety initiatives 5 - Root cause analysis (RCA) and action planning 3 - Safety event reporting and just culture 3 - Quality improvement (QI) methods and measurement - Building an aim statement and driver diagram 3 - Equity in QI 2 - Measurement for improvement 3 - PDSA cycles and iterative testing 3 - Sustainability and reliability 2 #### Scholarship, research methods, and critical appraisal (advanced) 20 Designing, appraising, and translating research; research governance and ethics. - Knowledge translation and guideline development (overview) - From evidence to practice 3 - Advanced critical appraisal and statistics (applied) - Causal inference and confounding control (overview) 5 - Interpreting complex trial designs 4 - Research ethics and integrity - Human subjects protections 4 - Open science and reproducibility (overview) 4 ### Old Age Psychiatry 134 questions #### Capacity, legal, and ethical issues in geriatric psychiatry 29 Capacity, guardianship, elder abuse, driving, and end-of-life interfaces. - Driving and firearm safety in dementia - Functional assessment and counseling 3 - End-of-life psychiatry and palliative care interface - Delirium near end of life 3 - Depression vs demoralization; existential distress 4 - Guardianship and substitute decision-making (principles) - Least restrictive alternatives 4 - Capacity evaluations in older adults - Financial and medical decision capacity 3 - Testamentary capacity (overview) 4 - Elder abuse, neglect, and self-neglect - Ethical tensions: autonomy vs protection 4 - Recognition and reporting pathways 4 #### Late-life mood, anxiety, and psychotic disorders 33 Diagnostic complexity and medication safety considerations in geriatric psychiatry. - Late-life anxiety disorders - Benzodiazepine risk and alternatives 3 - Somatic symptom overlap in older adults 4 - Late-onset psychosis and delusional disorder - Antipsychotic dosing and monitoring in older adults 3 - Differential: dementia, delirium, sensory impairment 5 - Sleep disorders in later life - Insomnia, circadian shifts, and sleep apnea 4 - REM sleep behavior disorder and neurodegeneration 4 - Late-life depression and suicidality - Differential and medical comorbidity 4 - Treatment strategies and safety 6 #### Neurocognitive disorders and differential diagnosis 57 Dementia syndromes, mild cognitive impairment, reversible causes, and diagnostic workup in later lif... - Neuropsychiatric presentations of neurologic disease - Parkinson disease psychosis and depression 5 - Stroke and post-stroke depression 5 - Alzheimer disease and related dementias (ARD) - Alzheimer disease clinical course 4 - Dementia with Lewy bodies 2 - Frontotemporal dementia 4 - Vascular cognitive impairment 4 - Behavioral and psychological symptoms of dementia (BPSD) - Assessment of triggers and unmet needs 4 - Nonpharmacologic interventions 4 - Pharmacologic interventions and risk mitigation 4 - Delirium in older adults - Management of agitation in delirium 4 - Recognition and prevention 4 - Major and mild neurocognitive disorder assessment - Cognitive testing and interpretation 4 - History, collateral, and functional assessment 4 - Workup for reversible/secondary causes 5 #### Systems of care and polypharmacy in older adults 15 Care pathways across community, hospital, and residential settings; minimizing harms from complex me... - Long-term care and BPSD management systems - Interdisciplinary care planning 4 - Transitions of care 3 - Polypharmacy and medication safety - Anticholinergic burden and deprescribing 4 - Psychotropic monitoring in frailty 4 ### Special Populations 396 questions #### Advanced Special Population Integration 14 Category placeholder to maintain structure; see 'Special Populations (Advanced)' domain set above. - Integrated advanced special populations review - Critically ill neonate/child 3 - Geriatric frailty and anticoagulation complications 3 - High-risk pregnancy emergencies 3 - Immunocompromised/oncology emergencies 3 - Palliative and end-of-life care 2 #### Cultural, linguistic, and refugee mental health 17 Culturally safe care, interpreter use, trauma and displacement, and diagnostic adaptations. - Refugee trauma and complex needs - Care coordination with social/legal supports 5 - Pre-, peri-, post-migration stressors 4 - Cultural formulation and culturally bound expressions - Eliciting explanatory models 5 - Interpreter-mediated assessments 3 #### Geriatrics and Frailty (Core) 31 Atypical presentations, falls, delirium, polypharmacy, and disposition safety in older adults. - Atypical presentations and geriatric assessment - Atypical infection/ACS presentations 3 - Delirium recognition 3 - Disposition safety 3 - Frailty and functional assessment 4 - Polypharmacy and adverse drug events 3 - Falls and trauma in older adults - Disposition and safeguarding 3 - Head injury on anticoagulants 3 - Hip and pelvic fractures 4 - Rib fractures and respiratory compromise 2 - Syncope vs mechanical fall differentiation 3 #### High-Risk and Under-Served Groups (Advanced) 34 Clinical care tailored to specific physiologic and social contexts. - Care of patients with advanced cancer and comorbidities - Complications of therapy affecting other organs 4 - Decision-making under limited prognosis 2 - Infection risk management 4 - Transitions to hospice 3 - Patients with serious mental illness - Capacity and adherence challenges 3 - Delirium vs psychiatric symptom overlap 2 - Metabolic monitoring for antipsychotics 2 - Suicide risk in medical illness 3 - Patients with substance use disorders and complex illness - Hospital-based addiction care 3 - Infections related to injection drug use 3 - Pain management with OUD 3 - Trauma-informed care 2 #### Immunocompromised Patients (Core) 26 Oncology, transplant, HIV, and iatrogenic immunosuppression presentations and ED priorities. - Oncologic and therapy-related complications (intro) - Disposition 2 - Immunotherapy adverse events awareness 3 - Spinal cord compression awareness 3 - Thrombosis/PE risk in cancer 3 - Tumor lysis syndrome awareness 2 - Fever in immunocompromised patients - Disposition 2 - HIV and opportunistic infection awareness 3 - Neutropenic fever 2 - Steroid/biologic immunosuppression 3 - Transplant patient infection risk 3 #### Intellectual disability, autism, and communication differences 18 Adapting assessment and treatment for neurodevelopmental and cognitive differences across lifespan. - Challenging behavior and risk management - Positive behavior support planning 4 - Psychotropic use: target symptoms and monitoring 3 - Diagnostic overshadowing and medical contributors - Communication-adapted interviewing 6 - Pain, constipation, seizures, sleep problems 5 #### LGBTQ+ and gender-related mental health care 16 Affirming assessment, minority stress, gender dysphoria-related care principles, and psychiatric com... - Gender dysphoria care principles (within psychiatrist scope) - Assessment and comorbidity evaluation 4 - Collaborative care with gender-affirming services 5 - Minority stress and stigma-related mental health risks - Assessment of discrimination, violence, and support 4 - Suicide risk and protective interventions 3 #### Pediatrics 80 Age-specific assessment, stabilization, and high-risk pediatric presentations. - Febrile infant and pediatric sepsis (foundational) - Disposition 4 - Empiric antibiotics 5 - Initial evaluation 4 - Pitfalls 3 - Risk stratification concepts by age 4 - Pediatric assessment and physiology essentials - Age-adjusted vitals and shock recognition 4 - Fever and serious bacterial infection risk 5 - Pain assessment and analgesia 3 - Pediatric airway differences 4 - Safeguarding basics 5 - Pediatric dehydration and GI illness - Assessment of dehydration 4 - Disposition 3 - Electrolyte derangements awareness 4 - Oral rehydration therapy (ORT) 4 - When to suspect surgical abdomen 5 - Pediatric respiratory distress syndromes - Bronchiolitis 4 - Croup 4 - Disposition and family counseling 3 - Foreign body aspiration 3 - Pediatric asthma 5 #### Perinatal and reproductive psychiatry 16 Assessment and treatment planning around pregnancy, postpartum, lactation, and reproductive transiti... - PMDD and reproductive transitions - Diagnosis and treatment overview 4 - Perinatal mood and anxiety disorders - Medication risk-benefit counseling 4 - Safety planning and mother-infant considerations 3 - Screening and differential diagnosis 5 #### Pregnancy and Gynecologic Emergencies (Core) 86 Physiologic changes, early pregnancy complications, and common OB/GYN emergencies in the ED. - Second/third-trimester bleeding (overview) - Disposition and transfer 4 - Pitfalls 4 - Placenta previa/abruption awareness 5 - Postpartum hemorrhage awareness 5 - Preterm labor awareness 6 - First-trimester bleeding and ectopic pregnancy - Complications and pitfalls 5 - Disposition 4 - Initial evaluation 4 - Management pathways 5 - Ultrasound interpretation (conceptual) 4 - Hypertensive disorders of pregnancy (core) - BP management principles 3 - Disposition 3 - HELLP syndrome awareness 3 - Magnesium sulfate therapy 3 - Preeclampsia/eclampsia recognition 5 - Pregnancy physiology and ED implications - Cardiovascular/respiratory changes 5 - Disposition and follow-up 4 - Laboratory and imaging considerations 6 - Resuscitation modifications 4 - Trauma considerations 4 #### Safeguarding, Social Determinants, and Vulnerable Groups 42 Discharge planning and safety for patients with social vulnerability or safeguarding needs. - Homelessness, substance use, and high-utilization care - Behavioral health comorbidity 4 - Documentation and ethical considerations 2 - Harm reduction in ED 2 - Linkage to care and follow-up 3 - Medical risks and barriers 3 - Patients with disabilities and communication barriers - Capacity and consent considerations 2 - Communication accommodations 2 - Discharge planning 2 - Pitfalls 3 - Safeguarding and abuse risk 2 - Domestic violence and sexual assault (core) - Forensic pathways awareness 3 - Mandatory reporting (contextual) 3 - Medical care essentials 4 - Safety planning and resources 4 - Trauma-informed care 3 #### Severe psychosocial vulnerability and marginalized contexts 16 Homelessness, incarceration, HIV, chronic pain, and other contexts requiring adapted and equitable c... - HIV and neuropsychiatric complications - Depression, cognitive impairment, medication interactions 5 - Incarcerated individuals and reentry planning (overview) - Continuity of care and medication access 3 - Chronic pain and opioid risk - Integrated pain and mental health care 4 - Homelessness and serious mental illness - Engagement and harm reduction 4 [ View Psychiatry ](https://mdster.com/speciality/psychiatry) [ View pricing ](https://mdster.com/pricing) [ MDster home ](/ "MDster home") Master your medical exams with evidence-based learning. 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