Mastering the cognitive knowledge within a field such as psychiatry is a formidable task. It is even more difficult to draw on that knowledge, procure and filter through the clinical data, develop a differential diagnosis, and finally form a rational treatment plan. To gain these skills, the student often learns best by directly interviewing patients, guided and instructed by experienced teachers and inspired toward self-directed, diligent reading. Clearly, there is no replacement for education at the patient’s side. Unfortunately, clinical situations usually do not encompass the breadth of the specialty. Perhaps the best alternative is to prepare carefully crafted cases designed to simulate the clinical approach and decision making. In an attempt to achieve this goal, we have constructed a collection of clinical vignettes to teach diagnostic or therapeutic approaches relevant to psychiatry. Most important, the explanations for the cases emphasize mechanisms and underlying principles rather than merely rote questions and answers.