Academic Program
The general psychiatry residency program is an accredited four year training program leading to eligibility for specialty certification by the American Board of Psychiatry and Neurology. The program is approved for 32 residency positions during the four years of training including typically 8 residents in each of the first two years. Most physicians enter this program in the first year of postgraduate training (PGY-1). This year includes six months of inpatient primary care (four months of internal medicine and two months of neurology) to meet the requirements of the American Board of Psychiatry and Neurology. There are occasionally a limited number of PGY-2 positions available for physicians who have already completed a PGY-1 year that included a minimum of four months of medicine, pediatrics or family practice. The residency is broadly based. Training covers the range of subject areas in contemporary psychiatry from the neurosciences to psychodynamic and psychoanalytic perspectives. We include special attention to cross cultural, ethnic and gender issues as they relate to diagnosis, treatment and the psychiatrist-patient relationship. There are both didactic and clinical assignments dealing with cognitive therapy, behavior therapy and treatment approaches involving the family and groups. In addition, the program places strong emphasis on the biopsychosocial model, and on providing resident familiarity with managed care, public service, and private practice psychiatric settings. The department continues to draw on a multi-disciplinary faculty from the various hospitals and graduate divisions for a depth and breadth that gives our residents a comprehensive education.
In addition to the clinical rotations, all residents attend a seminar series, a number of case conferences, journal club, and grand rounds. Residents are also encouraged to serve as clinical supervisors to medical students on the in-patient services and as small group leaders or lecturers in student didactic courses.
The format of the clinical rotations during the four year program is outlined below. (Occasional changes are made when new institutional opportunities become available or when RRC requirements change). The curriculum during each of the four years of training provides for both clinical and didactic experiences designed to enhance the residents’ skill and knowledge in working with patients presenting in a variety of different health care settings.
The contents of the clinical and didactic work of the training program is intentionally eclectic. When a resident graduates he or she will have had the requisite training to be proficient in diagnosis and treatment planning
Rotations
Year 1
The first postgraduate year comprises a minimum of four months in general internal medicine and two months in neurology. Resident applicants with a specific interest in child psychiatry may sometimes arrange four months in pediatrics. A PGY-1 resident may request more medicine or neurology and can use elective time for this purpose. Both medicine and neurology are inpatient training experiences and psychiatry interns are expected to function on a par with medicine and neurology interns. The inpatient internal medicine rotation is designed to enhance the residents’ knowledge and skill in managing acutely medically ill patients, providing after care for patients discharged following an acute medical or surgical illness, treating patients with chronic illness or illnesses on an outpatient basis, and handling acute medical emergencies. The inpatient neurology services provide additional basic medical training as well as specific training in diagnosing and managing major neurological disorders. These rotations are held at Hahnemann University Hospital. The remaining six months of the PGY-1 year are spent in psychiatry rotations on the in-patient services at Emergency Psychiatry at Friends Hospital. The first in-patient psychiatry rotation provides an introduction to the diagnosis and treatment of adults with serious mental disorders requiring hospitalization. Note that a PGY-1 year can begin with either the psychiatry or medicine and neurology rotations. Teaching rounds on internal medicine/neurology include morning report, house staff work rounds, teaching rounds with attending physicians, a core didactic seminar program, clinical pathological conferences, morbidity and mortality conferences and a journal club.
Rotation on the psychiatric in-patient units include individual supervision with the unit chief, and, when available, a fourth year resident and group supervision regarding group dynamics. Goals and objectives of the first post graduate psychiatry experience include mastering history taking and related interviewing, physical examination skills, emergency psychiatry, major psychiatric syndromes, differential diagnosis, and pharmacological and psychosocial treatment. The six months spent on medicine and neurology help provide the foundation for psychiatric practice. Didactic courses in psychopathology, psychopharmacology and psychiatric interviewing supplement ward supervision and, in addition, introduction to psychodynamic theory is also presented in the PGY-1 year.
Year 2
During the PGY-2 year, residents finish their in-patient experience at Friends Hospital, including a two month in-patient experience in Child Psychiatry, and at Hahnemann University Hospital with a required experience in the PMCU. They do a substance abuse rotation at Eagleville Hospital. They rotate through three months on the psychiatry consultation liaison service at Hahnemann University Hospital. The didactic program in the PGY-2 year includes an advanced literature course in psychopharmacology and didactics in consultation liaison and emergency psychiatry. In addition, the didactics include a nine month Introduction to Psychotherapy course based on the “Missouri modules” curriculum, as well as an overview of psychopathology from a psychodynamic perspective. Rounding out the class schedule are lectures on women and trauma, as well as neuropsychology. The PGY-2 year focuses the resident, under the guidance of experienced attendings and a psychiatric consultation staff, in being able to apply recently acquired psychiatric knowledge to the evaluation and treatment of medically ill patients with psychiatric complications. Residents can begin seeing an outpatient psychotherapy patient as early as the PGY-1 year, if desired, and are required to do so in the PGY-2 year.
Year 3
The major focus of the third year of training is out-patient psychiatry at either Northwest Human Services or Hahnemann University Hospital. Special attention is paid to balancing case loads so that residents receive a broad and comprehensive training and supervisory experience. They receive supervision in both individual and group settings. A concerted effort is made to p |