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 provide residents with training and supervision and work with couples, families, and groups. They also receive supervised training with community oriented programs, including day hospitals and community treatment teams. The didactic curriculum places special emphasis on the psychosocial aspects of psychiatry and in psychotherapy and differing psychotherapeutic modalities. Residents receive a course in cognitive behavior therapy and have required supervised treatment experiences, along with an advanced clinical psychopharmacology seminar. There are also opportunities for residents to see out-patients at a college health service and a community mental health service. Residents are typically assigned three to four individual therapy supervisors and have additional regular supervision in group, family and cognitive behavior therapy. There is also a continuous case conference.
Year 4
PGY-4 residents are required to function as senior residents for approximately half their time during three months of their PGY-4 year. This gives them additional experience in the administrative aspects of running a service on an inpatient ward. In addition, PGY-4 residents are required to maintain ten hours per week of long-term out-patients. There are six months of elective time scheduled into the training program. Most residents who wish to use their time for clinical work plan electives during the fourth year, but residents are free to use their elective time at any point in their training after the first year unless they wish to use it for more medicine or neurology. We see the fourth year as an opportunity for the residents to consolidate and expand on knowledge required previously. Electives are available in research, forensic psychiatry, pain management, neuropsychiatry, substance abuse, geriatrics and managed care. Actual PGY-4 programs are individualized after discussion between the trainee and program director.
Conferences
PGY-I SEMINARS
* Acculturation
* Clinical and Administrative Orientation
* Interviewing and Introduction to Psychotherapy
* Psychopathology - Signs and Symptoms, Course, Demographics
* Psychopharmacology - Clinical Use and Safe Effects of Psychotropic Medications
* Introduction to Psychoanalytic Therapy
* Substance Abuse and Treatment
PGY-II SEMINARS
* Advanced Psychopharmacology
* Child Development
* Child Psychopathology
* Consultation - Liaison Psychiatry
* Cross Cultural Psychiatry
* Emergency Psychiatry
* Introduction to Family Therapy
* Introduction to Psychotherapy
* Law and Psychiatry
* Psychological Testing
* Psychodynamic Psychopathology
* Substance Abuse
* Trauma in Women
PGY-III SEMINARS
* Group Therapy
* Psychodynamic Psychotherapy
* Therapeutic Frame
* Cognitive and Behavior Therapy
* Continuous Case Conference
* Human Sexuality
PGY-IV SEMINARS
* Administrative Psychiatry
* Advanced Interviewing
* Fetal Alcohol Syndrome and Fetal Alcohol Effects
* Forensic Psychiatry
* Geriatric Psychiatry
* Hypnosis
* Pain Medicine
* Psychoanalytic Concepts, Techniques & Case Material
* Transition to Practice
* Continuous Case Conference
CONFERENCES
* Inpatient Unit Case Conference
* Departmental Grand Rounds
* Journal Club & Biostatistics
* Monthly Meeting With Residency Director
* Outpatient Clinic Intake Conference
* Continuous Case Conference
* Cognitive Behavioral Therapy Weekly Case Supervision
Research
Research Track
Those with special interest in developing an academic career can apply for admission to this track. All of the required clinical rotations during the PGY-1, 2, 3 years are included, but individualized schedules can be developed which allow concentration on research activities particularly after the PGY-2 year. Clinical and basic research supervision is available from faculty in the departments of Psychiatry, Anatomy, Physiology/Biochemistry and Pharmacology. Residents in this research track are expected to write and submit for publication their research findings. A Chief Resident for Research position is available for interested residents.
Research in the Department of Psychiatry
The Drexel University College of Medicine Department of Psychiatry is nationally known for its academic excellence. At Drexel University College of Medicine, psychiatrists, psychologists and neurochemists collaborate to study a wide variety of psychiatric disorders. Residents are welcomed as collaborators by faculty researchers, and regularly participate in all phases of scientific work, including authorship of publications. Below is an outline of current research in the Department.
Schizophrenia. Schizophrenia research has been a high-priority area in the Department. Major areas of study have included clinical pharmacologic studies of standard and novel antipsychotic drugs; (Silvia Gratz, D.O.).
Mood and Personality Disorders.
Ongoing studies of the use of antidepressant in adolescents (Paul Ambrosini, M.D.) and autism (Richard Malone, M.D.)
Neurochemistry. A neurochemistry research laboratory has been established in the Department of Pharmacology under the direction of Eitan Friedman, Ph.D. Dr. Friedman has focused on identifying neurochemical markers in depression, major mood disorders, OCD, dementia and normal aging.
Cocaine-addicted mothers and infants. There are several research projects (Barbara Schindler, M.D.; Steven Alessandri, Ph.D.) Into the effects of maternal cocaine addiction on functioning of infants and children, comorbid psychiatric disorders, and prevention of cocaine abuse by pregnant women.
Evaluations
Residents are evaluated monthly by their attendings, every six months in outpatient clinic, and by outpatient supervisors. They are required to take the PRITE Residency In-training Examination and, as well, are given mock boards yearly to evaluate their oral examination skills. In addition, residents meet twice yearly with the Director of Residency Training in order to monitor their progress in attaining the goals of the program and their adequately meeting certification requirements for the American Board of Psychiatry and Neurology.
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