Goals and Objectives:

The training during the second post graduate year provides residents with experience in a wide diversity of clinical settings to enhance their clinical skills and knowledge base. Experiences include a child psychiatry rotation, an emergency psychiatry rotation, additional inpatient psychiatry, ECT, consultation-liaison psychiatry, and geriatric psychiatry. This variety of treatment settings will enhance their abilities to gather and organize date, integrate these data within a comprehensive formulation of the problem to support a well-reasoned differential diagnosis, formulate a treatment plan, and implement treatment and follow-up as indicated. The training provides residents with further opportunities to develop knowledge, clinical skills, sensitivity to cultural diversity and professional principles.

PGY- II residents will rotate at ECRH, the VA and at GRHS for these experiences. Educational objectives will include: 1) performing a complete initial psychiatric history and developing a coherent formulation and treatment plan for children and adolescents; 2) provide emergency psychiatric consultation as part of an organized psychiatric emergency service; 3) perform high quality consultation to the medical-surgical services of an acute care hospital; 4) perform on a geriatric psychiatric service with significant medical and psychiatric comorbidity; 5) continue to emphasize the importance of relating to patients and their families, as well as other members of the health care team, with compassion, respect, and professional integrity.

Core Competencies:

A. Knowledge: Residents will learn to provide competent care to patients with broad range of psychiatric disorders in a variety of treatment settings. Particular emphasis will be on psychiatric disorders of children and adolescents, substance abuse disorders, geriatric psychiatry, C-L psychiatry, Emergency room consultation, patients receiving ECT, and community mental health/correctional psychiatry. Patients of a variety of age groups, ethnicity, and of both sexes will be seen.

B. Skills: Residents will become adept at interviewing, history taking, mental status examination, differential diagnosis, treatment planning, diagnostic testing, and recording of findings in the various patient populations detailed above. They will have experiences with a wide array of psychotherapies and psychopharmacologic interventions with particular emphasis on the tailoring of these approaches for the child and adolescent, emergency, geriatric, medically ill, and substance abusing populations.

C. Attitudes: Residents will further consolidate their identities as psychiatrists and will remain committed to the scientific and ethical values that underlie the doctor-patient relationship.

A. Knowledge: Residents will expand their knowledge and learn to diagnose and treat a wide range of psychiatric disorders commonly encountered in the specific patient populations and treatment settings of the PGY-II year. They will expand their knowledge of the etiologies, prevalence, diagnosis, treatment, and prevention of all major psychiatric disorders seen in these settings. They will also continue to enhance their ability to understand research methods and to critically appraise the professional and scientific literature.

B. Skills: Resident wills become more skilled at applying their knowledge of psychiatric illness to particular clinical populations and settings, both as direct providers of care and as consultants. They will learn the skills to function effectively as a consultant to the medical-surgical floors and the physicians and patients seen there. They will develop excellent working knowledge of numerous psychotherapies and of somatic treatments utilized in the children, geriatrics, substance abuse, C-L, emergency, and community settings.

C. Attitudes: Residents will understand and appreciate the value and role of a strong knowledge base in the provision of comprehensive psychiatric care and consultation.

A. Knowledge: Residents will become increasingly familiar with the fundamentals of general psychiatry so that they can engage effectively in life-long learning.

B. Skills: Residents will practice their skills at dealing effectively with complex psychiatric illness through clinical reading and expert consultation.

C. Attitudes: Residents will continue in their development an appreciation of the value of life-long learning for competent patient care.

A. Knowledge: Residents will learn clinical techniques to insure respectful and ethical interactions between patients and colleagues, especially in the emergency room and C-L settings.

B. Skills: Residents will have the opportunity to develop their interpersonal and communication skills in didactic seminars, in supervision, and in the clinical setting.

C. Attitudes: Residents will further develop an appreciation of the value of interpersonal and communication skills for assurance of ethical and effective patient care.

A. Knowledge: Residents will study and receive mentorship in professionalism and ethical behavior in psychiatric practice as they apply to each of the specialized clinical settings they will encounter.

B. Skills: Psychiatric residents will develop their professional skills by interacting with their colleagues and supervisors, and to learn to practice psychiatry in accordance with professional norms.

C. Attitudes: Residents will develop a further appreciation of the value of professional and respectful treatment of patients and colleagues in all clinical settings.

A. Knowledge: Residents will learn about the importance of approaching patient care in a systems-oriented way, with particular attention to the challenges of promoting access of patients (regardless of socioeconomic status) to high-quality mental health services in both the public and private sectors. 

B. Skills: Residents will develop their skills at working ethically in various psychiatric contexts and clinical settings by discussing and participating in clinical cases that raise issues related to health-care systems. 

C. Attitudes: Residents will develop an increased appreciation of the value of thinking about various systems (such as managed care) insofar as they relate to the provision of ethical patient care in psychiatry.