Goals and Objectives:

The training obtained during the third postgraduate year should provide residents with the clinical skills and knowledge relevant to the treatment of a wide variety of psychiatric disorders in the outpatient setting. Residents will enhance their skills at conceptualizing illnesses in terms of biological, psychological, and sociocultural factors that determine normal and abnormal behavior. They are taught to gather and organize date, integrate these data within a comprehensive formulation of the problem to sup port a well-reasoned differential diagnosis, formulate a treatment plan, and implement treatment and follow-up as indicated. The training provides residents with the opportunity to develop knowledge, clinical skills, sensitivity to cultural diversity and professional principles.

PGY- III residents will work in both the VA and MCG psychiatric outpatient setting, with a variety of mental health professionals in a multidisciplinary setting. Educational objectives will include 1) performing a complete initial psychiatric history and developing a coherent formulation and treatment plan for outpatient psychiatric practice, 2) function as effective clinicians in outpatient psychotherapy and psychopharmacologic management, 3) provide continuous care of patients with a wide variety of mental illnesses in the outpatient setting , 4) make appropriate referrals to other clinicians and consultants when necessary, 5) perform high quality outpatient consultations to other health care professionals, mental health providers, and community agencies, and 6) relate to patients and their families, as well as other members of the health care team, with compassion, respect, and professional integrity. Experiences in forensic psychiatry, community mental health and substance abuse will also be provided.

Core Competencies:

A. Knowledge: Residents will learn to provide competent outpatient care to patients with a broad range of psychiatric disorders that are commonly encountered in clinical practice. Their patients will include at least 90% adults, at least 20% of whom will be followed for the full year. Their patients will include patients of both sexes and from various ethnic/minority groups. 

B. Skills: Residents will become adept at interviewing, history taking, mental status examination, differential diagnosis, treatment planning, diagnostic testing, and recording of findings. They will have experiences with a wide array of psychotherapies and psychopharmacologic interventions. They will have roles both as direct providers of care and as consultants to other healthcare providers and mental health professionals. 

C. Attitudes: Residents will 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 about the major theories and viewpoints in psychiatry, together with a thorough grounding in the generally accepted clinical facts. They will learn to diagnose and treat a wide range of psychiatric disorders commonly encountered in adults. They will expand their knowledge of the etiologies, prevalence, diagnosis, treatment, and prevention of all major psychiatric disorders in the DSM, including the biological, psychological, and sociocultural, and iatrogenic factors that affect long-term course and treatment of psychiatric illness. They will also enhance their ability to understand research methods and to critically appraise the professional and scientific literature. 

B. Skills: Resident will become more skilled at applying their knowledge of psychiatric illness to particular clinical problems, both as direct providers of care and as consultants. They will develop excellent working knowledge of numerous psychotherapies and of somatic treatments utilized in the outpatient setting. 

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 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 develop 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. 

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 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. 

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 an 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 by discussing and participating in clinical cases that raise issues related to health-care systems. 

C. Attitudes: Residents will develop an 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.