Clinical Rotation Goals and Objectives

PGY-I Year: Goals and Objectives

The overall goals of the first year of residency are integrative and introductory:  to provide supervised responsibility for assessing and treating a diverse population of psychiatric inpatients on a general psychiatry service as well as foundation in Internal Medicine, Family Medicine and Neurology.  

We expect that by the end of this year residents will have acquired:

• the ability to effectively take comprehensive history from patients and perform complete physical exam.
• summarize the findings and apply it to the case formulation.
• effective communication skills in the context of patient care such as communicating with patients and their families, hospital staff, attending psychiatrists, and outpatient providers.
• understanding at a basic level, the multiple treatment modalities such as psychological, pharmacological, behavioral, physical, and rehabilitative and formulate treatment plan employing these modalities with the supervising attendings.
• the ability to manage acute and subacute medical and neurological conditions in the inpatient setting
• understanding of broad categories of psychiatric illness as per Diagnostics and Statistics Manual V(DSM-V), their evidence-based treatments and prognosis for a variety of psychiatric patients.
• an appreciation of the milieu concept of inpatient psychiatric services.
• an understanding of the responsibilities and roles of other mental health practitioners integrated in treatment team.
• the capacity to assume a leadership role on the treatment team in an inpatient milieu
• the basics of common evidence-based psychotherapies.
• an understanding of vertical integration of clinical practice, incorporating outpatient, partial hospital, and inpatient treatment settings

PGY-II Year: Goals and Objectives

The overall goals of the second year are to continue to build on strong foundation in acute psychiatric services and introducing to ambulatory psychiatric services. These goals are achieved by continuous emphasis in patient care, communication in the context of patient care, advance treatment planning and delivery of treatment, providing more opportunities for leadership and autonomy in patient care, close supervision of residents on a various service such as inpatient emergency management and consultative liaison. These broad, patient-centered experiences are amplified by a didactic program of lectures in psychiatric assessment, treatment, and research.

We expect that by the end of this year residents will have acquired: 

• competency in thorough history taking, performing medical and psychiatric exam, considering bio-psycho-social factors for comprehensive assessments, thorough evidence based treatment planning, advanced communication skills in the context of patient care  to the broad and diverse patients in the acute psychiatric services including Geriatrics, Addiction and Child and Adolescent subspecialty psychiatric services.
• appreciation of the collaborative approach in patient care, various systems of care tied to acute psychiatric services, and ethical and legal questions in the field of psychiatry while delivering treatments. 
• capacity to assume a leadership role on the treatment team.
• knowledge in evidence-based psychotherapy modalities.

PGY-III Year: Goals and Objectives

The goal of this year is to promote residents' development toward independence by providing a comprehensive outpatient experience. In the outpatient setting, residents acquire competencies in more complex, subspecialty outpatient clinics where they are supervised by experts in the assessment and treatment of a variety of disorders, including but not limited to schizophrenia, psychotic disorders, mood disorders, anxiety disorders, drug and alcohol disorders, forensic issues, and sexual disorders. Community collaboration is an essential part of PGY3 experience. This includes collaborating with Mental Health Association, Assertive Community Treatment, Community Support Team, Mobile Crisis, Psychosocial Rehabilitation Services, Peer Support, Alcohol and Drug Services, and NAMI. 

We expect that by the end of this year residents will have acquired: 

• mastery of skills in psychiatric assessment and treatment in subspecialty outpatient settings.
• diagnostic skills in recognizing the psychiatric disorders that complicate medical and surgical conditions, as well as the capacity to provide this information in consultation to physicians in outpatient services.
• a firm grasp on the theoretical concepts/constructs and the practice pitfalls of outpatient psychotherapy both in time-limited symptom-focused and long-term insight-oriented treatment.
• supervised experience in outpatient community clinics.
• a capacity to function as an effective member of a primary-care team in assessing and treating ambulatory medical patients.

PGY-IV Year: Goals and Objectives

The goals of this year are those of completion and depth. Residents enhance mastery of providing a continuum of care by rotating in a community psychiatry intensive outpatient program and more advanced specialty clinics. Residents, through mentorship by faculty, use elective experience to develop advanced experience in a psychiatric subspecialty and to demonstrate how knowledge advances through research and close study. Residents develop communication and teaching skills by presenting their elective work to co-residents and faculty. Finally, an appreciation of psychiatric administration is provided to residents through a weekly meeting with the department director where discussions review the rationale behind past and present responses of the department to the demands of healthcare reform, managed care, and hospital needs.

We expect that by the end of this year residents will have acquired:

• advanced understanding of an elected subspecialty of psychiatry through close faculty mentoring and presentation of scholarly work in that subspecialty.
• understanding of the changing health care environment and of the competencies necessary for success in clinical practice and in other professional leadership roles.
• appreciation of rational approaches to administrative decisions within a system of psychiatric services in the current health care era.
• residents will transition into a leadership role within the health system.