Clinical Rotations and Curriculum

PGY-1

• One month: Emergency medicine

• Two months: Neurology

• Three months: Internal medicine

• Five months: Adult inpatient psychiatry

• One month: Consultation/liaison

PGY-2

• Two months: Partial hospitalization program

• Five months: Adult inpatient psychiatry

• Two months: Child inpatient psychiatry

• Three months: Consult/liaison/emergency psychiatry experience

PGY-3

• Half a month each: Electroconvulsive therapy, forensics, sleep, Community Psychiatry Capstone Clinic, family and couples therapy

• One month: Addictions

• One month: Elective

• Seven months: General outpatient/longitudinal clinic

PGY-4

• One month: Geriatrics

• Two months: Elective

• Eight and a half months: General outpatient/longitudinal clinic

• Half a month: Junior inpatient attending

This rotation is performed at sites connected to the Lebanon VA Hospital system or at the Pennsylvania Psychiatric Institute.

Resident education is provided through individual supervision during the course of patient care. Specific instruction is provided on inpatient detoxification, psychotherapeutic intervention, motivational interviewing and related topics. The Addictions Seminar also occurs during this rotation.

This structured rotation heightens residents’ awareness and recognition of drug and alcohol comorbidity in the psychiatric patient population. Residents spend the majority of their time evaluating new patients and treating program participants with individual or group therapy utilizing a variety of treatment modalities, ranging from short-term dynamic to cognitive-behavioral interventions.

The inpatient adult psychiatry service, based at Pennsylvania Psychiatric Institute (PPI), provides an atmosphere that is conducive to facilitating patient recovery. A therapeutic milieu with a high staff-to-patient ratio is maintained with an intensive treatment program provided by an interdisciplinary team of staff psychiatrists, psychiatric residents, nurses and psychiatric assistants. Care is coordinated with referring therapists, physicians and community agencies to assure maximum community involvement and continuity of care for patients once they are discharged. The facility is also equipped to perform ECT.

Patients are referred through a variety of sources, including inpatient units and emergency department of the “parent” health system (Penn State Health), other hospitals or emergency departments, crisis centers, community agencies, physicians and outpatient therapists.

PPI is the only university-affiliated inpatient psychiatric unit in central Pennsylvania, which provides residents with valuable experience in managing complex cases and dealing with patients from various backgrounds. This is a structured rotation designed to develop residents’ skills in comprehensive multidimensional psychiatric care, including pharmacotherapy, a variety of supportive therapies and acute psychiatric interventions. Residents also participate in family therapy sessions in order to assist patients and their families. Exposure to the forensic side of psychiatry is provided through participation in commitment hearings that take place on site at PPI.

As a supplement to the PPI inpatient rotation, first-year residents also serve a two-month rotation at the VA Lebanon adult inpatient facility, where they have the opportunity to follow patients from initial arrival in the emergency department through admission/discharge. Second-year residents may spend up to two months at the inpatient psychiatry unit at Penn State Health Holy Spirit Hospital in Camp Hill, Pa.

The inpatient child psychiatry service is located within Pennsylvania Psychiatric Institute. The unit serves 27 counties in Pennsylvania, including urban, suburban and rural populations. Two child psychiatry fellows and rotating medical students are also assigned to this unit. Mental health professionals within the Division of Child and Adolescent Psychiatry provide diagnostic and therapeutic services for children whose problems range from mild behavioral difficulties to severe psychiatric illness.

Residents work with an interdisciplinary team of staff psychiatrists, psychologists, social workers and nurses. Residents also actively participate in daily individual and group psychotherapy, family therapy, recreational therapy and psychopharmacological treatment. Emphasis is placed on gaining new perspectives on psychopathology across the life cycle.

By the end of rotation, the residents are competent to appreciate the structure of a comprehensive psychiatric evaluation for the child or adolescent patient and to understand how this differs from an adult psychiatric assessment.

The Community Psychiatry Capstone Clinic, located at the Division Street outpatient clinic of Pennsylvania Psychiatric Institute, focuses on an underserved and diverse population with severe, persistent mental illness, and provides interventions designed to reduce hospitalizations and maximize functioning in the community.

The program is designed for patients between 16 and 30 years old who have experienced their first episode of psychotic symptoms within the past two years. The clinic utilizes a coordinated specialty care model, with an interdisciplinary team providing comprehensive and early intervention for patients with early psychotic illness. Treatment modalities available include medication management, individual psychotherapy, family therapy, peer support, case management and supported education and employment. The approach to treatment is recovery-oriented, with an emphasis on shared decision-making and aligning with patients to work toward personal goals.

Residents assigned to this clinic rotate one half-day per week for three months during their PGY-3 or PGY-4 year of residency. Resident education is provided through directly supervised evaluation and treatment of patients and participation as part of a multi-disciplinary team in weekly team meetings. During the rotation, residents gain knowledge in psychopharmacological strategies for treating first-episode psychosis and about the use of long-acting injectable antipsychotics.

Consultation services for adult patients are provided to all clinical departments at Penn State Health Milton S. Hershey Medical Center, including critical care, internal medicine, general surgery, transplant surgery, plastic surgery, oncology, endocrinology, neurosurgery, neurology, obstetrics and gynecology and family and community medicine.

On this service, the psychiatric resident works closely with faculty and residents in other departments. The goal of each consultation is to offer practical recommendations that assist consulting physicians, residents and nursing staff in caring for their patients.

Medical students rotating in psychiatry are also part of the consult team, where residents are expected to enhance their learning experience by participating in medical student teaching.

Electroconvulsive therapy (ECT) is a part of the required specialty clinics rotation in the third year of residency. Patients of this service are referred by a variety of sources, including the outpatient clinic, local community agencies, psychiatrists, outpatient therapists or Hershey Medical Center or other hospitals in the area.

Patients are referred primarily for treatment of mood disorders; however, ECT is occasionally used for other conditions, such as intractable psychiatric disorders, schizophrenia or catatonia.

ECT is available for both inpatients and outpatients. The procedure is conducted at Pennsylvania Psychiatric Institute, usually every Monday, Tuesday, Wednesday and Friday.

Residents in this rotation will learn to perform ECT under the supervision of a member of the psychiatry faculty working together with an anesthesiology team. In the course of this specialty clinic, the residents become familiar with the technique of ECT, including electrode placement, stimulus intensity and waveform, treatment frequency, and impact of concomitant antidepressants, anticonvulsants and benzodiazepines. They become proficient in diagnostic indications and contraindications for ECT and are expected to understand legal regulations regarding the procedure.

Residents are encouraged to participate with the attending physician in consultation for patients referred for ECT.

Through electives, residents are able to further refine their expertise in an area of interest. They may utilize this time to pursue a number of clinical electives or research opportunities. They may opt to work within Penn State Health Milton S. Hershey Medical Center with any departmental faculty, or outside the facility.

Elective rotations generally occur in the PGY-3 and PGY-4 years. The amount of elective time is variable and determined by what is necessary to achieve the goals and objectives for the proposed clinical experience, but averages half a day each week for 12 months in the PGY-3 year and one full day each week for 12 months in the PGY-4 year. The resident is responsible for developing an acceptable proposal to pursue elective options, and the educational method depends upon the rotation in which the resident is involved.

Some examples of past electives include Neuropsychology, Administrative Psychiatry, Addictions, Forensics, Research, Cognitive Behavioral Therapy, Dialectic Behavioral Therapy, Sleep, ADHD, Autism, Psychodynamic Psychotherapy and self-directed electives.

As part of the emergency psychiatry experience, residents rotate through the Penn Medicine Lancaster General Health emergency department during daytime hours for two days each week during the consult/liaison rotation, and are on call in the evenings at Pennsylvania Psychiatric Institute during all rotations.

Residents in this rotation are involved with all aspects of evaluating, diagnosing and recommending disposition of psychiatric patients seen in the emergency department. They are supervised by an attending psychiatrist and work hand-in-hand with the social work team to arrange appropriate final disposition.

This is a structured rotation designed to develop the residents’ skills in evaluation, diagnosis, management and disposition for a broad variety of psychiatric emergencies. Utilizing different treatment modalities, the experience deepens the residents’ knowledge and understanding of psychiatric crises, including their consequences on the patient’s life.

This rotation takes place at Penn State Health’s Northeast Drive Psychiatry Clinic. Residents rotate two hours per week for three months occurring in PGY-3 or PGY-4. Patients and their family member(s) are seen by the therapist and resident together with the therapist modeling techniques used in marriage and family therapy. The resident has the opportunity to observe the process as well as eventually participate in directing the session. The resident and therapist discuss the case outside of the session in order for the resident to learn how this form of therapy is useful as well as create a treatment plan.

Resident education in this rotation is provided through observation, direct supervision with each patient and their family member(s), and through discussion with the therapist of techniques and assigned materials. Residents are exposed to the various therapeutic techniques and approaches used in marriage and family therapy.

This rotation takes place off-site, primarily at Camp Hill Prison. Residents will rotate for one half-day each week over a three-month period during their PGY-3 or PGY-4 year.

In this rotation, residents gain knowledge of the setting, structures and procedures of psychiatric care of incarcerated persons within a penal setting. They will assist with assessment and management of patients who are at varying stages of involvement with the legal system, including pre-and post-trial. Issues of co-morbidity with substance use or medical illness are also addressed during the rotation.

Residents will also gain experience in the criteria for involuntary treatment and competency issues as they relate to criminal proceedings. They will also learn about communication and collaboration with other medical and legal professionals in the correctional system.

Education is provided through direct attending supervision and observation, discussion and assigned readings.

Based at the VA facility in nearby Lebanon or at the Northeast Drive outpatient clinic, this outpatient rotation experience exposes the residents to the full range of psychiatric disorders seen in the elderly, including Alzheimer’s disease and other dementias, mood disorders (particularly depression), anxiety disorders and psychotic disorders.

In this rotation, residents develop skills in the assessment of psychological, social or medical factors that may contribute to maladaptive behavior in a geriatric population. Neuropsychological testing, laboratory tests and radiologic studies supplement psychiatric evaluations. When appropriate, specialists in medical gerontology, neurology or other medical disciplines are consulted.

The Penn State Health psychiatry program considers intensive outpatient experience to be an important part of psychiatric residency training. The outpatient adult psychiatry service is structured to meet the needs of a diverse population of patients. Treatment is provided within a bio-psychosocial framework to ensure well-balanced care. In addition to attending and resident psychiatrists, the clinic is staffed with nurses, psychologists and social workers.

This outpatient experience is highly focused on resident education. It is the primary rotation for training in psychotherapy competencies including cognitive-behavioral, psychodynamic, supportive and brief psychotherapies. Appropriate psychotherapeutic modalities may be combined with pharmacological management as indicated. Intensive supervision and therapy-focused didactics form a significant portion of resident training during this outpatient experience.

The Mood Disorders Clinic is part of the outpatient experience and is the primary opportunity for residents to perform comprehensive psychiatric assessments for patients presenting with the full spectrum of mood and anxiety disorders.

Residents work closely with a supervising psychiatrist to hone their interview skills, through observation of their technique and by observing attending interviews. Residents develop their diagnostic acumen and learn how to develop pertinent treatment plans addressing bio-psychosocial elements, which they then implement as they continue to treat their patients in supervised follow-up sessions.

This rotation trains residents in short-term, group-based treatment modalities. The program provides an alternative to psychiatric inpatient hospitalization as well as a transition from the hospital to the community. Patients attend the partial hospitalization program for six hours each weekday.

During this rotation, residents are involved in goal planning and are encouraged to assume leadership roles for the multidisciplinary team. The program is planned to deepen the residents’ knowledge of an intensive group-oriented Cognitive Behavioral Therapy psychotherapeutic approach. Individual and family therapies are utilized based on the patient’s needs. Intensive pharmacological management is employed along with appropriate psychotherapeutic modalities, including crisis intervention.

This rotation takes place at the Penn State Health Sleep Lab on the campus of Penn State Heath Milton S. Hershey Medical Center. Residents rotate one half-day per week for three months occurring in the PGY-3 or PGY-4 year.

The main educational method used in this rotation is patient-centered. Patients are initially seen by the resident; then, the resident discusses the case with the attending sleep specialist. After the initial discussion, both the attending and the resident examine the patient together to clarify or obtain any new relevant clinical history as well as to reassess the physical examination findings originally reported by the resident. Subsequently the resident and attending together formulate a management plan. In addition, the resident is provided with extensive reading material mainly from peer reviewed scientific journals on diagnosis and treatment of major sleep disorders.

Resident education is provided through direct supervision with each patient examined and through discussion with the attending physician of assigned reading materials and other relevant educational aspects. Residents are exposed to a wide variety of sleep disorder conditions including sleep-disordered breathing, insomnia, circadian rhythm sleep disorders, restless leg syndrome and periodic limb movement disorder, hypersomnias, narcolepsy and various REM and NREM parasomnias.

Psychiatry Residency didactics are each Thursday, with junior residents (PGY-1 and PGY-2) attending morning lectures and Grand Rounds, and senior residents (PGY-3 and PGY-4) attending morning lectures, Grand Rounds and afternoon supplemental didactics activities.

Below is an example two-year didactic series schedule for the residency. All junior and senior residents attend lectures over that two-year cycle. Lectures are grouped around certain themes, such as basic and advanced psychopharmacology, cultural competence, diagnostic overview, etc.

Introduction to Psychiatry

• How to Conduct a Psychiatric Evaluation/Case Presentation/Psychodynamic Formulation

• Professionalism

• The Basics of Prescribing (psychotropics)

• Emergency Psychiatry Issues

• Suicide

• Assessment/Management of Aggression

• Legal Issues - Introduction

• Delirium

• Ethics in Dealing with Confidentiality

• How to Refer

Alumni Spotlight "My experience at Penn State Psychiatry Residency Program was tremendous. I found the curriculum well-structured, challenging but rewarding. I was able to pursue my interest in biological psychiatry with many research projects while ensuring that I garnered extensive clinical skills and experience from a diverse patient population. The culture between the residents, attendings and the other specialists was always professional and education-oriented. The program prepared me for a demanding career, and its alumni network introduced me to many mentors who inspired my efforts and helped me greatly." Tuna Hasoglu, MD, Class of 2022

The Life Cycle

• Infant Development

• Child/Adolescent Development

• Adulthood

• Late Adulthood

• Normal Sexuality

• Diagnostic Categories Overview (DSM-5 Overview)

Philosophy of Classification and the DSM

• Evolutionary Psychology

• Overview of Child Psychopathology

• Neurodevelopmental Disorders - Intellectual Disabilities and Specific Learning Disorders

• Neurodevelopmental Disorders - Communication Disorders, Motor Disorders

• Neurodevelopmental Disorders - ADHD

• Neurodevelopmental Disorders - Autism

• Autism Spectrum in Adults

• Schizophrenia Spectrum and Other Psychotic Disorders

• Bipolar and Related Disorders

• Depressive Disorders

• Anxiety Disorders

• Obsessive-Compulsive and Related Disorders

• Trauma and Stressor-related Disorders/Dissociative Disorders

• Medical Aspects of Eating Disorders

• Disruptive, Impulse Control and Conduct Disorders

• Substance-related and Addictive Disorders

• Delirium

• Neurocognitive Disorders

• Personality Disorders

  • Overview of Personality Theory (Clusters A, B, C)

  • The Neurobiology of Personality Disorder The Paraphilias

• Medication-Induced Movement Disorders

• Neuroleptic Malignant Syndrome

• Other Medication-Induced Disorders

• Factitious Disorders/Malingering

• (Sexual Dysfunction, Gender Dysphoria: see "Sexuality." Sleep-Wake disorders: see "Sleep.")

Sleep

• Normal Sleep/Circadian Rhythms

• Sleep/Wake Disorders

• Pharmacotherapy of Sleep Disorders

Sexuality

• Normal Sexuality

• Sexual Dysfunction

• Gender Identity Issues/Disorders

• Paraphilias

Biological Psychiatry

• Medical Aspects of Eating Disorders

• The Neurobiology of Mood Disorders

• (Biological) Etiological Theories of Schizophrenia

• The Long-Term Treatment of Schizophrenia

• Neuroleptic Malignant Syndrome

• Neurotransmitters, Genes, and Theories of Depression

• Treatment-resistant Depression

• Treatment of Bipolar Depression/Treatment–resistant Bipolar

• Neuromodulation (ECT, VNS, Deep Brain)

• Catatonia and its Treatment

• The Neurobiology of Personality Disorders

• Psychiatric Genetics 101

• Neuropsychiatry of Paraneoplasia Syndrome

• Pharmacogenomics (see also: “Psychopharmacology”)

Psychopharmacology

• Rational prescribing: Intro to Antipsychotics, Antidepressants

• Cognitive Enhancers vs. Cognitive Disorder Treatment

• Medication Treatment of Dementia/Agitation in Dementia

• Pharmacotherapy of Atypical Depression/Late Luteal Phase Dysphoric Disorders

• Pharmacotherapy of Eating Disorders

• Pharmacotherapy in Borderline Personality Disorders

• Pharmacodynamics

• Pharmacogenomics

• Drug-drug interactions

• Psychopharmacology and Pregnancy

• Antidepressants

• Mood stabilizers

• Antipsychotics

• Pharmacotherapy of Anxiety Disorders

• Management of Intoxication & Withdrawal

• Pharmacotherapy of Sleep Disorders Medication Management of ADHD in Adults

• Neuroleptic Malignant Syndrome

• Medication-induced Movement Disorders

• Other Medication–Induced Disorders

• AP: "Side Effects"

• Combined Psychopharmacology and Psychotherapy

• Psychotherapy

• Introduction to Psychodynamic Formulations

• Basic Theories of Psychodynamics:

• Ego Psychology

• Object Relations

• Separation/Individuation

• Self-psychology (Kohut)

• Eriksonian Theory

• Behavior and Learning (Behavioral Therapy Theory)

• Cognitive Therapy for Medication Non-compliance

• Combined Psychopharmacology and Psychotherapy

• Psychosocial Rehabilitation: The Recovery Model

• (Group therapy - see separate listing)

Group Therapy

• Group Therapy

• Group Therapy for Substance Abuse Disorders

Substance Abuse Disorders

• Substance-related and Addictive Disorders

• Management of Intoxication and Withdrawal

• Co-Occurring Disorders

• Substance Abuse and Trauma

• Group Therapy for Substance Abuse Disorders

• The Impaired Professional

Child

• Infant Development

• Child/Adolescent Development

• Overview of Child Psychopathology

• Neurodevelopmental Disorders - Intellectual Disabilities and Specific Learning Disorders

• Neurodevelopmental Disorders - Communication Disorders, Motor Disorders

• Neurodevelopmental Disorders - ADHD

• Neurodevelopmental Disorders - autism

• Child Abuse

Forensic Psychiatry

• Introduction to Legal Issues

• Forensic Psychiatry

• Social Security Disability

Research

• Research Issues

• Research Ethics

• Psychiatry Trainee Research Day

• Evidence-Based Medicine

• The Case against Evidence-Based Medicine

Ethics

• AMA Code of Medical Ethics as Applicable to Psychiatry

• Introduction to Ethics

• Ethics in Dealing with Pharmaceutical Companies

• Ethics in Dealing with Confidentiality

• Research Ethics

Abuse/Trauma (more extensively covered in the psychotherapy didactic series)

• Elder Abuse

• Domestic Partner abuse

• Child Abuse

• Stalking

Neurology

• Neuroanatomy Review/Neuroradiology

• Headache

• Epilepsy

• Seizures and Psychiatric Illness

• Stroke

• Movement Disorders

• Multiple Sclerosis

• Tourette’s Disorder

• Fibromyalgia

• Chronic Pain

Psychiatric Practice

• The Impact of Patient Suicide on the Psychiatrist

• Professional Coding and Compliance

• The Impaired Professional

• Quality and Safety

• Regulation of Psychiatry in the United States

• The Private Practice of Psychiatry

• Finance and Regulation of Psychiatric Practice

• Political Aspects of Healthcare

• Administrative Psychiatry

• "Careers In..." Seminar (three to four sessions)

• The ABPN Board Exams and the Maintenance of Certification Process

• Maintenance of Licensure

• Role of Socioeconomic Status in Mental Health

• What Happens Next? (senior resident discussion of applying for positions)

• How to Prepare for the Job Search (follow up to What Happens Next)

Diversity/Multicultural Issues

• Multicultural Issues in Mental Health

• Role of Socioeconomic Status in Mental Health

• Latinx Issues in Mental Health

• African American Issues in Mental Health

• Asian Cultural Issues in Mental Health

• Amish Cultural Issues in Mental Health

• LGBTQ Issues in Mental Health

• The Consumer Perspective

History

• History of Psychiatry

• History of Addictions Treatment

Miscellaneous

• Violence and Mental Illness

• Tele-psychiatry

• Evolutionary Psychology

• Stalking

• Psychological Testing

• On Death and Dying

• Psychiatry Goes to the Movies (one to two sessions yearly)

• Alternative Therapies in Psychiatry

• Hypnosis and Psychotherapy

• Biofeedback and Relaxation Training

• Behavioral Treatment of Obesity

• Management of ID in Adults

• EMDR

• Religion and Spirituality in Psychiatry

• Quality and Safety

Psychotherapy is considered an important component of psychiatric treatment and emphasis is placed on appropriate training. The goal for residents at the end of training is to be able to do the following:

• Practice psychodynamic psychotherapy.

• Practice psychodynamically informed pharmacotherapy.

• Refer their psychopharmacology patients to therapists for therapy, describing rationale for a particular type of psychotherapy for that individual with brief psychodynamic formulation.

The psychotherapy training module consists of the following topics taught by various faculty members with expertise in each topic or therapy type.

• What is Psychotherapy?

• Different theories/different techniques

• Ego psychology/defense mechanism/Sigmund Freud

• Object relations theory/Melanie Klein/defense mechanisms

• Mahler stages/Winnicott's contributions

• Self-psychology/self-esteem development/narcissistic issues/Kohut

• Erikson stages of development, particularly adolescence/identity formation

• Short-term focused psychodynamic psychotherapy module

• Contemporary once-a-week psychotherapy module

• Psychoanalysis module

• Transference

• Counter-transference

• CBT theory/technique, Albert Ellis, Aaron Beck module

• Supportive psychotherapy

• Behavior therapy module

• Psychodiagnostic interviewing skills module (seven sessions)

• Borderline personality disorder/psychodynamic understanding/psychotherapeutic techniques

• Narcissistic personality disorder/psychodynamic understanding/psychotherapeutic techniques

• Grief and loss/psychodynamic understanding/psychotherapeutic techniques

• Termination of psychotherapy (planned and unexpected)

• Psychodynamic formulation module (two sessions)

The Department of Psychiatry at Penn State College of Medicine fosters an interest and respect for academic and scholarly traditions in several parallel activities. This is as an integral element in the residency training program even for those residents who do not foresee a career in academic medicine. The department’s view is that awareness of research and its methods is essential for ongoing development of psychiatry as a medical discipline as well as training of future psychiatrists as clinicians, who must be ever-more sophisticated consumers of research or become investigators themselves.

Using any criteria by which scientific productivity is measured, the department excels, whether it is by external funding, number and quality of peer-reviewed publications, honors and eminence of its faculty, or engagement by resident trainees in scholarly activity.

Learn more about departmental faculty and their research interests here. To highlight some of the ongoing research programs, there is a long tradition, since the department’s founding, of active research in sleep and its disorders, with several investigators and currently funded projects. In addition, the department boasts research groups in basic and clinical neuroscience, mood and psychotic disorders, behavioral disorders in children and adolescents, suicide predictors and autism, to name a few. Residents in the program have the opportunity to collaborate with nationally recognized faculty as they develop and pursue their own individual research projects.

During regular weekly didactics, the residents are exposed to several active researchers, and also gain knowledge about assessing research publications from scheduled didactic activities such as Journal Club and Evidence-Based Medicine (EBM) sessions, in which the residents review publications for presentation to their peers under faculty mentorship.

In parallel with these activities, residents are encouraged to begin planning for their own scholarly projects. The program assists in this effort by providing a faculty mentor to each resident during years PGY-3 and PGY-4. Optional protected time slots during PGY-3 and/or PGY-4 years may also be arranged to pursue well-devised mentored projects. Residents can select a longitudinal elective of one afternoon or more each week over three to six months in their PGy-3 or PGY-4 years, to complete their research.

The program’s expectation is that each resident will produce at least one scholarly project and present it as a poster, oral presentation or published paper by the time of graduation. These presentations occur at several local (departmental and Penn State Health Milton S. Hershey Medical Center), regional (local and state psychiatric associations), and national (major organizations such as APA, AACAP, IPS, ASCLP, etc.) levels. Residents have presented their work at all of these levels in recent years.

To foster and support these scholarly activities, in addition to providing regular faculty mentorship to all residents, the program provides funding to cover the cost of poster production, fixed yearly Educational Support funds and time to all residents for conference and meeting attendance costs, and supplemental educational award funding for residents who present their work at the national level.

Supervision is a supplemental educational activity which is distinct from but complementary to the usual clinical and didactic experiences in which all residents participate during their training.

Supervision may be direct (with the supervisor seeing the patient together with the resident), indirect (with the supervisor present in the clinical setting immediately available) or general (such as psychotherapy supervision which may occur off-site and either before or after the relevant clinical encounter).

Supervision is provided by faculty-level professionals, and may include physicians, psychologists and licensed clinical social workers. It may occur as one-to-one, with one resident and one supervisor, or in a group format with one supervisor and two to four residents. The focus is generally clinical and based on the cases being treated by the resident, as well as other aspects of the resident’s professional development.

All residents, throughout their PGY-1 through PGY-4 training years, receive regular supervision experiences while on psychiatry rotations.

For PGY-1 and PGY-2 residents on psychiatry rotations, supervision is direct on inpatient rotations where, during daily rounds, the resident and attending see the patients together. On some rotations, such as partial hospitalization and consult/liaison, supervision may vary between direct or indirect, and may also include group supervision. During their PGY-1 and PGY-2 years, each resident also receives a separate one hour per week of individual supervision with the rotation attending.

PGY-3 and PGY-4 residents receive two hours of individual one-to-one supervision each week. One hour is general longitudinal supervision, for topics involving clinical management, residency experience and professional development. The second hour is dedicated to psychotherapy supervision.

In the outpatient clinic setting, which is the main clinical setting for PGY-3 and PGY-4 residents, each three-hour clinic (morning or afternoon) has direct or indirect supervision with an on-site attending during the clinic block. In addition, for each three-hour clinic, residents also receive one hour of supervision, consisting of one attending and two to four residents, at the end of the clinic block. For residents assigned to clinic both in the morning and afternoon, this would equal two hours of group supervision for the day.

In addition, residents who are undertaking scholarly projects may receive additional unscheduled supervision, usually one-to-one with faculty who are advising and mentoring the residents during poster and publication preparation.

Mentorship

In addition to the supervision modalities described above, the program offers a separate mentorship program for all residents throughout their training. This mentorship is aimed at additional guidance from faculty as residents advance toward independence and in preparing for their post-residency careers.

Topics pertaining to fellowships, practice types and settings, developing special clinical areas of expertise and general career planning are examples of what might be discussed in the mentoring relationship.