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Psychiatry Residency: Program Curriculum |
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Residency & Fellowship Programs > Psychiatry > Psychiatry Residency: Program Curriculum |
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General Curriculum Our curriculum follows the ACGME and RRC requirements for Psychiatry Residency Programs based on scientific and professional mandates to ensure the quality of our graduates’ training, and provide maximal educational advantages for our residents. Additionally, we are designing and implementing a web-based instruction and evaluation system that is unique in our field and will provide residents with near-instantaneous, relevant educational experiences and feedback. These changes are based on the highly regarded Vermont Integrated Curriculum (VIC) now guiding student learning at the University of Vermont College of Medicine. Clinical rotations and didactic seminars are coordinated over the four years to provide a rational developmental sequence. We encourage each resident to develop a special area of interest during the first two years and to explore this interest with increasing intensity during the third and fourth years. One half day per week throughout the four years of training is dedicated to didactics. This time, meant to be free of interruption, begins each Tuesday morning with a Balint Group. All residents are assigned to one of two groups led by experienced faculty, which focus on the dynamics of the doctor-patient relationship. Seminar sessions, shaped by learning objectives relevant to each level of training, follow the Balint Groups. Each session runs for ninety minutes. The offerings are diverse and comprehensive. The yearly schedule, with some variation, lists thirty different seminars ranging from Human Behavior to Research Methods and from Advanced Neuroscience to Cross-Cultural Psychiatry. After their respective seminars, all residents gather for their weekly lunch meeting. The didactic program, where possible, is coordinated with teaching activities on the individual clinical services and with Department-wide academic functions such as Grand Rounds. Additional weekly educational activities include a lunchtime journal club, clinical combined rounds, an interview training session, and psychotherapy supervision. Educational objectives are written for all clinical rotations and didactic seminars. The evaluations are competency based. Each year residents meet in two day-long retreats to review the training program experience. Program innovations and changes are addressed by a Residency Training Committee that meets twice monthly and is chaired by the Training Director; residents from all years of training are represented on the committee. The Director reviews each resident's educational progress and provides feedback on a regular basis. A full faculty review of all residents is conducted twice yearly. Teaching by Residents The Department is committed to the philosophy that an effective physician is a good teacher. On each clinical service, residents participate actively in the clinical instruction of third year and fourth year medical students. Residents also teach other physicians and professional staff through interactions and formal presentations. A practicum is held in the PGY-IV year on how to design an effective scientific presentation. As part of their selective experience, residents may assume an even larger teaching role within the Department. Involvement with educational activities is further encouraged through participation in the Residency Training Committee, in departmental workshops and retreats, and in teaching interviewing skills to first year medical students. The clinical curriculum is divided into 3 major segments: I. Primary Care Medicine and Neurology A. Medicine: All PGY I residents spend two months on the inpatient medicine ward at the Medical Center Campus. PGY-I residents spend an additional month in Primary Care Medicine for hospitalized psychiatry patients and an additional month of their choice of medicine, pediatrics or other specialty elective. B. Neurology: One of these rotations is completed in the PGY I year on an inpatient rotation that emphasizes diagnosis and management of common neurologic disorders. Residents become proficient in obtaining a neurologic history and performing a thorough neurologic examination. They learn to recognize the interplay between organic disease of the nervous system and psychiatric and psychological disorders, and to familiarize themselves with the common ancillary tests and procedures used in neurologic practice. The second month of the neurology requirement is completed at the Vermont State Hospital with one of our full time faculty members who specializes in neuropsychiatry. Outpatient Pediatric Neurology and Outpatient Consultation Neurology rotations may also be available to rotate through. II. Hospital-Based Psychiatry Residents may select a rotation at the Vermont State Hospital (VSH), located approximately 30 minutes from the Medical Center Campus. Residents provide supervised care to selected patients at VSH, develop skills in the psychiatric and medical management of the chronically mentally ill, and gain experience in close liaison with community mental health and forensic services. The rotation can be used to fulfill the forensic requirement. An inpatient child psychiatry selective at the Champlain Valley Physicians Hospital (CVPH) in nearby Plattsburgh, New York has been a popular rotation for residents who are deciding whether to pursue a career in the field of child psychiatry. B. Seneca Center: Seneca Center is a psychiatric partial- hospitalization program offering services more intensive than an outpatient clinic's, yet less restrictive than inpatient hospitalization. Seneca Center uses cognitive behavioral therapy, focused primarily in a group setting. Residents complete one month in their PGY II year and may use selective time for further training at this facility . C. Psychiatric Consultation Service (PCS): The Psychiatric Consultation Service is an active and popular service providing nearly all of the psychiatric consultations at the Medical Center Campus. Experiences on the PCS will include training in electroconvulsive therapy, pain management, telemedicine and end of life care. The resident is a key member of the consult team with responsibilities for teaching the medical students as well as for clinical care. House staff from neurology, internal medicine and family practice often elect rotations on the PCS. There are many opportunities to participate in clinical research as well.
For twelve continuous months in the third year residents train in outpatient psychiatry. During this time residents receive expert instruction in diagnostic, psychotherapeutic, and psychopharmacologic treatment of adults and geriatric populations. Residents follow their own patients and receive close individual and group supervision. Case conferences, didactic sessions, and an opportunity to participate in ongoing clinical research round out the ambulatory experience. A. Adult Clinics: The Outpatient Psychiatry Division provides comprehensive assessment, careful diagnosis, and treatment planning for the majority of the patients entering the Adult Clinics. Interventions include pharmacotherapy, long- and short-term psychotherapy, marital and couples counseling, and group therapies. Opportunities exist for forensic consultations, and consultations to the University of Vermont Student Health Service. The Psychopharmacology Clinic acts both as a consultation service for the area's physicians and mental health professionals, and provides ongoing assessments and treatment. Complicated medication problems are referred to the clinic from throughout northern New England and upstate New York. The resident works closely with attendings expert in psychopharmacology and participates in the assessment and treatment process. The Geriatric Clinic, an important subsection of the Psychopharmacology Clinic, also maintains active therapeutic and research components. B. Child, Adolescent, Family: The Center for Children, Youth and Families offers a comprehensive experience in the diagnosis, management, and treatment of psychiatric disorders in children and families. The Pediatric Psychiatry Clinic combines the internationally known empirically based taxonomy, the Child Behavior Checklist (CBCL) with the DSM-IV approach. Expert developmental assessment and diagnostic skills are combined with supervision in pediatric psychopharmacology and the manual based psychotherapies for the treatment of childhood and adolescent psychopathology. This diverse program includes a didactic seminar series, an active outpatient clinic, psychological testing, family and child psychotherapy supervision, and a wide range of consultations to various community agencies and schools. The research program is internationally known for its development of the CBCL, the Teacher's Report Form (TRF) and the Youth Self-Report (YSR). Numerous epidemiological treatment and genetic studies are currently underway in the center. C. Crisis Services: In the Crisis Services of Chittenden County residents develop and refine skills in crisis assessment of patients and families, in immediate diagnosis and disposition of acutely psychotic and suicidal patients, in utilization of community resources, in liaison with Emergency Services staff, and in forensic psychiatry. Residents work with and provide consultation to health professionals from the local community mental health center. The Director of Crisis Services also acts as clinical and educational supervisor for residents on call. D. Community Psychiatry: In collaboration with the Outpatient Director, the resident may select activities in a community setting and/or clinical or research work focused on the care of the severely and persistently mentally ill. This novel program emphasizes the complexities of providing care to the chronically and persistently mentally ill, in which residents may follow community mental health patients continuously for a one or two-year period. Expert supervision is provided by community mental health psychiatrists, who also train the resident in the treatment team approach that defines the practice of community psychiatry. E. Drug and Alcohol Service: The Department of Psychiatry, in collaboration with the internationally known Behavioral Psychopharmacology Unit, Day One (an intensive outpatient substance abuse treatment center) and Maple Leaf Farm (a residential treatment facility) provide the resident with a unique and state-of-the-art perspective for the assessment and treatment of substance abuse disorders. This experience reinforces and integrates knowledge and skills developed on other services where drug and alcohol problems are frequently seen. Additional training sites have included community agencies, Medical Center Campus outpatient programs, and the departmental NIDA-funded Substance Abuse Research and Treatment Center. PGY's I-III take call every ninth night on average. There is no call in psychiatry during the Medicine and Neurology rotations. To maximize resident efficiency and to ensure the highest quality patient care, residents are released from clinical duties at approximately 8:00 a.m. on the morning following call after sign out rounds. Included in this call is one twenty-four hour call per month. Rotations: Hospital Psychiatry, General – 6 months Educational Sessions: Psychotherapy Supervision (optional) Rotations: Hospital Psychiatry, Advanced – 3 months Outpatient Psychiatry – 12 months -General Adult Clinic Educational Sessions: Psychotherapy Supervision Rotations: Community, Forensic, Administrative Psychiatry – 3 months Psychotherapy Supervision |
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