Inpatient General Psychiatry
Inpatient general psychiatry rotations include clinical experience with geriatric as well as general adult psychiatric inpatients. Many of these patients also have comorbid substance abuse problems.
During the inpatient psychiatry rotations, PGY1 and PGY2 residents work under the supervision of faculty psychiatrists in caring for patients with psychoses, affective disorders and severe anxiety, personality and adjustment disorders. Residents are involved in supervising and teaching junior and senior medical students.
PGY1 and PGY2 residents carry an average caseload of up to 10 patients and participate in daily attending teaching rounds and individual clinical supervision with faculty attendings and PGY-4 residents.
In addition to weekly teaching case conferences, required core readings, didactic seminars and Journal Club, the educational curriculum includes consultative access to staff psychologists and neuropsychologists as well as the availability of selected literature relevant to specific cases.
Residents will rotate at the VA Schizophrenia Unit.
PGY4 residents may choose to complete their 2-month elective on one of the inpatient units or the Consultation-Liaison Service assuming greater responsibilities and supervising junior residents and medical students.
During the 2-month Consultation-Liaison/Emergency Service rotation, residents evaluate new patients each day and provide follow-up care for those they have previously evaluated. All residents are involved in teaching medical students.
PGY-4 residents may spend 2 months on the service for their elective. During this rotation, they supervise and teach PGY1 and PGY2 residents as well as medical students.
Clinical teaching by faculty is an important aspect of daily attending rounds, individual clinical supervision and weekly case review conferences. Problem-based seminars and Journal Club are conducted weekly and cover the fundamentals of psychiatric diagnosis and treatment in the consultation setting, psychosomatic medicine, biopsychosocial case formulation and crisis intervention.
Although residents are permitted to begin building an outpatient caseload starting in PGY2, this aspect of residents' training is emphasized in PGY3, with additional blocks of elective time available in PGY4.
This educational experience provides residents with firsthand clinical experience in providing longer-term psychodynamic psychotherapy, time-limited psychotherapy, cognitive-behavioral therapy, and long-term supportive therapy and medical psychiatric follow-up of patients with chronic mental illnesses.
Residents spend one morning a week for 3 months on the ECT Service (which provides treatment for primarily outpatients).
Residents spend one day a week at the VA Pittsburgh Healthcare System, providing outpatient treatment for patients with PTSD, schizophrenia, and/or mood disorders. Residents also gain practical clinical experience with group, family and couples therapies during this year. They will also provide longer-term dynamic therapy, under supervision of a psychoanalyst, through the low-fee dynamic therapy clinic. There is also opportunity to provide brief psychodynamic therapy at a local college outpatient service. While rotating through the Outpatient Psychiatry Program, residents participate in all ongoing educational and academic activities while providing clinical care under close faculty supervision.
Child and Adolescent Psychiatry
PGY2 residents learn Child and Adolescent Psychiatry on acute partial hospital rotation under the supervision of a child and adolescent psychiatrist. Patients have a variety of emotional, behavioral and social problems that are addressed using an interdisciplinary team model. Residents have the opportunity to develop their skills in family assessment and intervention. They may use their elective time for additional training in this area. Our program has a strong Division of Child and Adolescent Psychiatry, which also offers the opportunity for additional fellowship training after three years of General Psychiatry.
Intensive Partial Hospital Psychiatry
During the intensive partial hospital psychiatry rotation, PGY2 residents work on a 3-month rotation under the supervision of both a faculty psychiatrist and psychologist in caring for patients with affective disorders and severe anxiety, personality, and adjustment disorders. They have the opportunity to develop group psychotherapy skills and follow acutely distressed patients for a longer time than in a typical inpatient setting. They may use elective time for additional training in this area.
The use of elective time is quite flexible, and with the training director's approval, residents may create electives to suit their educational needs. Some of the electives already established are as follows:
Residents learn outpatient evaluation and treatment for patients with a wide range of emotional and behavioral problems, including those that arise in the context of medical illnesses. The multidisciplinary staff provides pharmacological management, interpersonal therapy, cognitive-behavioral therapies, psychodynamic therapies, family therapy and group therapy. Residents are responsible for a caseload of 40 to 50 patients, providing psychotherapy and medication management. Residents also rotate one day a week at the VA Pittsburgh Healthcare System, providing outpatient treatment on the PTSD, Schizophrenia and/or Mood Disorder service. Residents also have an opportunity to provide short-term psychodynamic psychotherapy in the student mental health clinic of Carnegie Mellon University or to work in a rural community psychiatric clinic.
Residents have protected time to attend weekly seminar series, a number of case conferences, Journal Club, and weekly Grand Rounds. The schedule for each year is as follows.