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Psychiatry Residency Training Program
 
  Applicants Department GME Office Home School of Medicine UW UWHA

Residency Policies & Procedures
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V. CLINICAL ROTATIONS

GOALS AND OBJECTIVES FOR INPATIENT PSYCHIATRY ROTATIONS
INITIAL LEVEL (PGY-1 OR FIRST 6 MONTHS)

Goal:  The goal of inpatient psychiatry rotations is to provide supervised clinical experience and instruction in the assessment, diagnosis, and treatment of psychiatric inpatients with a variety of conditions.

Supervision: Each resident must receive a minimum of two hours of direct supervision per week, at least one of which is individual, and must have direct access (in person or by telephone) to a supervising attending at all times.

Objectives:
Residents completing inpatient psychiatry rotations at the initial level are expected to:

1. Patient Care

  • Perform a psychiatric diagnostic interview, including a formal mental status examination.
  • Conduct comprehensive medical evaluations of psychiatric patients, including assessment of medical conditions likely to mimic or exacerbate psychiatric conditions; make appropriate use of laboratory and diagnostic procedures; and obtain consultation when indicated
  • Obtain collateral information from old records, family, outpatient treatment providers
  • Make accurate Axis I-V DSM-IV diagnoses in psychiatric inpatients and generate an appropriate differential diagnosis
  • Provide a biopsychosocial formulation which takes a longitudinal view of the patient's life history
  • Collaborate in formulating and implementing treatment plans and discharge plans
  • Manage acute behavioral disturbances in a safe and effective manner
  • Demonstrate the ability to educate patients and families about psychiatric illness, treatment plans, medications, and the need for follow up care, and to conduct a family interview.

2. Medical Knowledge

  • Display appropriate knowledge of basic and clinical sciences relevant to Psychiatry
  • Understand the indications for psychological and neuropsychological testing in the evaluation of psychiatric inpatients
  • Demonstrate knowledge of the basic principles and applications of the major classes of psychotropic medications, their limitations and side effects, and important possible drug interactions
  • Understand the indications, side effects, and effectiveness of electroconvulsive treatment (ECT)

3. Practice-Based Learning and Improvement

  • Regularly use information technology in the service of patient care
  • Locate and critically appraise scientific literature relevant to patient care
  • Participate in practice-based improvement activities (such as case conferences, case reviews, and/or CQI projects)

4. Interpersonal and Communication Skills

  • Create and sustain effective therapeutic relationships with patients and families
  • Demonstrate basic interviewing skills (i.e. establishing rapport, clarifying the purpose of the interview, attending to cues, making transitions smoothly, demonstrating empathy, eliciting important information)
  • Develop a therapeutic alliance with patients, while maintaining appropriate professional boundaries.
  • Understand the role of other mental health professionals (nurses, social workers, psychologists, occupational therapists, etc.) on the team, and work collaboratively with them
  • Provide informative sign out to other providers caring for his/her patients (e.g. short call resident, night and weekend providers)
  • Communicate effectively with the patient's other care providers (e.g. outpatient mental health providers, primary care physicians)

5. Professionalism

  • Demonstrate respect for others, compassion
  • Demonstrate reliable attendance and appropriate professional attire
  • Demonstrate integrity, accountability, responsible and ethical behavior
  • Demonstrate "ownership", i.e. attitudes and behaviors consistent with being the patient's physician and taking responsibility to ensure that each patient receives excellent clinical care
  • Demonstrate understanding of patients and their illnesses in a sociocultural context, including displaying sensitivity to patients' culture, ethnicity, age, gender, socioeconomic status, sexual minority status, and/or disabilities
  • Demonstrate concise and pertinent record keeping, including the prompt completion of discharge summaries

6. Systems-Based Practice

  • Understand basic legal issues involved in inpatient psychiatry, including indications for involuntary commitment, the psychiatrist's role in involuntary commitment proceedings, informed consent, duty to warn, and medicolegal aspects of record-keeping
  • Understand milieu issues on the inpatient ward
  • Advocate for quality patient care and assist patients in dealing with health care system complexities

7. Leadership

  • In collaboration with the attending and team, set expectations for medical student performance, evaluate students' strengths and weaknesses, and give feedback to and elicit feedback from medical students
  • Effectively teach medical students and test for retention and learning
  • Cultivate a role within the team as the primary "go-to" person for all patients
  • Begin to recognize team priorities, discuss with attending how to implement treatment plans, and progressively take a more active leadership role in team meetings and family meetings, as appropriate

8. Educational Attitudes

  • Display openness to supervision; accept constructive criticism
  • Seek direction when appropriate; demonstrate eagerness to learn
  • Display flexibility, self-awareness, and the ability to continuously improve one's clinical skills and practice based on feedback

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Psychiatry Residency Training Program
1959 NE Pacific Street, Box 356560
Seattle, WA 98195-6560
206-543-6577
email: psychres@u.washington.edu