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Psychiatry Residency Training Program
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Residency Policies & Procedures
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Goal:  The goal of adult outpatient psychiatry rotations is to teach and provide supervised clinical experience in the comprehensive, integrated care of psychiatric outpatients, including diagnostic assessment, formulation of a treatment plan, and provision of psychotherapy and/or psychopharmacologic treatment, as indicated.

Supervision: Each resident must receive a minimum of one hour of direct supervision per clinic day (or 30 minutes per clinic half-day), and must have direct access (in person or by telephone) to a supervising attending at all times.

On completing the adult outpatient psychiatry rotation, the resident is expected to be able to:

1. Patient Care

  • Perform adequate psychiatric diagnostic interviews in an outpatient setting, including establishing rapport, eliciting important clinical information, and assessing emergent issues (e.g. suicidality, homicidality).
  • Include in the assessment developmental, psychodynamic, cognitive, sociocultural, and other biopsychosocial factors contributing to the presenting symptoms and important in treatment planning.
  • Make appropriate multiaxial DSM-IV diagnoses in psychiatric outpatients.
  • Develop individualized treatment plans for outpatients, integrating medication and different forms of psychotherapy, as appropriate.
  • Manage a wide variety of chronic or episodic psychiatric disorders over time, including the use of medications, crisis intervention, patient education, and psychotherapy, to maximize patient function and minimize the need for hospitalization.
  • Use appropriate laboratory, neuropsychological, and other testing in the diagnosis and monitoring of psychiatric outpatients.
  • Use collateral information (e.g. from family members, caretakers, past treatment records) in assessment and treatment, and display understanding of associated issues of confidentiality and informed consent.
  • Set appropriate goals for treatment and guide the patient through the process to termination.

2. Knowledge

  • Display appropriate knowledge of treatment guidelines, best clinical practices, and clinical pathways that can be used to guide treatment planning. The resident should recognize both the importance and limitations of published research and treatment guidelines in selecting treatment interventions for particular patients.

3. Practice-Based Learning and Improvement

  • Locate and critically appraise scientific literature relevant to patient care.
  • Regularly use information technology in the service of patient care.
  • Participate in practice-based improvement activities (e.g. improving the resident's individual clinical practice through supervision and reading, case conferences, case reviews, quality improvement projects).

4. Interpersonal and Communication Skills

  • Engage patients in treatment; maintain a basic therapeutic alliance throughout the duration of treatment.
  • Recognize his/her own characteristic responses to patients ("countertransference") and the effects of these responses on treatment.
  • Work effectively as part of a multidisciplinary outpatient team, collaborating with other mental health providers involved in the care of the patient (e.g. case managers, psychologists, social workers, nurses).

5. Professionalism

  • Demonstrate respect for others, compassion.
  • Demonstrate reliable attendance and appropriate professional attire.
  • Demonstrate integrity, accountability, and an ethical approach to outpatient treatment (e.g. maintaining professional boundaries, obtaining informed consent for treatment).
  • 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, accurate, and timely record keeping.

6. Systems-Based Practice

  • Provide clinically appropriate and cost effective care.
  • Make appropriate referrals for further medical or surgical evaluation, or for inpatient psychiatric care.
  • Appropriately advocate for quality patient care; help patients with system complexities.
  • Interact effectively with primary care providers and third party payors.

7. Leadership

  • Display effective team leadership skills, including the ability to triage, prioritize tasks, and delegate work as appropriate.

8. Educational Attitudes

  • Display openness to supervision; accept constructive criticism.
  • Seek direction when appropriate; demonstrate eagerness to learn.

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Psychiatry Residency Training Program
1959 NE Pacific Street, Box 356560
Seattle, WA 98195-6560