Residency Policies & Procedures
V. CLINICAL ROTATIONS
GOALS AND OBJECTIVES FOR PRIMARY CARE IN PSYCHIATRIC
Overall Goal: The overall goal of this rotation is to provide
a PGY-4 psychiatry resident with supervised clinical experience providing
primary medical care within a psychiatric treatment setting, such as
a community mental health center.
Supervision: The resident will work closely with, and will be
supervised by, a combined-trained family physician and psychiatrist, who
will be in clinic at the same time as the resident and who will see patients
with the resident for initial and follow up primary medical care visits.
At the conclusion of this rotation, the resident will be able to:
1. Patient Care
- Appropriately select and apply population-based preventive health
screenings for the following within the SMI (seriously mentally ill)
- Cardiovascular disease risk factors (HTN, cholesterol, diabetes,
- Cancers (colon, cervical, breast, prostate)
- Osteoporosis o Infectious disease (HIV, syphilis, gonorrhea, chlamydia,
- Apply evidence-based treatment algorithms and goals of care for common
cardiovascular co-morbidities in the SMI population:
- Tobacco Cessation
- Utilize brief psychotherapy techniques to motivate health behavior
change in clinic visits.
2. Medical Knowledge
- Describe the physical health implications of psychotropic medications,
and develop integrated treatment plans that balance these risks and
benefits with the community psychiatrist.
- Discuss the health behavior change literature and its application
to chronically mentally ill patients.
3. Practice-Based Learning and Improvement
- Locate and critically appraise scientific literature relevant to
- Regularly use information technology in the service of patient care.
- Describe the cycle of quality improvement, and apply it to basic clinical
4. Interpersonal and Communication Skills
- Effectively communicate with primary care providers and community
psychiatrists, and other members of the client's healthcare team.
- Work within an interdisciplinary primary care team, understanding
the tasks, roles and expectations of a nurse care-manager, medical assistant
and primary care physician in the health of those with SMI.
- Work within an interdisciplinary community mental health team to
better understand the roles of the treating community psychiatrist and
- 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
- Develop and use a disease registry to monitor outcomes.
- Describe the breadth of health-services interventions currently being
employed nationally, and the pros and cons of each approach.
- Evaluate the concept of the Patient Centered Medical Home, contrast
it with Medicaid Health Homes, and appraise the evidence base for collaborative
- Define the key components along the spectrum of mental health and
primary care integration.
- Discuss the evidence base for primary care integration in behavioral