Residency Policies & Procedures
V. CLINICAL ROTATIONS
GOALS AND OBJECTIVES FOR ELECTIVE PRIVATE PRACTICE
OF PSYCHIATRY ROTATIONS
Goal: The goal of the elective private practice psychiatry
rotation is to teach and provide supervised clinical experience in:
a) the comprehensive, integrated care of psychiatric outpatients in
a private practice setting and b) the organization and conduct of a
psychiatric private practice.
On completing the private practice psychiatry rotation, the resident is
expected to be able to:
1. Patient Care
- Screen prospective patients by telephone, with attention to asking
appropriate clinical screening questions, and describing oneself and
one's practice, including costs of 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.
- 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.
- 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.
- Demonstrate knowledge of the organization and management of a private
practice, including the clinical and fiduciary responsibilities of the
provider, record-keeping, scheduling and time management, finances and
billing, and professional liability insurance.
3. Practice-Based Learning and Improvement
- Locate and critically appraise scientific literature relevant to
- Regularly use information technology in the service of patient care.
- Develop a system for ongoing continuing medical education.
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.
- Demonstrate respect for others, compassion.
- 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 understanding of the multidisciplinary mental health treatment
team and display effective communication patterns with other psychiatrists,
psychologists, social workers, and alcohol and drug counselors. Learn
to distinguish the role of the team leader and the consultant.
- 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.
- Define the scope of one's practice, identify limitations in the range
of provided services, and demonstrate effective integration of outside
clinical consultations into the development of treatment plans.
- Appropriately advocate for quality patient care; help patients with
- Interact effectively with primary care providers and third party payers.
- Display an understanding of the role of federal, state, and local
health care system and regulatory agencies and their importance for
the private practice of psychiatry.
7. Educational Attitudes
- Display openness to supervision; accept constructive criticism.
- Seek direction when appropriate; demonstrate eagerness to learn.