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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 THE VA PUGET SOUND VETERANS ADMINISTRATION URGENT CARE PSYCHIATRY ROTATION

Goal: The goal of the Urgent Care Psychiatry rotation is to provide a supervised clinical experience leading to the development of knowledge and skills in the evaluation, crisis management, and triage of patients seen in an urgent care setting. As part of this rotation, psychiatric residents will learn to evaluate acute mental health problems specific to veterans, including combat and non-combat related PTSD and military sexual trauma. They will also complete a scholarly presentation related to their urgent care experience.

Objectives

On completing the Urgent Care rotation, the resident is expected to be able to:

1. Patient Care

  • Perform pertinent diagnostic interviews.
  • Develop initial differential diagnoses.
  • Establish rapport with and assess acutely ill psychiatric patients.
  • Make rapid assessments of acutely psychotic patients.
  • Rapidly and effectively evaluate and document suicidality and suicide risk.
  • Effectively evaluate and document dangerousness (including homicidality) and intervene appropriately.
  • Effectively assess alcohol and drug intoxication and withdrawal.
  • Determine the appropriate level of care for each patient, admit patients to the inpatient psychiatric service as indicated, and triage patients to appropriate outpatient services.
  • Document and describe the assessment and plan in a complete, accurate, and succinct manner.
  • Understand the medical, neurological, and other physiological causes for psychiatric symptoms and seek medical, neurological, or other specialty consultations appropriately.
  • Develop beginning brief crisis counseling skills.
  • Use medications appropriately in an urgent care setting.
  • Develop skills in the coordination of care for urgent care psychiatry patients in consultation with current outpatient providers.

2. Knowledge

  • Display appropriate knowledge of basic and clinical sciences relevant to psychiatry.
  • Display knowledge of the assessment and treatment of acute psychiatric illness.
  • Display knowledge of clinical syndromes frequently seen in the veteran psychiatric population, including PTSD from combat, non-combat, or sexual trauma.
  • Understand the usefulness and indications for stat laboratory and other diagnostic tests.

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 (CQI), when appropriate.
  • Review and synthesize relevant literature and give a one-hour scholarly presentation on a psychiatric topic of the resident's choice, related to urgent care psychiatry.

4. Interpersonal and Communication Skills

  • Create effective therapeutic relationships with patients, families, and caregivers in the urgent care setting.
  • Display empathic listening skills.
  • Work effectively with social workers, nurses, and other medical staff.
  • Display effective verbal and written communication skills.

5. Professionalism

  • Demonstrate respect for others, compassion.
  • Demonstrate integrity, accountability, responsible and ethical behavior.
  • 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.

6. Systems-Based Practice

  • Prioritize and expedite patient evaluation and referral from the urgent care setting.
  • Display familiarity with internal VA and community referral sources.
  • Demonstrate understanding of when to make an MHP referral, make MHP referrals when needed, write appropriate affidavits, and testify in civil commitment court as indicated.
  • Understand the legal principles of duty to warn and participate with the supervising attending and site leadership in contacting an identified potential victim who has been threatened, if necessary.
  • Decide on the appropriate level of care for each patient.

7. Leadership

  • Display effective teamwork skills, including the ability to triage, prioritize tasks, and share workload, as appropriate.
  • Display skills in teaching and supervising medical students.

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
206-543-6577
email: psychres@u.washington.edu