FIRST YEAR

GOALS

PGY-1 Year

The PGY-I year consists of four months of medicine or pediatrics, two months of neurology and six months of outpatient psychiatry at the North Community Mental Health Center. By basing the introduction to psychiatry in an outpatient setting residents develop skills in evaluation, differential diagnosis, pharmacotherapy, supportive psychotherapy and treatment planning in a setting that is less demanding than the acute psychiatric hospital. By the PGY-II year, the resident has solidified his/her identity as a physician and learned basic psychiatric skills. In addition, during the PGY-I year residents become familiar with the range of facilities and services available to the mentally ill in the District of Columbia. Such knowledge and experience greatly facilitates the learning that occurs in the PGY-II inpatient year and the quality of care provided to hospitalized patients.

North Community Mental Health Center - Clinical PGY-1 Rotation

This six-month rotation provides an introduction to adult outpatient psychiatry and a comprehensive overview of psychiatric practice in a Community Mental Health Center. Residents will become knowledgeable of the full range of psychiatric and mental health services available within the District of Columbia. During this rotation, the resident's work is closely supervised. Most of the time is spent working with one attending psychiatrist in the Clinical Services Unit of the North Community Mental Health Center. The resident gains experience in psychiatric assessments, medication management and supportive psychotherapy with individuals and groups. Residents also work with an interdisciplinary treatment team to plan the overall treatment and rehabilitation of patients. In the Intake Unit the resident conducts psychiatric evaluations of individuals applying for admission to CMHC and participates with the Intake Team in the disposition and initial treatment planning process. Residents spend one morning a week in the Community Outreach Unit working with patients with a poor history of compliance with treatment. The resident accompanies the unit psychiatrist and other team members on home visits to assess and provide treatment to patients that refuse to attend clinical appointments. In the Geriatric Unit residents will have an introduction to group therapy with an opportunity to co-lead a psychotherapy group. In addition to the didactic activities at North Center, residents participate in grand rounds, clinical case conference, journal club and meetings of the Residents' Association on the St. Elizabeths Campus.

Internal Medicine and Pediatrics

This is an experience that is obtained at Providence Hospital or Children's Hospital through a four-month rotation that emphasizes general medicine and primary care. There is a full complement of certified faculty/staff which provides ongoing supervision, teaching, and evaluation geared towards rendering the resident competent in clinical knowledge, judgment and skills, and humanistic qualities and professional attitudes. Rotations include inpatient services, ambulatory care, and electives. There is also a medical record audit clinical evaluation exercise. Residents anticipating a career in Child Psychiatry may wish to fulfill their primary care requirement by completing a four month rotation in pediatrics at Children's Hospital. Individuals contemplating becoming board eligible in neurology and psychiatry can arrange an eight-month rotation in Medicine, which is the minimum required to be board eligible in Neurology. Residents with prior residency training in medicine, pediatrics, or family medicine do not require further medical training and enter the program at the PGY-II level..

Neurology Rotation

Neurology training occurs at the Neurology Consultation Service of the Neurology Clinic which is located on the St. Elizabeths Campus. Residents experience a two-month full-time neurology experience rotation including tardive dyskinesia during their first year. Residents who enter at the PGY-II level begin their training on the Acute Care wards and experience a two-month part-time neurology experience rotation at the Neurology Consultation Service in their fourth year in the program. Residents attend monthly Neurology Grand Rounds and monthly Neurology Case Conferences. Neurologist Steven Wolf, M.D., and his staff provide teaching and supervision. Residents evaluate and attend to child, adolescent, adult, and geriatric patients from inpatient and outpatient services for Commission patients. This Neurology rotation has been developed to provide residents with an experience most relevant to their careers as psychiatrists. Emphasis is placed on history taking, differential diagnosis and treatment of patients in a clinical setting. The rotation provides a superb opportunity to evaluate the interaction between neurological and psychiatric disorders. Learning is enhanced through assigned reading, individual and group supervision, teaching seminars, case presentation conferences, and academic lectures. Residents become especially skilled in evaluating the neurological effects of psychotropic medications.