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Psychiatry and Behavioral Sciences

Quillen College of Medicine

Curriculum

Formal didactic instruction occurs on Tuesday afternoons from 1-5 pm. Grand Rounds features presenters from local, regional, and national pools as well as senior residents' presentations which are part of the graduation requirement. Residents meet weekly for Resident Council. Every fall residents take the PRITE (Psychiatry Resident in Training Examination). Their scores compare with local and national peer scores to identify strengths and weaknesses that can be addressed. Clinical Skills Exams occur each year to assess resident progress and provide regular feedback.

PGY 1 and 2 years have a one hour weekly case conference. PGY 3 and 4 years have one hour a month available for scholarly project preparation as well as board review. 

PGY 1

Orientation curriculum starts a week before July 1 to prepare incoming interns for their year of rotations. The PGY 1 year emphasizes interviewing, diagnostic, and treatment skills, which expand as the residents move through their rotations in emergency psychiatry, inpatient psychiatry, and inpatient internal medicine. There is additional experience with outpatient neurology and primary care. Residents are expected to pass their Step 3 during the PGY 1 year. 

Sample PGY I Rotation Schedule:

July

Inpatient
Psychiatry

Aug.

Outpatient
Neurology

Sept.

Inpatient
Psychiatry

Oct.

Inpatient
Internal  Medicine

Nov.

VAMC Emergency
Psychiatry

Dec.

Outpatient
Neurology

Jan.

Inpatient
Psychiatry

Feb.

VAMC Inpatient
Internal  Medicine

Mar.

Outpatient
Primary Care

Apr.

VAMC Emergency
Psychiatry

May

Outpatient 
Primary Care

June

Inpatient
Psychiatry

PGY 2

This year builds on fundamentals with introduction to supportive psychotherapy as well as child psychiatry, consultation- liaison psychiatry, and inpatient psychiatry which correlates with the primary rotations in this year. Residents develop more complex inpatient care plans and informally mentor first year residents on these units, as well as doing night float call coverage.

Sample PGY II Rotation Schedule:

July

Inpatient
Psychiatry

Aug.

2 weeks Consult/Liaison 
Psychiatry 
2 weeks Night Float

Sept.

Inpatient
Psychiatry

Oct.

Child Inpatient
Psychiatry

Nov.

Inpatient
Psychiatry

Dec.

2 weeks Night Float
2 weeks Consult/Liaison
Psychiatry

Jan.

Child Inpatient
Psychiatry

Feb.

2 weeks Night Float
2 weeks Consult/Liaison
Psychiatry

Mar.

2 weeks Night Float
2 weeks Consult/Liaison
Psychiatry

Apr.

Inpatient Geriatric
Psychiatry

May

Consult/Liaison
Psychiatry

June

Inpatient
Psychiatry

PGY 3

The 3rd year of residency has a strong  emphasis on more advanced psychotherapy learning and individual therapy supervision utilizing direct viewing (camera, one-way mirror, or in the room) interview sessions, review of videotaped sessions, and discussion of the resident's cases with experiences in supportive, cognitive-behavioral, and psychodynamic therapies. Advanced psychopathology and psychopharmacology, including substance abuse, are also presented this year. Rotations in a number of outpatient clinics give the residents opportunity for a more independent role in diverse patient exposure and supervision. Also, didactic time is available to work on grand rounds or a scholarly project.

Sample PGY III Rotation Schedule> July-June Outpatient Clinics:

Monday
a.m.

Psychotherapy
Clinic

Tuesday
a.m.

VAMC
Mental Health
Clinic

Wednesday
a.m.

Adult Outpatient 
University Psychiatry
Clinic

Thursday
a.m.

Student Counseling
Clinic

Friday
a.m.

VAMC Adult Outpatient
Tele-Psychiatry Clinic

Monday
p.m.

VAMC Mental
Health Clinic

Tuesday
p.m.

Didactics

Wednesday
p.m.

VAMC Substance
Use Clinic

Thursday
p.m.

University Health
Clinic

Friday
p.m.

Psychopharmacology
Buprenorphine
Clinic

 

Note: All residents will do Adult Outpatient Psychiatry (University and Veterans Affairs Medical Center), Substance Use Disorder, and Psychotherapy clinics as well as one of the outpatient specialty clinics.

PGY 4

The final year curriculum focuses more on resident consolidation of prior learning with more senior roles in inpatient and C/L roles helping to mentor junior residents as well as a half day of Medication Continuity Clinic. Six months of electives round out the curriculum with the residents' particular interests helping direct sub-specialization or work choices. Recent past electives have included Hospital Psychopharmacology, Veterans Clinical Living Center Consultation, Tele-psychiatry, Women's Health, PTSD, Emergency Psychiatry, Consultation-Liaison Psychiatry, ECT, Transcranial Magnetic Stimulation, Group Psychotherapy, Substance Abuse, Pain Management, and Research. Residents are encouraged to develop new electives that suit their interests. Residents complete their scholarly project this year and are strongly encouraged to present this at a national meeting. Senior residents also teach a course to PGY1's throughout the year. Psychiatry and Neurology Board Review course, Transition to Practice, and continuation of clinical psychotherapy supervision in a group format prepares the resident for future board certification and employment.

Sample PGY IV Rotation Schedule:

July

2 weeks Consult/Liaison
Psychiatry
2 weeks Night Float

Aug.

2 weeks Night Float
2 weeks Consult/Liaison
Psychiatry

Sept.

Elective

Oct.

Elective

Nov.

Consult/Liaison
Psychiatry

Dec.

Inpatient
Geriatric

Jan.

Elective, and
half day Medication
Continuity Clinic

Feb.

Inpatient
Psychiatry

Mar.

Elective

Apr.

Inpatient
Psychiatry

May

Elective

June

Elective

 

DIDACTICS

PGY I COURSES

Interview Skills
Introduction to Psychopharmacology
Introduction to Psychopathology 
DSM-V
Case Discussion

PGY II COURSES

Child Psychiatry and Child Psychopharmacology
Introduction to Psychotherapy: Supportive, CBT, and Psychodynamic Psychotherapy
Case Discussion

PGY III COURSES

Advanced Psychopharmacology
Advanced Psychopathology
Advanced Psychodynamic Therapy
Case Conference
Transition to Practice
Grand Rounds Preparation/Scholarly Project Development Time

PGY IV COURSES

Continuing Case
Case Conference
Stahl's Psychopharmacology Master Course
Transition to Practice
Scholarly Project Development Time/Psychiatry Board Review Time
Teaching a course to PGY1's

COMBINED COURSES/TOPICS

Journal Club
Quality Improvement
Chair Rounds
M&Ms
Internal Medicine Topics
Neurology
Forensics

TRAINING SITES

We offer residents a diversity of experiences with our various sites in a university town that services a large patient catchment area including rural areas of Tennessee, as well as veterans through the VAMC.

1) East Tennessee State University & Quillen College of Medicine

ETSU Psychiatry Building Residents have outpatient general adult and psychotherapy clinics as well as didactics at this site, which is housed on the campus of the Veterans Administration Medical Center (VAMC). Residents also have the opportunity to be involved with Tele-psychiatry and TMS at this site.

Student Counseling CenterUniversity students can receive psychotherapy from a variety of counselors at this location. Psychiatry residents provide supervised psychiatric medication services here.

University Health Center - This is a general medical clinic through the Nursing department for university students where faculty and psychiatry residents provide medication management.

Family Medicine Clinics - Residents have outpatient primary care experience in one or more of the three nearby family medicine clinics as part of a team with family medicine residents and medical students.

2) Veterans Administration Medical Center (VAMC)

The James H. Quillen Mountain Home VA Medical Center services the 41 county area of Tennessee, Virginia, and Kentucky. Psychiatry training experiences here include adult inpatient, outpatient, substance use, Consultation-Liaison, PTSD, Community Living Center (geriatrics), ER, Tele-psychiatry, CBT psychotherapy, and ECT, as well as an outpatient Neurology and inpatient Internal Medicine. Residents work in interdisciplinary teams including consultive roles. The VAMC is a comprehensive care hospital offering medical, psychiatric, and surgical services for residents.

3) Woodridge Hospital

A free standing 84 bed psychiatric private hospital affiliated with and across the street from Johnson City Medical Center that offers child and adult inpatient, intensive outpatient, and crisis services. Residents do several inpatient adult and child psychiatry ward months at this location.

4) Johnson City Medical Center (JCMC)

This is a large regional tertiary referral center that has medical, surgical, women's, and pediatric services. JCMC is an acute-care teaching hospital where psychiatry residents receive one month of inpatient general internal medicine as part of their primary care training.

 

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