Clinic Department

Psychiatry

Psychiatry Residency Program

Academic Activities

The Office of the Program Director provides the schedule for the resident presentations at the Grand Rounds/Case Conference. The final draft of the resident’s presentation for Grand Rounds Case Conference is due four (4) weeks prior to case presentation. The resident should contact his/her individual supervisor four (4) weeks prior to the case conference. He should discuss the case with the individual supervisor. At the case conference, the resident should be prepared to present only a brief summary highlighting the presentation followed by elaboration on any aspects of it which were not originally included in it, more current developments in the resident’s treatment of the patient, and some detailed process notes of session material which highlight the patient’s conflicts, defenses, the therapeutic process, and the resident’s questions about the treatment of the patient. The case presentation has detailed objectives per level of training which are provided upon entry to the residency.

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Education in psychiatry requires attendance to a number of lectures, seminars, and conferences, as well as a considerable amount of reading, perhaps more than in any other specialty. This is a requirement for the resident to be able to learn the vast amount of knowledge necessary to practice modern psychiatry, and accordingly. This is a mandated by the American Board of Psychiatry and Neurology.

To accomplish this, attendance at all conferences and reading of all assigned literature is a mandatory part of each resident’s training. It is each resident’s responsibility to attend, at a minimum, all required classes and read all assigned literature for each class, and to inform the class teacher, as well as the training director (via his assistants), of any classes not attended, and the reason. The new Essentials on accreditation of Residency Programs require that a minimum of 70% of all classes be attended. Attendance will be considered by the curriculum committee as a serious part of each resident’s evaluation, as will be completion of required and additional reading. It is understood that circumstances may arise which interfere with attending a class or seminar, e.g., a clinical or personal emergency. It is an expected courtesy for a resident to notify the teacher of any classes you cannot avoid missing, and to offer a brief explanation, since teachers invest a great amount of effort in preparing and teaching their assigned seminars and courses.

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Each resident is assigned a minimum of clinical supervisors during the first two years of training, as well as during the third and fourth years, each to be seen on a weekly basis for the academic year. These supervisors are selected to allow each resident an experience with a variety of background training and therapeutic approaches. During later subspecialty rotations, supervisors experienced in specialized areas are assigned, e.g., child psychiatry, consultation and liaison psychiatry, family therapy, substance abuse, and administrative and forensic psychiatry. Attendance to all supervisory sessions will be required for progression in training. Resident supervision should be at least 2 hours/week. Supervisors will sign patient log and resident attendance to supervision.

Supervision is intended to provide a format for the integration of the didactic and clinical aspects of psychiatric education. Using the evaluation and treatment of specific patients as a starting point, supervision can be used to discuss interviewing principles and problems, information gathering and interpretation, and the differential diagnosis of the patient including dynamic, interpersonal, and organic factors. Supervision of inpatient can also include interviews through one-way mirror. This would be resident interviewing of a patient, as well as the supervisor interviewing a patient. Also discussed in supervision are recommendations for patient management techniques, and initiation of treatment with the variety of available psychotherapies, including psychodynamic psychotherapy (supportive and uncovering), and/or behavior therapy.

Residents are expected to gather and present to a supervisor both the current and past historical information about patients, and to also discuss the current functioning of their patients. To do this it is often useful to present “process notes”, a detailed recounting of the developments during the sessions with an individual patient. Sometimes audiotape or videotaped interviews may be appropriate adjuncts to supervision. Curiosity about what makes a given patient “tick”, as well as receptivity to discussing problem areas for each patient is helpful attitudes for a supervisor.

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The major goal of the Residency Training Program in Psychiatry is to provide and monitor the gradual and stepwise acquisition of residents’ knowledge, skills, and attitudes, including the mentioned 6 core competencies, necessary to become a well prepare psychiatrist plus a board eligible psychiatrist, as outlined in the General and Special Requirements for psychiatry by the Accreditation Council for Graduate Medical Education.

The course schedule of lectures, seminars, meetings, clinical supervision, and clinical experiences are aimed at providing the basis for progress in training. To monitor this progress, a series of regular thorough evaluations of each resident’s performance and progresses are undertaken, as described in the in the following section:

The director of the resident’s clinical services also completes regular rotation evaluations. Competencies are directly discussed with each resident by the respective supervisor or service chief, and signed by both resident and evaluator. A summary is made of each resident’s strengths, weaknesses, and recommendations for his further training by the Training Director, who then reviews individually with each resident a synopsis of his or her evaluation. The resident is also encouraged to evaluate his/her training in person and in writing at regular intervals.

There are some instances when a resident’s progress is not sufficient. There is a process of remediation for a resident having special difficulty, which may require additional clinical or didactic assignments, or in extreme circumstances, the placement of the resident on probation.

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The objective of the Ponce School of Medicine Psychiatry Residency Training Program is to prepare each resident for the contemporary practice of general psychiatry according to the Essentials of the Accreditation Council for Graduate Medical Education as described in the Directory of Graduate Medical Education Programs.

In order to achieve this overall objective, each resident must complete a three or four-year program in psychiatry residency training, which consists of a series of, required competencies, seminar and clinical rotations, which are described in detail in the program description of the PSM Psychiatry Handbook “Training Essentials and Competencies". Successful completion of each of these competencies, seminar, clinical rotations, and supervision is necessary for graduation.

The progression of increasing responsibility required for each resident during each year of training is also outlined in the program description manual, and is further defined and monitored by each clinical service chief, teacher and supervisor. Demonstration of satisfactory knowledge, attitudes, and skills in each component of training is required for graduation.

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