Educational Objectives:The inpatient psychiatry rotation is intended to teach the resident to conduct a thorough biopsychosocial psychiatric assessment including a complete psychiatric history, mental status examination, and physical examination. Under attending supervision, the resident is expected to initiate appropriate work-up, consultations, and ancillary procedures. The resident makes a biopsychosocial formulation of each case and formulates and implements a treatment plan. The resident also learns to recognize, analyze, and manage the dynamics in an inpatient setting and learn how to work with an interdisciplinary team. The resident learns how to provide individual and group psychotherapy and to set appropriate boundaries in a therapeutic relationship. The resident develops skills in timely, concise, and accurate documentation, including progress notes, treatment plans, and discharge summaries.
Description of Rotation : PGY-I residents complete a required 3-month, full-time rotation on the Inpatient Psychiatry Teaching Units in their PGY-I year. This rotation is split between two Acute Inpatient Psychiatry Wards. Ward 2-3-C has a total of 28 beds, including 12 beds that serve as a National Referral Inpatient Service dedicated to treating female veterans. This specialized unit is dedicated to providing state-of-the-art psychiatric care for female veterans. The resident evaluates, treats, and follows acute admissions to the inpatient unit. Additional inpatient psychotherapy supervision for the inpatient psychiatry residents on this rotation is provided by several senior psychotherapy-oriented psychiatrists and psychologists.The 2 teaching units are staffed by a total of 7 psychiatrists, 3 nurse practitioners, one full-time psychologist, two social workers, an occupational therapist, and designated nurses and nursing assistants. Since these wards are teaching units, the trainees can include a PGY-IV level Psychiatry Senior Teaching Resident, up to five PGY-II or PGY-I level Psychiatry Residents, one or two Psychology Interns, a Social Work Intern, and 1-2 Occupational Therapy students. Nursing students from nearby affiliated programs also receive part of their clinical experience on the unit.The resident completes a diagnostic assessment and manages all aspects of the patient’s inpatient stay. The resident interacts with the treatment team in the management of patients. This involves performing initial evaluations, daily follow-up, team participation, treatment planning, and discharge planning. The resident may also conduct community meetings on a weekly basis and may co-lead medication groups.The resident completes all necessary evaluations, paperwork, progress notes, medication adjustments, evaluation of privileges, and discharge summaries. The resident’s autonomy in his/her decision-making is based upon his/her abilities and personal comfort in management. The inpatient attending psychiatrists are ultimately responsible for the jointly-made clinical decisions.
Expected caseload : The PGY-I resident’s case load is about 4 patients.