Department of Psychiatry

Psychiatry Residency Program

Rotations and Didactics

PGY-1 | PGY-2 | PGY-3 | PGY-4 |     All years: Retreats | Grand Rounds | Resident Review Committees

PGY-1 Clinical Rotations

The PGY-1 psychiatry internship is designed to solidify core physician knowledge and skills and to develop competence in key elements of psychiatry: psychiatric interviewing and case presentation, psychiatric diagnoses/DSM-IV, basic psychopharmacology, emergency assessment and crisis stabilization, supportive psychotherapy, and motivational interviewing. 

The PGY-1 year is divided into 4 three-month rotation blocks: 2 blocks of primary care and neurology, and 2 blocks of psychiatry (see diagram).  Residents with an interest in child/adolescent populations may meet a portion of the primary care and neurology requirements at The Children’s Hospital (TCH). 

Outpatient Psychiatry Experience: The PGY-1 year includes a year-long, half day per week, outpatient psychiatry clinic.  This closely supervised experience is designed to teach interviewing, diagnostic, and brief psychotherapy skills, offer residents exposure to the full range of mental illnesses and functional levels, and begin longitudinal experiences with patients and families.  

PGY-1 Didactics

PGY-1 residents have 5.5 hours per week of protected didactic time while on psychiatry rotations.  This curriculum is designed to teach core psychiatry knowledge and skills, including:

• Psychiatric diagnosis & DSM-IV
• Diagnosis and management of psychotic disorders, bipolar disorder, substance use disorders, particularly in acute care settings
• Basic psychopharmacology
• On-call skills
• Delirium and agitation
• Suicidal patients, crisis intervention/brief treatment models
• Capacity, competency, involuntary mental health treatment
• Psychiatric interviewing, supportive psychotherapy, motivational interviewing
• Introduction to evidence-based medicine

PGY-2 Clinical Rotations

The PGY-2 year is designed to develop advanced knowledge and skills in complex psychiatric diagnosis, psychopharmacology, and consultation-liaison psychiatry.  It also provides training experiences in sub-specialty areas of psychiatry and longitudinal outpatient psychotherapy. 
The PGY-2 year is comprised of 4 three-month rotation blocks (see diagram).  Two of the blocks are inpatient psychiatry.  The VAMC inpatient service specializes in the PTSD, substance use disorders, psychotherapy, family therapy, geriatrics, and psychopharmacology.  The University of Colorado Hospital (UCH) inpatient psychiatry service utilizes a Dialectical Behavioral Therapy and solution-focused CBT model and also provides expert consultation and treatment for bipolar disorder.  Consultation-liaison psychiatry is a 3-month rotation (divided into 2 six-week segments) focusing on psychiatric manifestations of general medical illnesses, psychological aspects of health and illness, and medical decision-making.  Special patient populations include trauma, burn, organ transplant, and ob-gyn. The 4th three-month block is devoted to a specialty area in psychiatry, allowing residents to explore interests, deepen knowledge of a particular sub-specialty, and perhaps refine plans for post-residency fellowship training.  PGY-2 residents have two hours weekly of regularly scheduled individual supervision, one from the primary attending at the inpatient site, and one at their outpatient clinic.

Outpatient Psychiatry Experience: PGY-2 residents have a year-long, half day per week outpatient psychiatry clinic.  Residents follow ongoing cases from the PGY-1 year and develop longitudinal treatment plans and more advanced psychotherapy skills; some residents co-facilitate psychotherapy groups. 

PGY-2 Didactics

PGY-2 residents have 5.5 hours per week of protected didactic time.  The curriculum is designed to refine knowledge and skills in complex diagnosis, advanced psychopharmacology and treatment planning, and mastery of the brief psychotherapies.  Psychodynamic and developmental perspectives are emphasized, as well.  The didactics include:

• Phenomenology, pharmacology, and psychotherapy of major psychiatric disorders; epidemiology, treatment planning, prognosis
• Neuroscience
• Psychotherapy—brief psychotherapies, DBT, introduction to psychodynamic
• Psychological development and psychopathology
• Ethics, forensic psychiatry, cross-cultural psychiatry
• Research methods, evidence-based medicine
• Emergency, consultation, and psychosomatic psychiatry

PGY-3 Clinical Rotations

The PGY-3 year is an outpatient year, including longitudinal core experiences in outpatient psychiatry, long-term psychodynamic psychotherapy, CBT, group psychotherapy, child & adolescent outpatient psychiatry, expert consultation/advanced psychopharmacology, and geriatric psychiatry.  Residents have extensive elective options to pursue research & scholarly projects and specialty clinics.  Residents receive 4-5 hours of individual and small-group supervision each week in the various psychotherapeutic modalities.

PGY-3 Didactics

PGY-3 residents have 6.5 hours per week of protected didactic time.  The curriculum includes a 2-hour per week psychotherapy observation course demonstrating CBT and psychodynamic psychotherapy via video feed with concurrent faculty and resident discussion.  The didactics include:

• Psychotherapy: psychodynamic, group, CBT, Dialectical Behavioral Therapy
• Evidence-based medicine—interactive case-based seminar
• Child/family psychiatry
• Substance Abuse
• Personality disorders
• Career planning

PGY-4 Clinical Rotations

The PGY-4 year is designed to enhance scholarship, leadership, and teaching skills.  Residents usually pursue a chief residency, research project, or in-depth clinical electives to further their individual goals.  Core experiences include a year long experience in advanced psychotherapy and a community mental health center rotation.  Residents receive 3-5 hours of individual and small-group supervision each week. 

PGY-4 Didactics

The fourth year didactics are seminar format and advance residents’ ability to read and critically appraise the current literature, major theories and controversies in the field, etc.  The didactics include

• Couples/family therapy, eating disorders
• Special topics and comparative theory
• Advanced psychodynamic technique
• History of psychiatry
• Pharmacology literature seminar
• Public & administrative psychiatry
• Career planning

Retreats

The psychiatry residency has an annual fall and spring retreat. 2008 spring ’s all-resident retreat was held April 30th at Hudson Gardens in Littleton, Colorado.  This spring’s theme was “Connection and Reflection.”  The event featured an inspirational and thought-provoking speech by Dr. Robert Freedman, department chair, on envisioning a future career in psychiatry, competitions among resident teams in psychiatry trivia and how well they know their fellow residents, personal goal setting, and small discussion groups with recent program alumni.  It was a beautiful spring Colorado day, affording residents the chance to wander and ponder in the gardens, soak up some sunshine, get to know each other, and have some fun. Pictures

The 2008 fall retreat will be October 1 at Arapahoe Community College. It willl include residents and fellows from all the psychiatry training programs and the theme is health and wellness, with workshops on nutrition, time management, fitness, yoga, and meditation.

The 2009 Spring retreat is planned for on April 29, with other details to be determined.

Department of Psychiatry Grand Rounds

The Department of Psychiatry offers weekly presentations of recent research, critical reviews of current areas, and case conferences.  Speakers include invited national and international experts, departmental faculty, and psychiatry residents.  Grand Rounds runs weekly September through May, Wednesdays 12:10-1:15 pm. 

Resident Review Committees

The training director meets approximately monthly with each resident class to monitor the educational and professional progress of the residents and the program, address concerns, monitor call and duty hours, and foster communication among residents and between the residents and the training office.