The University of Texas Medical School at Houston Department of Psychiatry & Behavioral Sciences
Department of Psychiatry and Behavioral Sciences
The Department of Psychiatry and Behavioral Sciences at the University of Texas Medical School at Houston

Educational Overview
(PG Year Goals)

 


PGY-1 | PGY-2 | PGY-3 | PGY-4 | CHART | Research Track

PGY - 1

The PGY-1 year is a transitional year rotating through Primary Care, Neurology and Psychiatry. The clinical rotations and course curriculum in the PGY-1 year foster the resident’s developing identity as a competent and caring physician. These rotations offer broad clinical experience, excellent teaching, and appropriate levels of responsibility. In addition, residents begin to develop knowledge and skills in the diagnosis, management and treatment of severely disturbed and mentally ill inpatients. PGY-1 residents will do 6 months of Psychiatry at the Harris County Psychiatry Center (HCPC), 4 months of Primary Care (including possibly Inpatient, Internal Medicine, Psychiatry and Behavioral Sciences, Family Medicine and/or Ambulatory Care Rotations and Emergency Medicine), and 2 months of Neurology through different affiliated hospitals.

Psychiatry residents rotating on medicine, neurology, and Psychiatry and Behavioral Sciences rotate on specific services chosen through a collaborative agreement with the residency directors of the respective departments. While on non-psychiatry rotations, residents function as a level I trainee of the host department. However, regular contact with the Department of Psychiatry is maintained through weekly resident meetings with the chief residents and semi – annual individual meetings with the Program Director. As well, the Program Director has an open door policy.

PGY - 2

The PGY-2 year builds on the PGY-1 experiences in medicine, exposing residents to inpatient psychiatric treatment in academic and private and public psychiatry hospitals, with more complex, dually diagnosed and medically complex patients. PGY-2 residents develop skills as psychiatric educators through increased responsibility for the teaching and supervision of medical students, and through coursework and supervision on education and educational techniques. Residents take all call at the Harris County Psychiatric Center.

The PGY-2 residents will spend 12 months at the Harris County Psychiatric Center during the PGY-2 year. PGY-2 residents rotate at the child/adolescent units at HCPC for 2 months. The resident is expected to act as the patients’ primary physician and is responsible for all aspects of patient care, while working closely with the attending physician. The resident is responsible for taking the psychiatric and medical history and performing a complete mental status and physical exam, along with initial assessment, problem list, and initial treatment plan on each patient assigned to him or her. Any positive findings should be reviewed and confirmed. The resident is then responsible for writing orders for initial work-up, therapy, and for the disposition of the patient, all under supervision of the attending psychiatrist. There will be a minimum of one hour per week individual supervision of each resident by the faculty attending in the PGY-2 year.

Experience is gained in interviewing skills, problem-oriented treatment planning, psychopharmacological and other somatic therapies and individual, group and family therapies.Teaching conferences take place throughout the training year. In addition, PGY-2 residents attend didactic sessions to enhance their clinical and interviewing skills and will be designated to interview a patient he/she has not seen before in 30 minutes. During this time the resident will get the history of the patient including mental status and previous medical issues. Afterwards, the resident will have 30 minutes to present the history and develop a differential diagnosis. A senior faculty supervisor will then critique the interview and presentation. These seminars are geared to assist residents to develop skills and prepare them appropriately to succeed in the three required clinical skills assessment exams. This short interview is not what one will normally carry out, but this one hour session is the format of the psychiatry oral examination which is required to receive board accreditation.

PGY-3

The PGY-3 year is an outpatient year and the residents are based at the Behavioral and Biomedical Sciences Building (BBSB), Veterans' Administration (VA) sites at Conroe, Texas City and Richmond, Memorial Hermann and Prevention and Recovery Center (PaRC) for this year. The PGY-3 year is designed to enable residents to function more independently and to follow a large number of patients longitudinally; PGY-3 provides year-long experience in the general psychiatry outpatient and long-term psychotherapy training clinics. Residents provide teaching and supervision for medical students and provide back-up for PGY-2 residents who take call.

Adult patients are referred to our clinics from within The University of Texas Hospitals, insurance, and word of mouth. Problems vary from complex diagnostic issues to more common affective, anxiety and adjustment disorders. Residents are assigned to two or three general clinics per week, performing intakes and providing psychiatric follow-up to many patients. The clinics are designed to enable residents to pick up a large caseload of patients with varied diagnoses and treatments. Residents follow some patients in long-term psychodynamic psychotherapy, offer Interpersonal therapy or Cognitive Behavior Therapy to others, follow some family or couples cases, and have ample opportunity to work collaboratively with psychologists and social workers in coordinated treatment. Wednesdays are deemed academic days for PGY-3 residents. They are expected to attend academic lectures, mandatory resident meeting, as well as three hours of didactic seminars. All residents are exempt from their clinical duties during their seminar time.

PGY-4

In the PGY-4 year, residents solidify leadership and administrative skills, enlarge clinical confidence and autonomy, and focus on individual specialized areas of interest. This year allow the resident to pursue areas of interest discovered in the first three years of training.

One PGY-4 resident is chosen to serve as Administrative chief resident. The chief resident facilitates resident meetings, works closely with the Residency Training Director on administrative issues, and acts as a liaison between the residency office and the residents.

PGY-4 rotations are C&L with services at the following major rotations: LBJ, MHH and MDA hospitals. Residents obtain comprehensive experience in emergency psychiatry. Sometimes there are funded “elective” rotations in private hospitals but only funded rotations can be taken as an elective and at times none are available.

CHART

Year 1 6 Months 2 Months 4 Months
Psychiatry HCPC Neurology MHH Primary Care – MHH, LBJ/HCHD (Internal Medicine – 3 months Family Practice – 1 month)
Year 2 10 Months 2 Months
Inpatient Psychiatry, Emergency and C&L Psychiatry, HCPC including Geriatrics, Dual Diagnosis, Emergency and Community Psychiatry Child/Adolescent HCPC
Year 3 12 Months
Full-time Outpatient, BBSB, VA sites, MHMRA and PaRC, Including Geriatrics, Dual Diagnosis, Emergency and Community Psychiatry
Year 4 12 Months
Consult Liaison (Including Administrative and Emergency Psychiatry) MDA, MHH, LBJ, HCPC, NPC

Research Track

For interested and eligible residents, the adult psychiatry residency program at UT-Houston offers a research track in their residency training from the PGY-1 year onwards. We can accommodate up to two residents per year for the research track with provision for protected time to engage in formalized research training and also in mentored research activities. Research-track residents are assigned a mentor in the PGY-1 year and are encouraged to attend courses in research offered through the UT Houston Health Science Center. In the PGY-2 year, they rotate at least three months with faculty members actively involved in clinical research at the UT Harris County Psychiatric Center. In the PGY-3 year, they are assigned to the various research clinics within the departments including the UT Center of Excellence on Mood Disorders and the Center for Neurobehavioral Research on Addictions (CNRA). During the PGY-4 year, residents in the research track can take electives up to six months in the Center for Neurobehavioral Research on Addictions. If the resident is interested in pursuing a career devoted to research, the department would be able to fund post doctoral fellowships under the auspices of the above mentioned clinical research centers. The overarching goal of the research track is to help the residents acquire necessary skill sets and technical expertise and also to establish valuable mentoring relationships in order to prepare them for a productive career in academic research.