Department of Psychiatry
and
Behavioral Sciences
Residency Training Program -
Academic Overview
Residency
Training Program
The program offers four years of training for those applying directly from medical school and is designed to give the resident comprehensive exposure to the many facets of contemporary psychiatric practice. Rotations include treatment experience with patients ranging from children to the elderly. Residents rotate on services devoted to the assessment and management of patients with acute and chronic psychotic states of both toxic-organic and functional etiology, patients who suffer from alcohol and substance abuse conditions, patients with forensic problems, and patients requiring psychotherapy. Experience in consultation psychiatry on medical/surgical units is provided in the PG 4 year.
First Postgraduate Resident Year
In the first year of residency after medical school or for residents who have had training outside the United States but are in the first year of their training in the United States, the resident must spend four months on primary care (either family practice, internal medicine or pediatrics) and two months on neurology. The residents are asked, as soon as the match is completed, to register their preference of primary care area they would like to start in or if they would like to start with primary care/neurology or psychiatry. Preferences are filled on a first come first served basis.
The four months of primary care is combined with the two months in neurology. There is an attempt to match these in a way that keeps the primary care/neurology as a solid block but sometimes the six months on psychiatry may be split. The resident will perform on a par with PGY 1 peers in these other specialties.
The balance of the first graduate year is spent in psychiatric rotations on adult inpatient units at the Harris County Psychiatric Center (HCPC), a 250 bed public psychiatric hospital that provides short- and intermediate-term treatment to more than 4,000 people annually. Experience in these programs helps develop the resident’s skills in psychiatric assessment, diagnosis, case presentation, and inpatient management within the context of the multidisciplinary team approach.
The PGY 2 residents have all their rotations at HCPC. Often all six months of the PG 1 year have been on general psychiatry but occasionally some rotations on some of the subspecialty units at HCPC may already have occurred. In the combination of PG 1 and PG 2 years, a resident will spend two months on the receiving unit at HCPC where patients are initially admitted to the hospital and usually transferred to an appropriate unit within 12 to 36 hours. Over the first two years of residency, residents will have at least one month on the geriatric unit. In the PG 2 year, the resident will have two months in Child Psychiatry, usually with one month on the Adolescent Unit and one month on the Child Unit.
The experiences broaden the resident’s perspective in evaluation and management of a great variety of patients with acute and chronic mental illness. There is close faculty supervision using a biopsychosocial model. Professional identity is developed as the resident serves the patient and the patient’s family as a physician and psychiatrist within the treatment team. Experience is gained in interviewing skills, problem-oriented treatment planning, psycho-pharmacologic and other somatic therapies, and individual, group and family therapies.
In addition to teaching conferences, the resident is placed in the role of teacher, with faculty supervision for the instruction and supervision of medical students during their basic clinical psychiatry clerkships.
In the PG 2 year, the resident begins to see outpatients at the University of Texas-Houston Mental Sciences Institute (MSI) in the Family Therapy clinic. MSI is an educational and research facility providing approximately 30,000 outpatient visits annually.
During this year, the resident has a continuous supervised outpatient experience. This rotation, for the most part, is at MSI but, the resident spends one day a week at one of the Mental Health Mental Retardation Authority (MHMRA) clinics in the city doing intakes and seeing individual patients for follow up.
Three days of the week are devoted to outpatient adult care, including the MHMRA rotation. One day a week, for six months, involves intakes and follow up of child psychiatry patients. One day a week, Wednesdays, is devoted to academic lectures, resident meetings, seminars and individual patient visits.
MSI has clinics that provide services for addictions, geriatrics, and treatment of behaviorally disturbed, mentally retarded and autistic individuals. The residents have the opportunity to get involved in these specialty areas if they so desire.
PGY 4 residents spend at least four months, though possibly more as consult liaisons at the Lyndon B. Johnson General Hospital and/or Hermann Hospital.
"Selective" rotations, where the resident has the opportunity to locate funded positions in areas of special interest, are encouraged.
Some PGY 4 residents rotate full time at the MHMRA clinics including the Crisis Center. Occasionally private practice groups will fund PGY 4 residents for full-time participation in private sector combined inpatient/outpatient managed care activities. Full-time research slots are sometimes available for the interested residents during the PG 4 year.
PGY 1 and PGY 2 residents are on-call at HCPC nights and weekends on a rotating schedule. One resident does "short calls" and goes home sometime before 11p.m. if clinical load permits. The other resident does the "long call" and stays until the following morning. There is a backup PGY 3 or PGY 4 resident. These residents are available for consultation by phone and, in unusual circumstances, may come to the hospital to help with an usually high number of admissions.
An attending physician is on call for HCPC and another attending for MSI. These physicians can be contacted either by the resident on call at HCPC or by the backup resident when there are difficulties.
PGY 1 residents attend seminars throughout the year. General topics covered are patient evaluation and treatment selection, somatic treatment methods, alcohol and substance abuse, adult psychopathology, developmental issues, psychosocial therapies, morals and ethics in medicine as well as cross-cultural psychiatry. PGY 2 residents attend seminars covering many of the same general topics as PGY 1 residents though with a different level of complexity. Neurology and neuropsychiatry are emphasized in the PG 2 year.
The PGY 1 and 2 residents present cases to the department chairman every other week and on alternating weeks view videotaped cases. Residents review both the initial interview and ongoing psychotherapy then discuss with faculty the issues being developed in these cases.
PGY 3 residents attend seminars with an emphasis on psychosocial therapies, public policies towards the mentally ill, ethics, as well as child and adolescent psychiatry.
Once a month a PGY 3 resident participates in a joint presentation with a Psychology resident who has had contact with the same patient. Selected faculty discuss the patient and treatment issues.
In the final year of residency training, PGY 4 residents attend one a week. The topics change throughout the year. Some of the issues addressed are managed care, private practice staffing and administration.
Available to PGY 3 & 4 residents is the department chairman’s "Original Thinker’s Seminar." This seminar is designed to familiarize residents with the history of psychiatry theory by reviewing and discussing classic papers.
"Academic lectures" provide the resident with an opportunity to hear from some of the leading researchers and clinicians in psychiatry and neurology. Academic lectures are regularly schedules nine months of the year, three times a month. Speakers brought in from all over the country as well as our own senior faculty, present in their areas of expertise.
Through a gracious donation from the Cooper family, a lectureship has been established to provide funding to bring in outstanding leaders in psychiatry and neurology research to speak about treads, policy and ethics.
Research
Opportunities
There is a good deal of research done in the Department of Psychiatry and Behavioral Sciences. The department is second in the medical school as far as getting research grant dollars. Residents have opportunities in the PG 3 and PG 4 years to get involved with specific mentors if there are areas that interest them. As noted earlier, PGY 4 residents may elect to take electives in a research area if funding is available.
The Department of Psychiatry and Behavioral Sciences uses the standard National Resident matching Program Application for Residency. PGY 1 residents are selected through the match. Once the completed application forms are reviewed, the applicant may be invited for an interview. The interview process is from October through January. For more information or an application package, please contact:
Glories E. Softly
Residency Training Coordinator
Department of Psychiatry and Behavioral Sciences
The University of Texas-Houston Mental Sciences Institute
1300 Moursund, Room 267
Houston, Texas 77030
713-500-2570
713-500-2530 (fax)
Glories.E.Softly@.uth.tmc.edu
Department of Psychiatry &
Behavioral Sciences Main Page
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Last Modified by amd 8/12/99