Psychiatry Residency Clinical Rotations
Adult Inpatient - 11 months || Chief Adult Inpatient - 3 months || Geriatric Inpatient - 1 month || Outpatient Care - 12 months || Adolescent Inpatient - 2 months || Neurology - 2 months || Community Psychiatry - 1 months || Primary Care - 4 months || Consultation/Liaison - 3 months || Substance Abuse - 1 month || Electives - 8 months || Developmental Disabilities - 1 month (FTE)
Primary service area - Springfield and vicinity (population 160,000)
Referral area - Central and Southern Illinois (population 2,000,000)
Residents care of patients from all socioeconomic, racial, gender, and age groups
PGY-1 residents are required to rotate through four months of family medicine. Residents are supervised by faculty from the corresponding department and work with a resident and attending team learning the identification, assessment, diagnosis, management, and continuity care, and further treatment planning for a range of acute and chronic medical conditions. The rotations generally occur in Memorial Medical Center but may involve ambulatory care clinics held at other departmental sites. Residents take call duty with the service on which they are rotating.
PGY-2 residents are required to rotate through two months of inpatient adult neurology while being supervised by faculty from the Department of Neurology and participating in the care of patients with a variety of neurological acuity. Residents generally spend one month on the inpatient neurology service at Memorial Medical Center, providing care to a general acute neurologically ill population, and one month on the Neurorehabilitation Service at Memorial Medical Center providing care to patients undergoing post-acute care for neurological conditions such as trauma, stroke, spinal injury or conditions, and neurodegenerative conditions. Residents are exposed to a range of conditions that are relevant to psychiatric differential diagnosis and which can form the border zone between psychiatry and neurology. Residents on the inpatient neurology service take call duty for the neurology service. Residents in neurology and psychiatry participate in a weekly interdisciplinary case conference in which selected cases from both services are discussed by faculty from a variety of perspectives.
PGY-2 residents rotate through one month on the substance abuse consultation service at Gateway Foundation Alcohol and Drug Treatment Centers where they are trained in the evaluation, recognition, diagnosis, and treatment planning of inpatients with substance abuse, dependence, withdrawal, and substance-related disorders. Residents are also trained in motivational interviewing techniques. Supervision is provided by School of Medicine MD faculty who serve as adjunct faculty in the Department of Psychiatry.
ADULT INPATIENT PSYCHIATRY
The Adult Inpatient Psychiatry rotations take place on the acute psychiatric units of the two general hospitals; Memorial Medical Center and St. John's Hospital. The patient population at Memorial Medical Center varies in ages from 18 and older and includes patients with a wide range of mood, anxiety, psychotic, substance related, personality disorders, behavioral and psychiatric disorders associated with various dementing illnesses, and other mental disorders due to general medical conditions. St. John's Hospital is for patients who are over 60 years of age. Residents gain experience in the evaluation, diagnosis, treatment planning, and medical management of psychiatric and co-morbid medical disorders. In addition, residents rotating at the two general hospitals interact often with other medical and surgical services to provide integrated care. Residents regularly interact with allied healthcare staff such as nurses, social workers, case managers, and mental health technicians. PGY-1 residents will spend eight months on Adult Inpatient Psychiatry rotation, PGY-2 residents will spend three months, and PGY-4 residents will spend an additional three months on the Adult Inpatient Psychiatry service in the role of chief inpatient resident. Supervision is provided on each rotation by departmental faculty. Medical students participate regularly on the inpatient team.
CHILD AND ADOLESCENT INPATIENT PSYCHIATRY
Residents rotate for two months during the PGY-2 on the Child and Adolescent Inpatient Psychiatry unit located at St. Mary's Hospital. The patient age range is up to to 17 years of age and is drawn from a large area of central and southern Illinois. Psychopathology includes mood disorders, attention deficit with hyperactivity disorder (ADHD), psychotic disorders, conduct and oppositional-defiant disorders, autistic spectrum disorders, and others. Supervision is provided by faculty from the Division of Child Psychiatry. Residents interact frequently with allied staff and services and are exposed to family evaluation and therapy, forensic issues, group therapy, individual evaluation, diagnosis, and treatment planning all within the context of a multi-disciplinary treatment team approach. Medical students participate regularly on the inpatient team.
PGY-2 residents will spend one month on the Community Psychiatry rotation. Residents rotate through Memorial Behavioral Health, Community Recovery Services, a psychosocial rehabilitation program for severe and chronic mental disorders. Residents participate in medication management clinics, home visits, team meetings, and are supervised by the medical director and a psychiatry faculty member. This model of care delivers wrap-around case management, nursing, and psychiatric services to patients with diagnoses including schizophrenia, schizoaffective disorder, bipolar disorder, and major depressive disorder, substance abuse/dependence, and personality disorders. Patients who are psychiatrically hospitalized are cared for by the faculty/resident team to provide continuity of care. Also during the Community Psychiatry rotation, residents attend and participate in a clinic for the developmentally disabled population with concomitant psychiatric disorders for one day each week where they are supervised by a faculty from the Division of Developmental Disabilities of the psychiatry department.
Residents rotate on the Consultation/Liaison service providing psychiatric consultation to non-psychiatric medical and surgical services at Memorial Medical Center and St. John's Hospital during the business day. PGY-2 residents spend two months on this service and PGY-4 residents spend one month on the service. Supervision is provided by faculty from the Division of Medicine-Psychiatry in the Department of Internal Medicine. Residents see a variety of psychiatric problems including delirium, dementias, mental disorders due to a general medical condition, substance related disorders, adjustment disorders, personality disorders, psychological conditions affecting medical disorders, psychotic disorders, anxiety disorders, mood disorders, evaluations of decisional capacity, and suicide attempts. Residents are trained in evaluation, diagnosis, treatment planning, and follow-up care in psychiatric consultation.
PGY-3 residents rotate through 12 months of outpatient psychiatry in a variety of clinics including forensic, geriatric, child and adolescent, developmental disabilities, treatment-resistant disorders, and new patient evaluation. In addition, residents follow their own caseload of patients for psychotherapy and psychopharmacological management. Direct supervision occurs through the specific attending supervisor for each clinic. Residents also receive direct supervision by a clinical supervisor and a psychotherapy supervisor.
SPECIAL NEEDS CLINIC
PGY-2 residents attend and participate for two months in a clinic for the developmentally disabled population with concomitant psychiatric disorders for one day each week where they are supervised by a faculty from the Division of Developmental Disabilities of the psychiatry department.
PGY-4 residents have eight months of electives that can include further inpatient adult or child and adolescent psychiatry, psychotherapy, neuropsychology, research, forensic psychiatry, outpatient chief resident, ECT, psychopharmacology, consultation/liaison, developmental disability, the partial hospitalization program, and a variety of other electives that can include time at other institutions for special training experiences or research. Residents continue to work with faculty supervisors throughout this period.