Commencing what will form the backbone of their classroom didactics, PGY-2 residents are excused from clinical responsibilities for 7 hours each Wednesday to attend five parallel courses divided thematically into Phenomenology & Clinical Neuroscience, Psychotherapy, Clinical Psychopharmacology, Social & Psychiatry Services, and Process Group. Additionally, the training directors hold a weekly meeting with PGY-2 residents at the start of each week’s class day.
In Phenomenology & Clinical Neuroscience, residents learn the meticulous understanding of and ability to describe symptoms of mental illness, including the multiple ways of conceptualizing patients’ presentations, from both subjective and objective frames of reference. With our goal to provide a translational means for residents to understand and talk to their patients as well as a literacy in approaching new research findings, we teach the underlying neuroscience of the various symptoms and syndromes, including intermediate phenotypes and a much more in-depth look at emotion, cognition, learning, and behavior, from socially observable phenomena down to genetics and epigenetics. In the latter third of the course, residents are taught using an experience-heavy pedagogical approach, departing from a basic lecture format in many instances and highlighting the approachability and clinical relevance of the material.
With a primary goal of our psychotherapy curriculum being to foster knowledge and skills—techniques, theories, efficacy, application—in the established and emerging evidence-based treatments, the curriculum grows in its breadth and depth, such that the 1 hour per week PGY-2 psychotherapy course morphs into a more substantial 2-3 hours per week experience in PGY-3 and 4. (This reflects classroom time and does not include other psychotherapy-focused learning experiences for residents, like weekly case conferences, supervision, etc.). Early on, residents are taught how to attend to patients’ moment-to-moment cognitions, emotions, and behaviors, how these may be acknowledged and therapeutically addressed, and core listening and responding skills common to a variety of different therapeutic orientations. Questions such as, What is the patient trying to tell me? and What do I say next?͟—as well as the How, When, and Why of it—form the core conceptual and pragmatic scaffolding on which this series is built. Following this pragmatic and practice-heavy introductory series, residents attend an 8-month weekly series on various Models of the Mind, with each theory-heavy component followed by learning techniques fundamental to a specific psychotherapy practice. The technique component often includes learning from the process of the instructor’s actual ongoing treatment of patients.
Psychopharmacology didactics begin with a brief overview of the nuts and bolts of the field, including pharmacodynamic and pharmacokinetic principles, the concept of target symptoms, and assessment of efficacy. The course goes on to examine, in nuanced fashion, each major class of psychiatric medications. Goals of the curriculum include mastery of psychopharmacology related to acute care psychiatry and how to adjust psychopharmacological treatments in the transition of patients from inpatient settings to alternative levels of care.
In keeping with the pedagogical philosophy behind our didactic curriculum, Social & Psychiatry Services is a comprehensive, multi-year course consisting of several discrete modules. Residents learn about the practice of psychiatry in systems, including the principles of publicly-funded mental health services, emergency psychiatry, and consultation-liaison psychiatry, including clinical, social, ethical, legal, administrative, and safety-based elements. Residents are introduced to increasingly complex issues in forensic psychiatry, including attending mock trials. This course also includes an introduction to mental health ethics, taught by Jacob Appel, MD, JD, (PhD in process), a graduate of our program and a highly-regarded former university professor of bioethics.
Process Group offers PGY-2, 3, and 4 residents a unique training experience in which residents come to learn about themselves and their peers and to process and examine their experiences in real time. Process Group is an in vivo training in how groups function and the effects of an individual within and upon the group. (As a resident, you work not only in tight-knit groups with your peers but also in larger groups within the medical system, where issues of leadership, professionalism, communication, responsibility, and individuality are ever-present.) In Process Group, residents are invited to share their thoughts, feelings, etc. and simultaneously be part of and observe a group experience, fostering growth and development. While not explicitly therapy, Process Group also fosters crucial self-reflection/assessment, resident cohesion, and an opportunity to discuss, in a confidential and supportive environment, the pressing emotional, social, and interpersonal issues involved in being a resident in psychiatry. The process which unfolds from week to week often helps with the pressures and stresses of residency. A fundamental agreement between members of the group and the leader(s) is that all said within the group is confidential. Each PGY class has its own weekly group, with leaders who remain the same through all 3 years. The leaders are chosen from experienced members of the voluntary faculty who have no supervisory or evaluative functions in the residency.
Explore a sample PGY-2 didactic schedule.