Program Highlights

While our residency program has been carefully structured to provide comprehensive and balanced training and education in psychiatry, it also offers you plenty of flexibility to tailor the experience to meet your specific interests.

Key elements of each stage of the program are highlighted below.

Medicine

Internal medicine rotations for our residents are arranged with the University of Rochester's Internal Medicine Program. Rotations include emergency and inpatient services, providing interns with the solid internal medicine foundation they need to begin practicing psychiatry. Throughout this training, our Medicine in Psychiatry faculty supervises and instructs residents in the evaluation and management of patients' medical conditions.

Neurology

The Neurology Consultation Service at Rochester General Hospital (the largest of the affiliated hospitals) is the site of the two-month neurology rotation. In this setting, residents see a wide variety of clinical neurological problems while being supervised and taught by full-time clinical faculty of the Department of Neurology.

Acute- and Intermediate-Stay Inpatient Psychiatric Care

Training in these levels of care immerses residents in a combination of inpatient, emergency, and consultation/liaison services. Training is rounded out with formal didactic seminars, Residents' Morning Report, service-based case conferences, and close supervision by teaching attending faculty. The main clinical rotations for inpatient training are:

General Acute Inpatient Services
Over the course of the PGY-1 and -2 years, all residents spend four to seven months in this services.

Geriatrics and Neuropsychiatry (GNPU)
PGY-2 residents spend three months on this service that treats equal volumes of general and specialty cases. Geriatric and neuropsychiatry cases allow residents to learn a team approach to evaluation and management of these specialty patients. Our trainees work alongside psychogeriatric specialists and fellows in the geriatric program.

Rochester Psychiatric Center (RPC)
Residents in the PGY-1 or -2 year spend three months in our state hospital collaboration services at one of two sites: an intermediate-stay treatment service for patients with serious mental illness or the Regional Forensic Unit (RFU).

The intermediate-stay service provides tertiary assessment and treatment programs for refractory patients. In this setting, residents are involved with experimental psychopharmacology studies and state-of-the-art rehabilitation programming.

In the RFU—a secure mental health setting—residents team with fellows from the forensic psychiatry program and are supervised by forensic faculty specialists. They participate in the evaluation of acutely ill prisoners with a wide variety of psychiatric disorders. Electively, they can also work with patients declared "incompetent to proceed with trial" and "not responsible by reason of insanity."

Child and Adolescent Acute Services
PGY-2 residents rotate on this regional referral service, which provides evaluation and short-term treatment to children aged 5-18 years with a variety of major psychiatric and behavioral disorders. The rotation includes inpatient and partial-hospital components.

Emergency Psychiatry

Psychiatric Emergency Department
During the PGY- 1 or -2 year, residents rotate in the Psychiatric Emergency Department and engage in a two-month experience in emergency and crisis evaluation and intervention. This department is part of a Comprehensive Psychiatric Emergency Service with extended observation beds, a crisis clinic, and a mobile team for community outreach and home assessments. Residents of all years participate in emergency room call.

Consultation Psychiatry

Psychiatric Consultation Services
PGY-2 residents spend three months on this active service, which provides more than 1,500 consultation visits per year to the inpatient and ambulatory medical/surgical services at Strong Memorial Hospital. Consultation in primary care and specialty ambulatory clinics (including organ transplantation and comprehensive epilepsy services) may be part of the resident's elective experience. In this multidisciplinary service, psychiatry residents are part of a team that includes geriatric fellows and residents from internal and family medicine programs.

Long-Term Care (Strong Ties)

Through the Strong Ties Community Support Program, PGY-1 residents get their first exposure to longer-term care models. PGY-3 residents have a major rotation in our ambulatory center for the care of the seriously and persistently mentally ill. They become integral members of multidisciplinary teams which provide clinic-based primary and collaborative care, continuing day treatment, and rehabilitation services. Additionally, PGY-3 residents participate in an ongoing seminar series focused on long-term care and seriously and persistently mentally ill patients.

Ambulatory Psychiatry

Residents begin to follow ambulatory patients during the PGY-2 year. PGY-3 residents have a defined rotation in the Psychotherapy Consultation Clinic (PTCC) and Psychopharmocology Clinic (PCC). In PGY-2-4, residents work with clinic-based teaching attendings and assigned supervisors and preceptors to gain experience and expertise in office-based care of ambulatory patients.

Psychotherapy Training

A fundamental goal of this program is to equip graduating psychiatrists with a solid theoretical and clinical background in psychotherapy, enabling them to provide excellent psychotherapeutic care to patients in individual (brief and long-term), group, and family settings. As part of their training, residents gain experience working with a patient base, engage in organized didactic programs that provide a theoretical framework, and tap the knowledge of experience of enthusiastic faculty supervisors. The department recently established its Psychotherapy Institute, to elevate and sharpen the focus on this important area of patient service among all trainees in all disciplines throughout the region.

Somatic Therapies Training

Another fundamental goal of residency training is to graduate psychiatrists who are competent and confident using biological treatments for mental disorders in emergency, acute and ambulatory settings.

Starting with an introduction to fundamentals of psychopharmacology in PGY-1's Psychopathology and Basic Psychopharmacology Seminar, and continuing with the Neuroscience in Psychiatry and Advanced Psychopharmacology Seminars in PGY-2, residents gain essential knowledge about drug therapies and their underlying neurobiology.

Additionally, each resident spends two weeks part-time with the Electroconvulsive Therapy Service. This, together with consultations during an inpatient rotation, provides residents with a solid understanding of the science and techniques of ECT treatment.

Family and Marital Therapies

Our department's long heritage and experience in family-focused care is passed along to residents through expert training and supervision in family therapies. Didactics on family systems topics begin in PGY-1, and supervision in family interventions is a regular part of training. Additional formal and informal elective experiences are available through the Division of Family Programs, which offers fellowship certification.

Specialty Populations

Addictions Psychiatry
Our Department is fortunate to have a continuum of services for patients with addictions. These include inpatient, partial-hospital, general and methadone maintenance clinics, and family support groups. PGY-2 residents spend one month in addiction services and other treatment setting conducting evaluations and follow-ups with a faculty specialist in addictions. Didactic seminars in the first three years of training include topics in addictions psychiatry. Elective opportunities are available for senior residents.

Child and Adolescent Psychiatry
Exposure to child and adolescent psychiatry is important for general psychiatric trainees. The main clinical experiences take place during PGY-2's Child and Adolescent Acute Services rotation and in the PGY-3's ambulatory year, following an ongoing child case under the supervision of a child specialist. PGY-1 didactics in normal development and psychopathology provide a developmental perspective and highlight child topics. An ACGME-accredited residency in child and adolescent psychiatry is available for residents at the PGY-4 level and above.

Forensic Psychiatry
PGY-3 residents have a three-month seminar series and clinical experience with the Monroe County Socio-Legal Center. This advanced learning experience covers topics such as:

Evaluating psychopathology in legal settings
Ethics
The interface of psychiatry and the law
Legal regulation of psychiatry
Conducting specialty evaluations in criminal justice settings, including the Monroe County Jail and probation, and parole departments.

Geriatric Psychiatry
PGY-2 residents have a two-month rotation on our geriatrics inpatient service. PGY-3 residents have a part-time rotation in geriatrics, either at a University-affiliated nursing home or the CMHC Older Adults Clinic. In these settings, residents are supervised by psychogeriatric specialists and work with geriatric fellows. Seminars in PGY-1, -2, and -3 feature topics in geriatric psychiatry as well.

Mental Retardation and Developmental Disabilities (MRDD)
PGY-3 residents rotate through this ambulatory specialty clinic, conducting evaluations, providing consultations, and following patients in ambulatory care. An MRDD specialist supervises these cases. Didactic seminars in PGY-1, -2 and -3 years include MRDD topics.

Residents as Scholars and Teachers

Research
Scholarship, in its broadest definition, is an integral component of residency training. We recognize that no dominant scientific approach presently explains all psychiatric conditions. Thus, research is essential to the future development of psychiatry as a medical discipline, and to future psychiatrists, either as clinicians or investigators.

Although it is not required, we encourage all residents to participate in supervised independent research. Each PGY-4 resident is expected to prepare a publication-quality, scholarly paper, which may be based on the resident's own research or reflect an innovative or scholarly literature review. The work is then presented at the Departmental Grand Rounds. Close supervision by an assigned mentor is an essential component of this experience.

Teaching
There are numerous opportunities for residents to leverage their knowledge in the course of their training by teaching others.

PGY-1 and -2 residents on inpatient services have direct responsibility for third-year medical students during psychiatry clerkships.
PGY-3 and -4 residents, in addition to working with medical students in ambulatory psychiatric clinics, supervise junior residents in a variety of settings.
Many residents also elect to become small group leaders for the medical school's first- and second-year courses.
The chief resident and PGY-4 residents have opportunities to develop advanced teaching and administrative skills.