PGY-1 Curriculum

Training during the first year initially focuses on enhancement of primary medical skills, with rotations in internal medicine or pediatrics. Residents spend four months in primary care. A two month neurology rotation is spent at the Veterans' Administration Hospital. The neurology service offers inpatient, outpatient and consultation-liaison experience during this time. Residents receive their first exposure to inpatient psychiatric treatment during 6 months of rotations, which are spent at the VA Medical Center and at the state psychiatric hospital, the Memphis Mental Health Institute. Trainees assume primary responsibility for their patients under the close supervision of staff psychiatrists.

This phase of residency emphasizes the development of skills in psychiatric interviewing, differential diagnosis and the formulation of a comprehensive treatment plan that includes pharmacologic, psychological and social components. Residents are also assigned an individual supervisor who serves as a resource for the resident during the entire first year of training. In the second, third, and fourth years of their training, residents are assigned two faculty members each year per year for individual outpatient supervision.

Trainees assume primary responsibility for their patients under the close supervision of staff psychiatrists. All residents are assigned a faculty member for individual supervision throughout the PGY-1 year. Residents are assigned two faculty supervisors throughout the PGY-2 through the PGY-4 years. This phase of residency emphasizes the development of skills in psychiatric interviewing, differential diagnosis and the formulation of a comprehensive treatment plan that includes pharmacologic, psychological and social components.

Courses and Seminars

Orientation and Psychiatric Emergencies (2 months)

The course is an introduction to the residency program and instruction in crisis intervention, suicidology, the violent patient, families in crisis, emergency interviewing, legal issues, psychiatric manifestations of medical illness and treatment planning.

Interviewing and Mental Status (2 months)

Patient attitudes toward psychiatry, the "expert-patient" relationship and verbal and non-verbal communication are discussed. Methodology, direct observation, role-playing, and videotapes of interviews conducted by faculty and residents are utilized to introduce techniques and principles of the psychiatric interview.

Introduction to Psychopharmacology and Psychobiology (4 months)

This seminar focuses on the classification, therapeutic uses and side effects of psychotropic agents as well as important drug-drug interactions.

Managed Care and Medical Economics (1 month)

The course is designed to help residents understand the impact of economic issues on the provision of psychiatric services. It covers the following topics: history and evolution of the insurance industry, model structures, Medicaid in Tennessee, Medicare, disparities in mental health coverage and carve-outs, and managed care practice.

Diagnosis and Treatment of Psychiatric Disorders (4 months)

Designed to acquaint the resident with an overview of diagnosis of psychiatric disorders and treatment planning, the course complements the resident's clinical experience and reviews current research relating to various diagnostic and treatment issues, as well as the rationale for ongoing revision of the Diagnostic and Statistical Manual.

Forensic Psychiatry and Ethics (2 months)

Basic issues of civil and criminal forensic psychiatry are presented, including child custody, competency, the insanity defense, and the legal regulation of psychiatric practice. Case histories are used in discussions of issues such as confidentiality and the right to refuse treatment.