Didactic Curriculum

PGY-1

Overview of Psychiatry
This is a year-long seminar for all PG-1 residents. It begins with a two-month review of psychiatric history taking, the mental status and cognitive exams, psychiatric emergencies and basic psychopharmacology. It proceeds to a review of the major domains of modern psychiatry. The course covers symptoms, diagnosis, clinical course, psychopathology, epidemiology, clinical psychopharmacology, and psychotherapy. Time is allotted for special (top)ics such as culture, forensics, ethics, and psychological testing. Residents will have the opportunity to meet many of our faculty.

Emergency Psychiatry
A case-based overview of basic (top)ics in emergency psychiatry, including emergency management of affective and psychotic disorders, drug intoxication/withdrawal syndromes, the evaluation of suicidality and homocidality, elementary forensic issues, and culture.

Clinical Case Conference
PG-1 (and PG-2) residents present patients from their teams. Patients are interviewed and then discussed by the faculty. The course emphasizes interviewing techniques, criterion-based diagnosis, biopsychosocial formulation, pharmacotherapy and treatment planning. Cases are scheduled so that special areas such as families, culture, forensics, geriatrics, and addictions are covered regularly over the course of the year.

The Biopsychosocial Formulation
In-depth tutorial geared toward gathering the psychosocial, developmental, and relational history. From these data, a formal biopsychosocial formulation is developed. Residents prepare comprehensive formulations weekly and submit them in writing for review and discussion. Readings are also included.

Reactions to Patients
Residents participate in a group tutorial with a specific focus on their reactions to patients during the course of their inpatient admissions and brief psychotherapy. This tutorial includes work on self-reflection and its use in clinical management.

PG-1 Group
Goals for this group include assistance with the transition from medical student to resident, fostering the consolidation of this first-year class, receiving practical advice from each other and advanced residents about clinical rotations, sharing with colleagues clinical experiences with patients, discussing diverse cultural and ethical issues, and meeting with rotation coordinators and key faculty.

Grand Rounds
Research (top)ics, clinical presentations of particular syndromes, in-depth presentations in psychopharmacology and psychotherapy, followed by a discussion period. The planning group, comprised of multidisciplinary senior faculty ensures a broad range of issues presented by national experts. Departmental multidisciplinary case conferences are held five to seven times during the year.

Journal Club
All residents meet to discuss a specific (top)ic or paper with a faculty member who has expertise in the chosen area. Critical readings of psychiatric literature and focused articulation of ideas are the primary goals.


PGY-2

Clinical Psychopharmacology
This course provides an in-depth presentation of the psychopharmacology of psychosis, major depression, bipolar disorder, the specific anxiety disorders and severe character pathology, as well as special topics. Links are consistently made between clinical aspects and neurobiology/neuroscience. A didactic introduction to ECT is included.

Introduction to Neurobiology
This course provides more junior trainees with an introduction to the molecular and genetic neuroscience and neurobiology of the major psychiatric disorders. Domains include schizophrenia, the addictions, affective disorders, anxiety disorders, and dementias.

Introduction to Psychotherapy
This is a modification of the year-long course developed by B. Beitman. It systematically presents an integrated model of psychotherapy, with an introduction to psychodynamic, cognitive-behavioral and interpersonal principles. It covers the core knowledge and basic skills of psychotherapy.

Emergency Psychiatry/Crisis Intervention
Case-based review of topics in ER and crisis intervention psychiatry. Emphasis alternates between the ER and short-term crisis outpatient settings, with progression during the year from intermediate to advanced skills. Relevant cultural and forensic issues are addressed.

Ways of Listening: Interviewing/Identifying the Task of Psychotherapy/Introduction to the Oral Board Format
This course gives residents the opportunity to observe clinicians and residents interviewing patients. The initial segment focuses on interviewing styles, maintenance of the alliance, psychosocial and developmental issues, timing, boundaries, and "surprise". The middle segment provides the opportunity to perform and observe interviews and engage in Q/A sessions in the model of oral boards. The course leader and the other residents will critique these sessions. The final segment focuses on the initial interview as a means to establish the initial task of psychotherapy.

Normal Development and Developmental Psychopathology
This course reviews the fundamentals of child and adolescent development. Residents will read and discuss the classic framework writings of Erickson and Margaret Mahler. The course presents the biopsychosocial model of understanding developmental psychopathology and addresses the major domains of child and adolescent psychiatry.

Geriatric Psychiatry
Core readings with discussion of geropsychiatry, including the approach to the geriatric psychiatry patient, psychosocial and sociocultural issues in aging, dementia, late-life depression, geriatric psychopharmacology, legal and ethical issues, aging and personality, and psychosis in the elderly.

Addiction Psychiatry
This seminar covers a broad range of topics relevant to the understanding of addictive disorders. The basics of addiction, including epidemiology, neurobiology, and genetics are addressed. There is a strong emphasis on how to understand addiction and make inroads as a therapist. Approaches presented include 12-step programs, motivational enhancement therapy, and cognitive-behavioral therapy. Recent advances in the pharmacology of addiction, as well as techniques of inpatient and ambulatory detoxification, will be discussed.

Introduction to Family Therapy
This course covers the basic aspects of systems theory, family interventions, and the family as a sociocultural unit. Cross-cultural, gender, and alternative-lifestyle issues are also discussed.

Principles of Clinical Research
This course covers principles of biostatistics, research design, current prominent models of psychiatric clinical research, and critical reading of the literature. It prepares those anticipating research as a central focus of their advanced years for this work.

Psychosomatic Medicine and Neuropsychology Conference
Employs case presentations to review topical material. Clinical material, videotapes, and neuroimages are presented when relevant. Areas in behavioral neurology and psychology are integrated. This is a multidisciplinary conference. Consultation/liaison psychiatry and neuropsychology faculty members and trainees attend.

Clinical Case Conference
PG-2 (and PG-1) residents present patients from their teams. Patients are interviewed and then discussed by the faculty. The course emphasizes interviewing techniques, criterion-based diagnosis, biopsychosocial formulation, pharmacotherapy, and treatment planning. Cases are scheduled so that special areas such as families, culture, forensics, geriatrics, and addictions are covered regularly over the course of the year.

Grand Rounds
Research topics, clinical presentations of particular syndromes, in-depth presentations in psychopharmacology and psychotherapy, followed by a discussion period. The planning group, comprised of multidisciplinary senior faculty, ensures a broad range of issues presented by national experts. Departmental multidisciplinary case conferences are held five to seven times during the year.

Journal Club
All residents meet to discuss a specific topic or paper with a faculty member who has expertise in the chosen area. Critical readings of psychiatric literature and focused articulation of ideas are the primary goals.


PGY-3

Brief Therapy Seminar
This course focuses on work with outpatients in brief psychotherapy. A major section of this course is devoted to training and supervision of brief dynamic psychotherapy, with particular emphasis on the Mann and Strupp models.

Cognitive-Behavioral Therapy
Didactic presentation of the cognitive-behavioral model of a broad range of psychiatric illnesses and an empirical approach to treatment. Practical training in cognitive-behavioral therapies concentrating on anxiety disorders such as obsessive-compulsive disorders and panic disorders. Each resident carries one or more cognitive-behavioral cases throughout the year.

Family Therapy
This seminar covers a variety of issues in family therapy. The resident is given a broad exposure to basic concepts and prominent schools within the field of family treatment. There is a particular focus on structural family therapy. A subsection includes culture, ethnicity, and the family.

Group Psychotherapy
Core course in group psychotherapy, including group leadership, readings, and supervision. Primary experience will be in outpatient therapy, and there will be some exposure to inpatient group psychotherapy. This course will focus on issues of group leadership, stages of group development, group process dynamics, and the role of diagnosis. Psychodynamic, interpersonal, and cognitive models will be covered.

Advanced Psychopharmacology
This course covers a broad range of topics in neuropharmacology that are relevant to clinical practice. Relevant topics in clinical pharmacology are covered utilizing case material, research, and relevant neuroscience. Residents are also assigned papers to present to the group for critical review.

Advanced Neurobiology
This course covers a broad range of topics in neurobiology, including the neurochemical systems of the central nervous system, principles of molecular biology, clinical molecular genetics, clinical neurochemistry, clinical neuroendocrinology, and clinical neuroimmunology. Each of these elements is then applied to the core psychiatric diagnoses and their pharmacological treatment, including the psychoses, mood disorders, anxiety disorders, substance abuse disorders, and dementia. Residents are active participants ("teachers") in this course.

Public-Sector Psychiatry
This seminar covers a variety of central issues in public-sector psychiatry. Areas discussed include comprehensive care for chronic mental illness, systems of care, continuity in treatment, multidisciplinary issues, historical and political aspects, and specialized current treatment programs and strategies. There is also a focus on cross-cultural issues.

Forensic Psychiatry
This course covers the essential aspects of forensic psychiatry, including civil commitment, competency, expert testimony, psychiatric malpractice, criminal responsibility, informed consent, right to treatment, right to refuse treatment, psychiatric ethics, and mental health legislation. The course utilizes readings, case presentations and experience in the court and legislature.

Cross-Cultural Psychiatry Seminar
This seminar will cover issues relevant to mental health services for African-American, Latino, Asian, and other ethnic and religious groups, as well as issues pertaining to gender, gay and lesbian issues, and HIV disease. Selected readings will be utilized, as well as guest lecturers, film and other audiovisual material.

Outpatient Service Case Conference
This is a weekly outpatient service conference that addresses issues of treatment selection, initiation of treatment, treatment planning, continuity of care, administration, cultural issues, forensic issues, and multidisciplinary issues typical of outpatient treatment. The schedule is such that the special areas of families, culture, forensics, geriatrics, and addictions are covered regularly during the course of the year. Both ongoing cases and recent intakes are discussed.

Grand Rounds
Research topics, clinical presentations of particular syndromes, in-depth presentations in psychopharmacology and psychotherapy, followed by a discussion period. A planning group of multidisciplinary senior faculty ensures a broad range of issues presented by national experts. Departmental multidisciplinary case conferences are held five to seven times during the year.

Journal Club
All residents meet to discuss a specific topic or paper with a faculty member who has expertise in the chosen area. Critical readings of psychiatric literature and focused articulation of ideas are the primary goals.


PGY-4

Psychoanalytical Theory
Taught by three psychoanalysts, this course covers the development of psychoanalytic theory from early Freud to the present. Major developments in the field are discussed, using selected readings. The focus is on an understanding of the essential features of drive, psychology, structural theory, ego psychology, object relations theory, and self-psychology. Applications to clinical work are a constant feature.

Health Systems, Health Policy, Law and Ethics
This course is a series of presentations by experts in health care systems, policy, and administration and focuses on issues in the evolving health care field. It places particular emphasis on psychiatric service delivery systems, administration, and legal and regulatory issues. Ethical dilemmas in modern health care are a central focus. The course will include discussion of career options, followed by areas pertinent to job negotiations and transition to practice.

Advances in Psychiatry
This course provides advanced trainees with the opportunity to explore the most current advances in the field of psychiatry across a variety of subspecialty areas which change yearly and are selected six months in advance by the faculty and the PGY-4 class.

Inpatient Service Case Conference
PG-1 and PG-2 residents present patients from their teams. Patients are interviewed and then discussed by the faculty. The course emphasizes interviewing techniques, criterion-based diagnosis, biopsychosocial formulation, pharmacotherapy, and treatment planning. The PG-4 resident is administratively responsible for this conference, assists residents in preparation, and evaluates their performance. Cases are scheduled so that special areas such as families, culture, forensics, geriatrics, and addictions are covered regularly over the course of the year.

Outpatient Service Case Conference
This is a weekly outpatient service conference that addresses issues of treatment selection, initiation of treatment, treatment planning, continuity of care, administration, cultural issues, forensic issues, and multidisciplinary issues typical of outpatient treatment. The schedule is such that the special areas of families, culture, forensics, geriatrics, and addictions are covered regularly during the course of the year. Both ongoing cases and recent intakes are discussed.

Chief's Tutorial
This supervision provides detailed discussions about leadership, administration, "the institution as systems", the clinical-educational interface, teaching, and supervision.

Grand Rounds
Research topics, clinical presentations of particular syndromes, in-depth presentations in psychopharmacology and psychotherapy, followed by a discussion period. A planning group of multidisciplinary senior faculty ensures a broad range of issues presented by national experts. Departmental multidisciplinary case conferences are held five to seven times during the year.

Journal Club
All residents meet to discuss a specific topic or paper with a faculty member who has expertise in the chosen area. Critical readings of psychiatric literature and focused articulation of ideas are the primary goals.