Clinical Curriculum

Didactic Curriculum

Teaching by Residents

Evaluation

Resident Call

Curriculum Outline

Our curriculum follows the ACGME and RRC requirements for Psychiatry Residency Programs based on scientific and professional mandates to ensure the quality of our graduates' training, and provide maximal educational advantages for our residents. We have implemented a web-based instruction and evaluation system that is unique in our field, providing residents with near-instantaneous, relevant educational experiences and feedback. These changes are based on the highly regarded Vermont Integrated Curriculum (VIC) now guiding student learning at the University of Vermont College of Medicine.

Clinical rotations and didactic seminars are coordinated over the four years to provide a rational developmental sequence. We encourage each resident to develop a special area of interest during the first two years and to explore this interest with increasing intensity during the third and fourth years.

Didactic Curriculum

One half day per week throughout the four years of training is dedicated to didactics. This time, meant to be free of interruption, begins each Tuesday morning with a Balint Group. All residents are assigned to one of two groups led by experienced faculty, which focus on the dynamics of the doctor-patient relationship. Seminar sessions, shaped by learning objectives relevant to each level of training, follow the Balint Groups. Each session runs for ninety minutes.

Didactic outline (PDF)

The offerings are diverse and comprehensive. The yearly schedule, with some variation, lists thirty different seminars ranging from Human Behavior to Research Methods and from Advanced Neuroscience to Cross-Cultural Psychiatry. After their respective seminars, all residents gather for their weekly lunch meeting. The didactic program, where possible, is coordinated with teaching activities on the individual clinical services and with Department-wide academic functions such as Grand Rounds.

Additional weekly educational activities include a lunchtime journal club, clinical combined rounds, an interview training session, and psychotherapy supervision.

Evaluation

Educational objectives are written for all clinical rotations and didactic seminars. The evaluations are competency based. Each year residents meet in two day-long retreats to review the training program experience. Program innovations and changes are addressed by a Residency Training Committee that meets twice monthly and is chaired by the Training Director; residents from all years of training are represented on the committee. The Director reviews each resident's educational progress and provides feedback on a regular basis. A full faculty review of all residents is conducted twice yearly.

Teaching by Residents

The Department is committed to the philosophy that an effective physician is a good teacher. On each clinical service, residents participate actively in the clinical instruction of third year and fourth year medical students. Residents also teach other physicians and professional staff through interactions and formal presentations. A practicum is held in the PGY-IV year on how to design an effective scientific presentation.

As part of their selective experience, residents may assume an even larger teaching role within the Department. Involvement with educational activities is further encouraged through participation in the Residency Training Committee, in departmental workshops and retreats, and in teaching interviewing skills to first year medical students.

Resident Call

PGY-I, II, and III residents are responsible for on-call duties approximately once every nine days, with one twenty-four hour call per month. Call spans from 1700 to 0800 hours Monday through Saturday and 0800 to 0800 hours on Saturday and Sunday.

The on-call resident works closely with a full-time crisis clinician and a medical student while on call. The crisis clinician screens many of the patients presenting to the Emergency Department before the psychiatric evaluation. Duties of the on-call resident include evaluating psychiatric and medical concerns on psychiatric inpatients, completing urgent psychiatric consultations from medical and surgical floors, and evaluating all patients triaged to her/him by the crisis clinician.

As the only fully staffed psychiatric emergency service in the northern part of the state, the resident sees a diverse population with a broad range of psychopathology. Because 20-30% of psychiatric admissions occur after hours, a physician's assistant has been hired to admit up to two patients per evening until 2000 hours on weekdays. This allows the on-call resident to devote his/her attention to ER consultations and other crisis services.

Supervision of the weekday on-call resident is by phone with the assigned full-time faculty member. The resident may consult on any case with the supervisor and must consult on those cases specified in the On-Call Policy. On weekday mornings, post-call residents receive face-to-face supervision at 7:30 AM with the Director of the Crisis Service along with the resident assigned to the Crisis Service Rotation and all involved medical students. Each patient seen overnight is presented and discussed. Didactic material, mini-lectures and literature reviews are introduced when relevant. On weekends and holidays the faculty member on call spends most of the assigned day in the hospital with the resident and medical student.

PGY-I residents are accompanied in-house by a PGY-IV resident for their first three calls. To maximize resident efficiency and to ensure the highest quality patient care, residents are released from clinical duties at approximately 0800 hours post call after sign out rounds.

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