A. Goals and Objectives

A major goal of the Residency Training Program at OHSU is to graduate psychiatrists who have mature judgment; extensive knowledge about diagnosis, etiology, and treatment of all psychiatric disorders and common neurological disorders; competence to render effective professional care to patients; awareness of personal limitations; and recognition of the necessity of continuing their development throughout their professional careers.

Each rotation in the RTP has specific educational objectives in the areas of knowledge, skills and attitudes. *
Each is designed to provide a balanced mixture of clinical service, didactics and seminars, and supervision, which will enable residents to attain those educational objectives.

B. Clinical Experiences

A typical four-year rotation plan for OHSU residents is presented below:

PGY-1 follows a mixed internal medicine/psychiatry categorical schedule. Rotations consist of two months inpatient medicine, two months emergency medicine, two months neurology, and six months inpatient psychiatry (OHSU and/or the Portland VAMC).

PGY-2 includes three months of inpatient psychiatry at Portland Oregon State Hospital, six weeks of night float in the psychiatric emergency room at OHSU, six weeks of geriatric psychiatry at OHSU, 3 months as consult/liaison at OHSU and the VA, and six weeks of inpatient psychiatry at the VA and 6 weeks OHSU Inpatient Psychiatry. In addition, all PGY-2 residents spend one half day per week in the Adult Outpatient Clinic or in the primary care psychiatry program and one jour weekly in outpatient supervision, and 1/2 day weekly didactics at OHSU. PGY-2s begin to follow psychotherapy cases and participate in faculty specialty clinics.

Primary call for the VA and OHSU is covered by PGY1 and PGY2 residents. At the VA there are usually 5 residents in the primary call pool: the 2 PGY1's and 1 PGY2 on inpatient psychiatry at the VA, the geriatric resident and the VA consult resident. Thus each is on call an average of one night in every 5.
At OHSU there is a night float system. The nightfloat is the PGY2 on OHSU ER Psychiatry and works Sunday to Thursday from 8:00 pm to 8:00 am. There are four additional residents in the OHSU call pool: 2 PGY1s + 1 PGY2 on OHSU inpatient psychiatry and the OHSU psychiatry consult resident. From Monday to Thursday these residents take call from 4:30 pm to 8:00 pm. Friday and Saturday call are overnight ending at 8:00 am. Sunday call is 8:00 am to 8:00 pm. Generally the same resident is on call Friday and Sunday such that the overall number of weekends without call is higher.

PGY-3 residents spend one year in child and adolescent psychiatry, and six months are spent in community psychiatry electives. The other half of the year is spent on the addictions treatment rotation with six months at the Substance Abuse Treatment Program at the Vancouver VA and at the General Medicine Psychiatry program at the Portland VA.

PGY-3 residents (like the PGY-2s) spend one half day per week each in the VA Outpatient Clinic, the OHSU Child Clinic and the OPC at Adult Outpatient Clinic at OHSU or the Psychiatry Primary Care at the VA, where they continue to follow patients. Also 2 - 3 hours weekly are spent in outpatient supervision and 7 - 9 hours weekly in didactics.

Community psychiatry is offered two days a week for six months in tandem with child psychiatry. The focus of the community rotation is on the care of under-served rural populations and/or the urban deinstitutionalized chronically mentally ill. Residents can select from more than 40 potential training sites in rural and urban mental health programs, forensic psychiatry, transcultural settings and community support programs. Travel and lodging costs to all parts of Oregon are paid for by the program. Elective experiences in public community programs, state institutions or the OMHD central office are available for PGY-4 residents on either a six-month or one-year half-time basis as well. Supervision is provided both on site and at OHSU.

During the Community 6 months residents spend 1/2 day weekly in the VA emergency psychiatry clinic seeing walk-in patients and those in crisis awaiting mental health intakes.

The core of the child and adolescent psychiatry experience is the evaluation and treatment of selected children and adolescents and their families in an outpatient setting at OHSU. The intent is to give the resident familiarity with clinical psychiatric syndromes in children and adolescents, provide tools and working knowledge to help him or her be a competent evaluator of children and adolescents, and enable the resident to develop competence in family assessment and therapy. An underlying goal is to teach a developmental, multi-factorial approach to understanding people that should be as helpful in the psychiatrist's work with adults as with children and families. The resident can broaden this basic experience by electing a child and family-oriented community psychiatry placement concurrent with the child psychiatry rotation, and by continuing selected treatment cases into PGY-4.

As in the PGY-2 schedule, all PGY-3 residents spend one half day per week in the Adult Outpatient Clinic at OHSU or Psychiatry Primary Care clinic at the VA, where they continue to follow their patients, and 2 - 3 hours weekly in outpatient supervision and over one 1/2 day or 7 - 9 hours weekly in didactics.

The PGY-4 schedule consists of a combination of outpatient rotations and electives. During their rotation, the resident learns to care for ambulatory patients through various psychopharmacology and psychotherapeutic methods. Brief, time-limited therapies and long-term psychotherapy are possible.

On elective rotations residents pursue one or more administrative, clinical, teaching or research experiences in association with the departmental faculty at the VA, university services or in the community. Residents design their experiences with faculty guidance and have the opportunity to bring their own special interests to bear on their education.

Common electives include the Intercultural Psychiatry Program at OHSU, the Mood Disorders Clinic at the VA, the Child or Adult Sleep Disorders Clinic at OHSU, the Portland State University Student Health Therapy Clinic and the Chief Resident Elective.

Required rotations during the fourth year include a half day family therapy rotation for 6 months, a year long 1/2 day VA clinic, and a year long fullday OHSU Outpatient Clinic experience with one hour weekkly supervision.

Fourth years also have 1/2 day weekly for didactics.