Following several years of intensive planning, the Community Psychiatry Training Program at OHSU was started in 1973. In 1987, the name of this program was changed to the Public Psychiatry Training Program (PPTP) to emphasize the training experience in state institutions as well as community mental health programs. Residents are required to spend three months at Portland Oregon State Hospital during PGY-2 and six months half-time on community psychiatry during PGY-3. Electives are also available in PGY-4 for more specialized training in public psychiatry.
During PGY-2, two residents at a time are assigned to Portland Oregon State Hospital for their three-month rotation. They are assigned to a special teaching unit at POSH which helps them learn to function in a state hospital and in an enriched educational atmosphere. They are supervised at POSH by on-site faculty, as well as by faculty from OHSU who travel there regularly. On-site seminars on institutional psychiatry and the care of the chronic patient also take place during this rotation.
The PPTP has developed ongoing training agreements with most of the county mental health programs in Oregon. Residents may choose from among these the one that best fits their needs. During their six-month, half-time community rotation during PGY-3, two days per week are spent at the community placement and a half day per week at OHSU for seminars and additional supervision. All residents are required to negotiate a specific contract with the agency in which they are placed. These contract negotiations take place during the first few weeks of community placement and are put in writing. They are designed to meet the educational objectives of the program, as well as the needs of the resident and the community agency. Considerable flexibility is possible in the specific details of the contract, but residents are allowed to spend no more than 50 percent of their time in direct clinical services. They are also required to spend two hours per week working with children, adolescents, or their families; two hours per week with the chronically mentally ill; two hours per month in administrative activities; and to have an experience in forensic psychiatry as a mental health investigator for involuntary commitment or a mental health examiner for the court.
The clinical experience in community psychiatry is supported by a weekly multi-disciplinary seminar on public psychiatry, as well as by clinical and administrative supervision on-site in the community and back in the Department of Psychiatry at OHSU.
Special electives in public psychiatry are also offered in PGY-4. These include additional community or state hospital rotations, as well as geriatric, forensic, transcultural, community support, child and adolescent, administrative, and research experiences. All electives are closely supervised and offer a range of clinical and didactic experiences.
The residency training program provides a comprehensive curriculum in individual, group, family and sexual therapy. The psychotherapy curriculum is closely coordinated by the residency training director. It provides all residents with a firm foundation in the basic principles of psychotherapy upon which they will continue to build throughout their professional lives. It also provides those residents with special interest in one or more types of psychotherapy extensive elective opportunities which they may use to further develop their therapeutic skills.
Residents receive clinical experiences in individual psychotherapy of various types on essentially all of their rotations during the program, with brief, supportive therapy emphasized on inpatient units and the emergency room and more long-term techniques stressed in outpatient settings. Group therapy experiences are available on inpatient, community, alcohol and drug, and outpatient rotations. Family therapy is taught on the inpatient, community, child, alcohol and drug, and outpatient rotations.
A full range of didactics and seminars are provided on child and adult development, interviewing, and techniques and theories of individual, group, family and sexual therapy.
Psychotherapy activities are closely supervised by primary and clinical supervisors with extensive psychotherapy experience. All residents are assigned specific psychotherapy supervisors of multiple theoretical orientations. By the end of their training, all residents will have the opportunity to be supervised by faculty with analytical, behavioral and cognitive viewpoints. In addition, all residents will have been supervised by both male and female supervisors.
The Department of Psychiatry has a strong and unique program in biological psychiatry. Inpatient wards at OHSU and the VA are oriented to the diagnosis and treatment of patients with acute psychiatric disorders. The diagnosis frequently involves differentiating severe primary psychiatric disorders from mental disorders secondary to medical, neurological or substance abuse. Residents receive training in the proper use of neuroimaging, EEG, LP and laboratory investigations in differential diagnosis. Trainees on the inpatient wards obtain extensive experience with psychopharmacotherapy and ECT, as well as evidence bases psychosocial treatments. Additional experience is obtained throughout the program, but especially on consultation/liaison, community and outpatient rotations.
PGY-1 residents receive weekly seminars in basic psychiatric topics which includes the neurobiological basis of mental illness. The first year didactics include introductory coverage of pharmacotherapy with the entire range of psychopharmacological agents.
PGY-2 and PGY-3 residents receive a weekly series of lectures on biological psychiatry, which is part of the CORE IIA/IIIA seminar. The course is an in-depth treatment of behavioral neuroanatomy, neurotransmitters and receptors, neurobiological basis of mental illness, psychopharmacology, substance abuse, neurobehavioral disorders, and neuropsychiatric disorders. Faculty from the departments of Psychiatry, Anatomy, Neurology, and Behavioral Neuroscience coordiante their efforts to provide a coherent treatment of Neurobiological Psychiatry. In addition, several two-month elective seminars are provided which deal with biological psychiatry topics.
Faculty members actively pursue research on problems relevant to biological psychiatry and neuroscience, including affective disorders, schizophrenia, movement disorders, sleep disorders, autism and substance abuse.
Faculty from the Department of Psychiatry collaborate with their colleagues in the departments of Anatomy, Neurology, Behavioral Neuroscience, Pharmacology and Biochemistry and the Vollum Institue for Advanced Biomedical Research. Residents have an opportunity to engage in biologically based research with faculty in these collaborative departments and institutes. In addition, an opportunity for advanced fellowship training in molecular biology is available.