The two core experiences of the first year consists of longitudinal experiences in a psychiatric residential treatment facility (totaling 4 months FTE, carrying 8 patients a week) and a rotation on the Pediatric Consultation Liaison Service (totaling 4 months FTE) which includes consultation to both the pediatric hospital and specialty outpatient clinics. Additional experiences touch on the interface of psychiatry and medicine including palliative care, HemeOnc, gender clinic, domestic violence and child abuse. Outpatient experiences begin with exposure to group therapy in DBT and social skills for patients with autism spectrum disorders. Additionally trainees may begin to establish continuity patients for their outpatient clinic, with a focus on psychotherapy. Didactic seminars occur weekly all day on Wednesday. Long-term supervision occurs weekly with two faculty supervisors, each meeting for hour-long sessions. Additionally, while on services close supervision is available for trainees.
The second year of training consists primarily of outpatient and community based consultation rotations building on the assessment and treatment competencies achieved during the first year of training in the closely supervised hospital setting. During the second year more time is spent on psychotherapy interventions and combinations of psychopharmacology and psychotherapy. As residents gain more competence they are allowed more responsibility for decision making regarding decisions to hospitalize patients, initial development of treatment plans, etc., which are then discussed with supervisors, either in real time or at regularly scheduled weekly supervision. Not all outpatients are seen at each session but all are discussed with supervisors on a regular basis as the resident achieves higher levels of competence. Residents move into the community to provide consultation in schools, juvenile justice settings, community psychiatry intensive in-home service settings, addictions, and student health. Additionally residents spend three months on a pediatric neurology rotation one half day weekly. The second year rotations also afford the child residents an opportunity to enhance their skills in the area of teaching and supervision and to complete research projects undertaken earlier in their training. All of these rotations allow the resident to assume more and more responsibility as their competencies increase while having consistently available supervision. Didactic seminars occur weekly all day on Wednesday.
A major aim of the first year of the portal program is to complete adult psychiatry block rotations. These include acute inpatient at East Central Regional Hospital, Forensic Psychiatry also at ECRH, adult consultation liaison at Augusta University, emergency psychiatry at AU, and adult neurology psychiatry at Augusta University. Additionally, portals also take part in child psychiatry consultation liaison, as well as starting exposure to outpatient experiences in both child and adult psychiatry. These core experiences lay the foundation for a strong understanding of psychiatric care and provide for close clinical supervision as residents begin to learn a new specialty. Additionally, long-term supervision is available weekly with both child and general psychiatry faculty. In the first year of training portals join the general psychiatry residents for their didactics on Thursdays. Didactic programming in both general psychiatry and child psychiatry is based on a two-year format, allowing trainees to get exposure to all topics in the course of their training.
In the second year of the portal program, residents shift their focus to developing outpatient skills in general psychiatry and child psychiatry. At this time caseloads include both psychotherapy and medication management. As residents gain more competence they are allowed more responsibility for decision making regarding decisions to hospitalize patients, initial development of treatment plans, etc., which are then discussed with supervisors, either in real time or at regularly scheduled weekly supervision. Not all outpatients are seen at each session but all are discussed with supervisors on a regular basis as the resident achieves higher levels of competence. Additionally, there is a longitudinal experience in a psychiatric residential treatment facility to meet the needs of an acute experience in child psychiatry. Residents carry a caseload of four patients during a half-day for the course of a year. Didactic programming occurs all day Wednesday and all day Thursday to allow portals the opportunity to get exposure to the full programming for both general psychiatry and child psychiatry.
The third year of portal training closely resembles the final year of CAP training, with the addition of ongoing continuity patients in adult psychiatry. Subsequently, experiences are primarily outpatient and community based consultation rotations building on the assessment and treatment competencies achieved during earlier years of training. Residents move into the community to provide consultation in schools, juvenile justice settings, community psychiatry intensive in-home service settings, addictions, and student health. Additionally residents spend three months on a pediatric neurology rotation one half day weekly. The third year rotations also afford the an opportunity to enhance skills in the area of teaching and supervision and to complete research projects undertaken earlier in their training. All of these rotations allow the resident to assume more and more responsibility as their competencies increase while having consistently available supervision. Third year portals have completed general psychiatry didactics, and focus on the child seminar series occurring weekly all day on Wednesday.
