The training during the fourth post graduate year further expands the knowledge base of the general psychiatric resident and provides further opportunities for development of their clinical skills.
By the time the fourth year of training is reached, the basic fundamentals for the general psychiatrist have been taught and incorporated. Some trainees choose to transition to child psychiatry training at this point. For the others who remain in their fourth year, opportunities are there to function as assistant medical director on the acute care inpatient unit at MCG. Completion of ECT training is encouraged if this has not already been accomplished. Multiple elective opportunities at MCG, the VA, and other psychiatric facilities are available depending upon the interests of the trainee.
Emphasis is also placed on the role of the senior psychiatric resident as educator. They are increasingly involved in medical student teaching and lecturing, supervision, and mentoring. The completion of research interests and the completion of a senior project are emphasized as well. This also provides an opportunity to further hone psychotherapy skills and to increase comfort with their utilization.
Core competencies continue to be monitored and evaluated, with specific objectives being tailored to the individual and the composition of their year.
Patient Care
A. Knowledge: Residents will continue to broaden their capacities to provide competent
care and consultation to patients with a broad range of psychiatric disorders that
are commonly encountered in clinical practice. Their patients will include people
in all age groups and of both sexes. Some of their patients will be from various ethnic
minority groups.
B. Skills: Residents will become more highly skilled at interviewing, history taking,
mental status examination, differential diagnosis, treatment planning, diagnostic
testing, and recording of findings. They may choose to have more in-depth clinical
experience in psychotherapy and/or somatic treatments (such as ECT) provided in inpatient
and outpatient settings. They may have roles as direct providers of care, as consultants,
and as teachers of junior residents and medical students.
C. Attitudes: Residents will consolidate their identities as psychiatrists and will
remain committed to the scientific and ethical values that underlie the doctor-patient
relationship.
Medical/Psychiatric Knowledge
A. Knowledge: Residents will learn about the major theories and viewpoints in psychiatry,
together with a thorough grounding in the generally accepted clinical facts. They
will learn to diagnose and treat a wide range of psychiatric disorders. They will
learn the etiologies, prevalence, diagnosis, treatment, and prevention of all major
psychiatric disorders in the current standard diagnostic statistical manual, including
the biological, psychological, sociocultural, and iatrogenic factors that affect long-term
course and treatment of psychiatric illness. They may elect to learn more about research
methods in psychiatry and to teach and function as leaders in the role of chief resident.
B. Skills: Residents will become more skilled at applying their knowledge of psychiatric
illness to particular clinical problems, both as direct providers of care, as consultants,
and as teachers. They will develop excellent working knowledge of numerous psychotherapies,
and of somatic treatments (including psychopharmacologic interventions and ECT) that
are provided in inpatient, acute care, and outpatient settings.
C. Attitudes: Residents will understand and appreciate the value and role of a strong
knowledge base in the provision of comprehensive psychiatric care, consultation, and
teaching.
Practice-Based Learning and Improvement
A. Knowledge: Residents will become familiar with the fundamentals of clinical and
academic psychiatry so that they can go on to engage effectively in life-long learning.
B. Skills: Residents will learn how to deal effectively with complex psychiatric illness
through critical reading and expert consultation
C. Attitudes: Residents will develop an appreciation of the value of life-long learning
for competent patient care.
Interpersonal and Communication Skills
A. Knowledge: Residents will learn clinical techniques to insure respectful and ethical
interactions with patient and colleagues.
B. Skills: Residents will have the opportunity to develop their interpersonal and
communication skills in didactic seminars, in supervision, and in their roles as teaches
and administrative leaders within the residency program.
C. Attitudes: Residents will develop an appreciation of the value of interpersonal
and communication skills for assurance of ethical and effective patient care.
Professionalism
A. Knowledge: Residents will study and receive mentorship in professionalism and ethical
behavior in psychiatric practice.
B. Skills: Residents will develop their professional skills by interacting with the
colleagues and supervisors, and learn to practice psychiatry in accordance with professional
norms.
C. Attitudes: Residents will develop an appreciation of the value of professional
and respectful treatment of patients and colleagues in all clinical settings.
Systems-Based Practice
A. Knowledge: Residents will learn about the importance of approaching patient care
in a systems-oriented way, with particular attention to the challenges of promoting
access of patients (regardless of socioeconomic status) to high-quality mental health
care in both the public and private sectors.
B. Skills: Residents will develop their skills at working ethically in various psychiatric
contexts by discussing and participating in clinical cases that raise issues related
to health-care systems.
C. Attitudes: As they approach the transition to post-residency practice, residents
will develop an appreciation of the value of thinking about various systems (such
as private practice, managed care, and public-sector care) insofar as they relate
to the provision of ethical patient care in psychiatry.
