The General Psychiatry Program provides rigorous instruction and diverse clinical experiences in a challenging but supportive environment. We offer training experiences in psychopharmacology, psychotherapy and psychosocial interventions, neurosciences, public and community psychiatry, and psychiatric research. Despite the relatively large size of the program, faculty members are accessible and invested in helping trainees to meet their individual needs and career goals.
Residents learn to synthesize ideas through exposure to a wide spectrum of clinical practices and scientific evidence. This emphasis on empirical data is shared by all members of our highly diverse faculty.
The first year, the internship, is designed to provide a foundation for subsequent training in psychiatry. The clinical rotations and weekly teaching are integrated to prepare residents to competently manage a broad variety of medical and psychiatric disorders and emergencies. This is the first step in acquiring mastery over the range of skills needed by a 21st century psychiatrist.
Below is a sample annual rotation breakdown for PGY1.
|Blocks||Rotations (4-week blocks)|
|3 blocks||Family Medicine|
|3 blocks||Psychiatric Emergency Services|
|3 blocks||Substance and Trauma-Related Disorders|
|2 blocks||2 Weeks of Neurology and 2 Weeks of Night Float at WPIC|
|1 block||Medical Care of the Psychiatric Patient|
To accommodate ACGME intern year duty hour requirements, the PGY1 year is split into 13 blocks of four weeks each. Residents in the General Psychiatry Program spend three blocks in family medicine, one full block in neurology, two separated blocks comprising two weeks each of neurology and night float floor coverage at WPIC, and one month in Medical Care of the Psychiatric Patient. Some residents choose to spend additional time in these rotations during electives later in training. Family medicine is done through the UPMC St. Margaret’s family medicine program and includes three blocks of inpatient medicine. Residents spend two blocks in total with the UPMC neurology program and work on either the neurology consult or wards team.
Residents rotate through the WPIC psychiatric emergency room, the Diagnostic Evaluation Center (DEC), for three blocks and continue to take overnight call in the DEC throughout their second year. The free standing DEC, separate from the medical Emergency Department at UPMC, provides psychiatric evaluation, brief counseling and crisis intervention, routine pharmacologic management, referrals for acute inpatient hospitalization, partial day programs, and outpatient clinics. During the evenings, the residents are the primary medical doctors in the DEC, working with a directly supervising attending, "in house". Child attending supervision is available by phone as needed.
A three block rotation in substance-related disorders and anxiety disorders is divided into a 1-block rotation at the Center for the Treatment of Addictive Disorders (CTAD) and Post Traumatic Stress Disorder Clinic, VA Pittsburgh Healthcare System, and a total of two blocks rotating at WPIC on an inpatient service specializing in acute treatment of patients with comorbid psychiatric and addictive disorders.
The formal weekly teaching curriculum during PGY1 provides a fundamental psychiatric knowledge base upon which subsequent training and education will build. The curriculum includes lectures, seminars, case conference, grand rounds and workshops. These programs are directed and taught by faculty, many of whom are renowned experts in their fields.
The second year of residency training provides a core set of experiences covering the scope of inpatient psychiatry, including clinical rotations in adult, child, geriatric, and consultation and liaison (C/L) psychiatry services. The weekly teaching sessions are closely integrated with these clinical experiences. In addition, residents begin psychotherapy training with patient assignments and individual supervision in the middle of PGY2. At the end of the second year, residents can competently diagnose and treat a wide variety of common psychiatric disorders.
Residents in the General Psychiatry Program spend 10 to 11 weeks in four specialty inpatient services, reflecting four broad areas in clinical psychiatry. Each inpatient service has "teaching teams", with one resident supervised by one attending. Residents carry no more than eight patients at any given time. On each service, residents work closely with the supervising attending and the treatment team, comprising nurses, social workers, and other clinicians. Residents are given increasing independence in managing the assigned patients with time. Onsite medical coverage and specialty consultations are available through Presbyterian Hospital, which is physically connected to WPIC by an indoor tunnel. Residents continue to take overnight call at WPIC throughout their second year, except while on C/L rotation.
The consultation and liaison (C/L) psychiatry service provides psychiatric consultation to all units (medical, surgical, transplant, intensive care units, oncology, obstetrics, gynecologic, etc.). Residents are assigned patients for consultation and, under supervision, are expected to provide a set of management recommendations and follow these patients for the duration of the hospital stay. Lectures and seminars on C/L topics are conducted daily. Residents on this service are exempt from call at WPIC. Instead, they provide evening and weekend coverage to the C/L service from home, coming in as necessary and on weekends or holidays.
|Rotations (10- to 11-week blocks)|
|Mood Disorders Unit|
|Psychotic Disorders Unit|
|Geriatric Psychiatry Unit|
|Child and Adolescent Unit|
The formal teaching curriculum during PGY2 expands on the acquisition of fundamental psychiatric knowledge that began during PGY1, and is closely linked to the clinical experiences during this year. The curriculum includes lectures, seminars, case conferences, grand rounds and workshops.
The third year of residency training builds on the skills and knowledge acquired during the first and second years of residency through experiences in ambulatory psychiatry. Residents work in several general and specialty clinics that provide opportunities to learn about different models of care. These models include following patients independently, seeing patients concurrently with therapists, and working in close collaboration with multidisciplinary treatment teams.
At the end of the third year, residents are able to competently diagnose and treat patients, and provide longitudinal care in a variety of outpatient settings. They also achieve increasing levels of competency in psychotherapy.
Residents are required to complete two year-long clinics as well as the six-month requirements of Geriatric and Child Psychiatry. In addition, residents choose, at a minimum, three six-month electives. An elective typically occurs once per week for a half-day per week. Each clinic is directed by faculty who are experts in their fields. There are no call obligations in the third year, allowing residents more time to pursue other interests and projects. Residents continue psychotherapy training with additional patient assignments and individual supervision.
The table below shows the required and elective rotations for PGY3.
Bellefield Clinic – Mood, Anxiety, Personality Disorders (12 months)
|Comprehensive Recovery Service - Serious Mental Illness (SMI), Psychotic Disorders (12 months)|
|Bellefield Geriatric Center or Alzheimer's Disease Research Center – Major Neurocognitive Disorders and Old-Age Psychiatry (6 months)|
|Center for Children and Families – Child and Adolescent Psychiatry (6 months)|
|At least 3 Elective Outpatient Clinics (6 months each)|
The formal teaching curriculum during PGY3 provides a series of advanced topics, including courses on multiple modalities of psychotherapy, advanced psychopharmacology and evidence-based medicine.
In the final year of training, the majority of residents’ time is made available for elective training and proposal development suited to their specific career goals. PGY4 residents "round out" their training experience by choosing electives to fortify specific aspects of their training. This important feature enables senior residents to continue to handle longitudinal cases under supervision while carrying a light course load.
A large number (over 40) of elective opportunities currently exist and new ones are regularly proposed by residents and faculty to further diversify the training experience. Many residents choose elective training sites to explore career opportunities, while others may use the time to complete any remaining requirements such as Community Psychiatry and Forensic Psychiatry. There are currently no call obligations in the senior year.
The formal Thursday afternoon teaching curriculum during PGY4 provides a series of advanced topics and classes specifically geared toward preparation for careers after residency. Some of the time in the curriculum is set aside each year to accommodate requests by the senior class for additional coursework.