Training Competencies

PSYCHIATRY TRAINING

Competency Development

Approved by the Residency Training Committee July 22, 2004.
[Core Competency requirement in brackets]

See rotation descriptions for specific knowledge, skills, and attitudes objectives.

I. Specific Goals

Diagnostic Goals and Skills; sites where implemented
1. Complete initial evaluation of a patient for medical and surgical disorders, provide basic care for these illnesses, and appropriately request consultation for patient care. Brackenridge Hospital (BH), Austin State Hospital (ASH), Seton Shoal Creek Hospital (SCH) [Patient Care]
2. Diagnose, treat ,and appropriately refer patients with neurological disorders. BH; ASH [Patient Care]
3. Perform thorough evaluations of patients, including the psychiatric interview with mental status exam, physical and neurological exams; record this capably; develop a differential diagnosis, provisional diagnosis, formulation, and a biopsychosocial treatment plan. All locations. [Practice-based Learning]
4. Use the current Diagnostic and Statistical Manual of Mental Disorders. All `locations. [Patient Care]
5. Demonstrate skill in diagnosing medical disorders displaying symptoms regarded as psychiatric, as well as psychiatric disorders seen with organic presentations. All locations. [Medical Knowledge]
6. Perform a thorough psychiatric interview with sensitivity to the patient's background, and develop differential diagnosis and treatment plan based on the findings. All locations. [Interpersonal Skills]
7. Appropriately request psychological testing, and incorporate results into discussions. BH; ASH [Systems-based Practice]
8. Utilize research results in psychiatric practice. All locations. [Medical Knowledge]

Therapeutic Goals; sites where implemented
1. Describe the multiple influences on psychological and physical development throughout the life cycle. All locations. [Medical Knowledge]
2. Discuss the major theories and schools of thought in psychiatry, historically as well as the current concepts. ASH [Medical Knowledge]
3. Outline the role of ethics in the practice of psychiatry. All locations. [Professionalism]
4. Display respect for persons with diverse cultural backgrounds. All sites [Interpersonal Skills]
5. Describe the interrelationships of psychiatry and the law. Bastrop; ASH [System-based Practice]
6. Utilize major types of therapy (brief, long-term, psychodynamic, cognitive behavioral, group, family, crisis intervention, supportive). ASH; UT Mental Health Service, Austin State School (AStS). [Practice-based Learning]
7. Utilize pharmacological and other somatic therapies (including ECT) and drug and alcohol detoxification and treatment with or without psychotherapy. Shoal Creek Hospital. [Patient Care]

Administrative Goals; sites where implemented
1. Develop leadership roles. ASH, SCH, [Interpersonal Skills]
2. Maintain professional demeanor and boundaries. All sites. [Professionalism]
3. Maintain patient logs and other required documentation in a timely fashion. All sites. [Practice-based Learning]
4. Demonstrates knowledge of diverse systems involved in patient care. All sites. [System-based Practice]

Teaching/Research Goals; sites where implemented
1. Team teach at least one class. SCH [Medical Knowledge]
2. Carry out approved study/research project. SCH. [Practice-based Learning]
3. Provide patient education. All Sites. [Interpersonal Skills]

Liaison Goals; sites where implemented
1. Provide psychiatric consultation in a variety of medical, surgical and community settings. Utilize system-based information. ATCMHMR; BH. [System-based Practice]

II. Clinical Experiences

PGY I
1. Family Practice or Internal Medicine: 2 month rotation on inpatient services at St. David’s Hospitals
2. Pediatrics: 2 month rotation on inpatient services at Brackenridge Children's Hospital.
3. Neurology: 2 month rotation including inpatient consultation at ASH, outpatient clinic at Seton Brackenridge, and neuroradiology rounds at Seton Brackenridge Hospital.
4. Inpatient Adult Psychiatry: 6 month rotation at Seton Shoal Creek Hospital (SCH) on the Adult Psychiatric Service.

Based on site specific goals, the first year psychiatry residents acquire competencies in the following:

Perform initial evaluation of a patient with organic disorders, provide basic care for these patients, and appropriately request consultation
Perform a psychiatric evaluation, record capably; develop a differential diagnosis, formulation, and treatment plan.
Use the current Diagnostic and Statistical Manual of Mental Disorders
Display sensitivity for patient’s background.
Outline the role of ethics in psychiatry.
Maintain professional boundaries and demeanor
Maintain patient logs and other required documentation in a timely manner
Provide patient education.

PGY II
1. Inpatient/Outpatient Geriatric Psychiatry: 3 month rotation at St. David’s Hospital.
2. Consultation Liaison: 3 month rotation at Seton Brackenridge Hospital
3. Outpatient Adult Psychotherapy and Supervision: 3 hours per week for 12 months.
4. Inpatient Child and Adolescent Psychiatry: 2 months on the Child and Adolescent Psychiatric Service at SCH; 1 month outpatient at ATCMHMR
5. Inpatient/Outpatient Substance Abuse: 3 month rotation at SCH.

Second year residents are expected to maintain the above competencies and to achieve additional competencies in the requirements of rotational sites:

Utilize cultural assessment to develop dynamic formulation and treatment plan
Appropriately request psychological and incorporate findings in discussions
Describe the interrelationship between psychiatry and the law
Become competent in brief and supportive psychotherapy

PGY III
1. Outpatient Psychiatry: 12 month ½-time rotation at the University of Texas Counseling and Mental Health Center (young adults), or Veteran’s Outpatient clinic: 12 month ½-time (veterans/their families),
2. Forensic Psychiatry: 12 hours per week for 3 months at Bastrop.
3. Cognitive Therapy: 12 hours per week for 3 months at SCH.
4. Outpatient adult psychotherapy – 5 hours/week for 12 months.

Third year residents are expected to maintain the above competencies and to achieve additional competencies in the requirements of rotational sites:

Describe the multiple influences of psychological and physical development throughout the life cycle.
Become competent in Cognitive Behavioral Therapy
Develop leadership roles
Demonstrate knowledge of diverse systems involved in patient care.
Carry out approved study/research project
Team teach at least one class

PGY IV
1. Adult Outpatient Community Psychiatry: 9 month ½-time rotation at Austin-Travis County MHMR.
2. Outpatient Psychotherapy and Supervision: 8 hours per week for 12 months.
3. Psychiatric Emergency Service: 4 months half-time at ATCMHMR. (For residents going into the child psychiatry training program, this may be taken in the PGY-2 in place of the child and adolescent psychiatry rotation.)
4. Inpatient psychiatry, 3 months, at Austin State Hospital
5. Elective: ½ time for 5 months

Fourth year residents are expected to maintain the above competencies and to achieve additional competencies in treatment programs and systems of care:

Utilize research results in psychiatric practice
Discuss major theories and schools of thought in psychiatry, historically as well as current concepts
Become competent in psychoanalytic psychotherapy and psychotherapy plus psychopharmacology
Provide psychiatric consultation in aa variety of medical, surgical, and community settings

III. Seminars

A copy of the seminar schedule for the year may be obtained from the departmental administrative assistant. The seminars include the history of major schools of theory in psychiatry, review of psychiatric disorders, growth and development, psychopharmacology, alcohol and substance abuse, interviewing techniques, psychodynamic psychiatry, brief psychotherapy, cognitive-behavioral therapy, supportive psychotherapy, family therapy, psychological testing, forensics, and research methods as well as other topics required by ACGME.

IV. Additional Experiences