Half of the PGY I class begins on medical rotations while the other half begins with psychiatry. Three month block rotations permit those residents who started on internal medicine to begin psychiatric rotations in October and vice versa. Hence, the maximum consecutive time away from psychiatry during the first year is three months. Didactic course work is reserved for Wednesday mornings and an experiential support group meets biweekly throughout the first year. Residents on medicine rotations are given time off the service to attend these department-based activities. One of the three primary care months is an outpatient rotation. One month of Child and Adolescent Psychiatry during the PGY I year allows for early exposure for those interested in or eager to learn more about the field.
The PGY 2 year is an outpatient year divided accordingly:
3 days per week— Columbia Hospital Psychotherapy Center
1 day per week—CCAPS (Center for Consultative Academic Psychiatric Services), a county funded free clinic for people without insurance
1/2 day per week—Geriatric Psychiatry Clinic at the Clement J. Zablocki VA Medical Center
1/2 day per week—PTSD Clinic at the VA Medical Center
Starting outpatient psychiatry in the PGY II year allows residents to follow patients for up to three years in their continuity clinics in the 3rd and 4th years. PGY II residents take overnight call in the Psychiatric Crisis Service (free standing psychiatric emergency room) about one time every 6-8 weeks. On each call, the PGY II is paired with a PGY IV resident whose main responsibility is teaching the PGY II and preparing them for their PGY III night rotation in the PCS.
“In this program, you will get therapy training far beyond that which is offered at most other programs. Even if you don’t want to do therapy in your profession, what you learn will make you a better clinician in any area.”
Anonymous, Resident Response to 2013 Recruitment Survey
In the PGY III year, residents complete an additional 1 1/2 months on the inpatient unit at Community Memorial Hospital. They also have a 1 month Day Treatment Rotation at Columbia Hospital where they help lead groups and follow patients who need this intermediate level of care. These experiences are in private hospital settings, giving residents the opportunity to work in public and private settings. The division of the inpatient rotations between the PGY I and PGY III years is rare among training programs. We believe having experienced residents returning to the inpatient service provides an added dimension to patient care and to teaching medical students.
Another 1 1/2 months are spent on the Inpatient Psychotherapy rotation at the VA Medical Center. On this rotation, residents get significant experience leading groups. The one month Addiction rotation combines experiences at the VA Medical Center with additional day treatment and residential experiences at a private hospital. Residents supplement their rotation with online Suboxone training and additional online training in motivational interviewing. The PGY III residents to one month of Child Psychiatry Consults at the Children’s Hospital of Wisconsin. Four months are spent on the Consultation Liaison (C/L) service. Three of those months are at Froedtert Hospital, a major trauma and teaching hospital. Throughout the year, residents continue their half day continuity clinic.
The Psychiatric Crisis Service (PCS) night rotation at the Milwaukee County Mental Health Complex is a total of 1 1/2 months, split into three half-month blocks. Our PCS is a free standing psychiatric emergency room—one of the few in the country. There are more than 11,000 patient visits per year, with all Milwaukee residents on Emergency Detention needing to come through PCS. Evenings and nights are the busiest times with the best opportunity for learning. Residents do 14 hour shifts Monday through Thursday, and have three days off on the weekend.
The PGY IV year is viewed as a bridging and transitional year, where, in addition to clinical duties, the resident assumes greater responsibility for teaching, supervising, administration, and if desired, research.
The resident continues with long term outpatient cases and completes the second required month of neurology either through outpatient clinics or on the neurology consult service. Senior residents are required to supervise first and second year residents. Electives provide an opportunity for more intensive work in a myriad of clinical programs.
Individuals are accepted into the three-year program if they have completed an accredited PGY I training program with a minimum of four-months of primary care responsibilities, or an ACGME approved residency. Elective time may vary depending upon the amount of requirements completed.