One of the benefits of starting our outpatient training in the second year is the ability to follow patients for up to three years. During second year, residents are assigned a minimum of two individual supervisors. At least one of these has considerable psychodynamic or psychoanalytic training while the other is a more general psychiatrist. Second year residents also have Cognitive Behavioral Therapy supervision every other week. Additionally, residents work directly with attending supervisors on their clinical rotations.
Individual supervision of a trainee by a faculty member provides the psychiatric resident an opportunity to review in detail the patients with whom they are working. We find immediate feedback to be a major part of training and encourage residents and supervisors to review recorded psychotherapy sessions in supervision.
Our program offers the opportunity to explore diagnostic and treatment issues in the context of the systems, family, and experiences that the patient is coming from. We encourage residents to understand themselves and the role that they play in their patient’s care.
Resident Participation & Communication
We believe that resident input is crucial to the smooth functioning of the program. After all, it is the resident who is closest to the experience. The Chief Residents are the principal liaisons between residents and faculty. As such, they also attend the monthly Education Policy Committee meeting and meet weekly with the Residency Director. Residents from all four years are active on our recruitment committee.
Our Annual Program Review consists of regular meetings with the residency director, associate directors, chiefs, select faculty, and residents. We review both written and verbal feedback of each aspect of our residency—from specific didactics to rotations to retreats. In fact, our Psychiatric Crisis Service Night Float Rotation was developed through a collaboration of residents and faculty. To date, the feedback has been that it is a very educational and enjoyable experience.
The Chief Residents meet with all residents weekly during the Resident Business Meeting (RBM). This is a time for the residents to get together for lunch and to stay up to date on residency happenings. Residents are encouraged to express any concerns they may wish to discuss with the chiefs during this meeting. Additionally, the residency and associate directors have lunch with each PGY class every quarter, and our chairman meets with residents quarterly.
The Psychiatric Crisis Service and Admission Center at the Milwaukee County Health Division is an active emergency psychiatry intervention program with 11,000 visits per year. Residents learn how to make emergency and initial assessments, sharpen their diagnostic skills, and perform emergency recommendations for care.
PGY 1 residents do not take overnight call on any psychiatry rotations. PGY 3 residents participate in the PCS night rotation, but do not have any other overnight call responsibilities.
PGY 2 residents will have a few training calls with a PGY 4 to prepare them for the PCS night rotation. PGY 2 and PGY 4 residents have an average of one overnight call every six to eight weeks. Two residents and one staff psychiatrist are on call on the same night. Work flow usually diminishes to permit 4 hours sleep for each doctor working overnight. Residents must leave by noon on post call days.
Becoming an excellent psychiatrist does not happen easily. It takes hard work, sacrifice, and dedication. At the same time, we recognize that you need to develop yourself as a person and that you need time and energy to do that. For you, that may mean having time to spend with your family, or it may mean having the chance to connect with other residents in our experiential group. Or, it may mean using your $1500 annual working condition fringe benefit money and $300 annual book fund to attend conferences or present posters or workshops. Psychiatry training can be intense, exciting, and fulfilling.