Half of the PGY 1 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. Our primary care months include 2 months of inpatient internal medicine or family medicine, one month of emergency medicine and one month of ambulatory medicine. PGY 1 residents begin Child & Adolescent Psychiatry in their first year, allowing for early exposure to those considering further specialization.

The PGY 2 year is an outpatient year divided accordingly:

• 3 days per week – Center for Psychotherapies (CfP), located at Ascension SE Wisconsin Hospital – St. Joseph Campus
• 1 day per week – CCAPS (Center for Consultative Academic Psychiatric Services), general outpatient psychiatry clinic
• 1/2 day per week – Geriatric Psychiatry Clinic at the Clement J. Zablocki VA Medical Center
• 1/2 day per week – Anxiety & Trauma Clinic at the VA Medical Center

Starting outpatient psychiatry in the PGY 2 year allows residents to follow patients for up to three years in their continuity clinics in the 3rd and 4th years.

The PGY 2 year includes additional psychotherapy curriculum along with our weekly Wednesday didactics. At the psychotherapy center, residents learn mindfulness-based CBT, which continues throughout the year as a monthly meditation group. Additionally. Experiential group continues and meets monthly. PGY 2 residents do weekday “power shifts" from 6-10 p.m. in the Psychiatric Crisis Service (free standing psychiatric emergency room) toward the end of the year, in order to prepare them for their PGY 3 night rotation in PCS.

In the PGY 3 year, residents complete an additional 1 1/2 months on the inpatient unit at Froedtert Menomonee Falls Hospital. Additionally, PGY 3 residents work on the Eating Disorders Rotation at Rogers Memorial Hospital, one of the nation’s leaders in eating disorder treatment. They spend ½ month leading groups in the partial hospital program Columbia St. Mary’s 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 1 and PGY 3 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 return to the inpatient unit at the VA and 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. The PGY 3 residents to one month of Child Psychiatry Consults at Children’s Wisconsin. Four months are spent on the Consultation Liaison (C/L) service. Three of those months are at Froedtert Hospital, a level 1 trauma center and teaching hospital. Throughout the year, residents continue their half day psychotherapy continuity clinic.

The Psychiatric Crisis Service (PCS) night rotation at the Milwaukee County Behavioral Health Division is a total of 1 1/2 months, split into three half-month blocks. PCS is a free-standing psychiatric emergency room – one of the few in the country. There are more than 70,000 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 as part of their night float.

The PGY 4 year is viewed as a bridging and transitional year. In addition to clinical duties, the resident assumes greater responsibility for teaching, supervising, administration, and if desired, research. PGY 4 residents work in an Integrated Care Clinic (embedded in Primary Care), providing consultation to our primary care colleagues. 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. Electives provide an opportunity for more intensive work in a myriad of clinical programs.