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Curriculum

Clinical Training

The first year is a medically-based internship with clinical experience in a variety of fields related to the medical practice of psychiatry. The second year's emphasis is on strengthening interview techniques and the skills necessary to diagnose and treat patients with a variety of medical and psychiatric disorders. You also will begin working with one or more individual long-term psychotherapy patients, providing a welcome shift in perspective from the inpatient services.

The PGY-3 year is dedicated to the development of outpatient skills, which includes learning to perform a comprehensive assessment of the outpatient presenting for the first time as well as complex patients who have come to Mayo Clinic seeking a second opinion.

The structure of the fourth year provides a dynamic balance between elective flexibility and the vital opportunity to integrate all that a resident has learned in the preceding years. The latter goal is achieved by returning to the inpatient and consultation services but doing so with an expanded responsibility for the leadership and teaching of the team members. The former goal is served by encouraging the use of six months of elective time for residents to refine skills in selected areas.

Rotation Schedule

PGY-1
Family Medicine or Pediatrics 2 months*
Neurology 2 months*
Internal Medicine 2 months
Emergency Psychiatry 1 month
Child and Adolescent Psychiatry 1 or 2 months
Medical Psychiatry 1 or 2 months
Acute Adult Psychiatry 1 or 2 months
* Includes one month outpatient and one month inpatient
PGY-2
Child and Adolescent Psychiatry 1 or 2 months
Addiction Psychiatry 1 or 2 months
Consultation-Liaison Psychiatry 3 or 4 months
Medical Psychiatry 2 or 3 months
Acute Adult Psychiatry 2 or 3 months
*Outpatient
PGY-3
Outpatient Psychiatry 12 months*
Community Psychiatry
Consultation Psychiatry
Emergency Psychiatry
Forensic Psychiatry (elective)
Geriatric Psychiatry (elective)
Public Psychiatry (elective)
Research (elective)
*An integrated outpatient year containing experiences in all of the above
PGY-4
Electives 6 months
Senior Resident Associate 3 months
Selected from a menu of five inpatient & consultation services
Partial Hospital Program 1 month
Public Psychiatry 1 month
Electroconvulsive Therapy Service 1 month

The Adult Psychiatry Residency Program actively supports residents with a keen interest in Child and Adolescent Psychiatry, who enter adult training planning to pursue a Child and Adolescent Residency.

Over the years, we have observed residents whose passion for child training seemed to wane during their initial tenure in adult psychiatry. To help keep that passion alive, we have developed an "integrated track" that provides additional time in child psychiatry and pediatrics during the initial two years of adult training to offer a robust grounding in developmental psychiatry, enriched by both additional clinical experience and a supplemental didactic seminar tailored to their long term goal of practicing as child and adolescent psychiatrists.

Research and scholarly mentorship are an important component of this track. Knowing that interests can shift, however, we have structured this "integrated track" so that you still will have the flexibility to opt out and remain in the general adult program after the third year if desired.

Resident Responsibilities
Although there are no private inpatients at Mayo Clinic, there are teaching and non-teaching services on the inpatient units. The non-teaching teams have emerged as a reflection of the program's commitment to maintain an appropriate balance between service and education for the residents. Every teaching-service psychiatric patient is assigned to a team typically consisting of one attending psychiatrist, one or two junior residents, a registered nurse and a social worker.

Each resident cares for five to seven patients. A Mayo Medical School student or visiting clerk often is assigned to the psychiatric services, and residents are directly responsible for supervising and teaching these students. A senior psychiatric resident may be assigned and provide additional teaching and support.

Call Frequency
Your call schedule will vary by individual rotation. Mayo Clinic follows the recommendations of the Accreditation Council for Graduate Medical Education i.e., residents are provided with one day in seven free from educational and clinical responsibilities averaged over a four week period and duty hours must be limited to 80 hours per week with no greater than 30 hours of continuous duty.

Call duties vary by service assignment:

  • On the adult inpatient psychiatry units, the PGY-1 and PGY-2 residents assigned to these teams take call from 5 p.m. to midnight on a rotating basis (approximately once per week). When the call day falls on a weekend, the resident takes call from 8 a.m. to midnight.
  • There are multiple rotations for PGY-1 and PGY-2 residents during which they do not have on-call responsibilities (e.g., Emergency Psychiatry, outpatient Family Medicine and outpatient Neurology, and Consultation-Liaison Psychiatry).
  • Overnight call is provided by the PGY-3 residents who serve from 8 p.m. to 8 a.m. on a rotating basis (approximately once per week). These residents have a recovery day (i.e., free from usual clinical responsibilities) on the day following their call-night. There is overlap between 8 p.m. and midnight (i.e., two residents are in-house at the same time).

Career Development
When you first arrive at Mayo Clinic, you are assigned a mentor who is chosen purposefully to help you acclimate and make the most of your Mayo Clinic years. In subsequent years, you will have at least two assigned supervisors with whom you will meet weekly to review your patients as well as other informal supervisors.

Typically, residents develop one or more relationships with mentors centered on common interests or ongoing projects. The department is large enough (more than 40 M.D.s and 20 Ph.D.s) to offer a diversity of styles and strengths, yet small enough for you to know and be known. This context, coupled with regular conferences with the program director, provide a supportive setting in which to discuss and plan your career goals.

Mayo Clinic recruits many of its staff physicians from its own training programs. Thus, when you successfully complete the Psychiatry Residency Program, job opportunities may be available at one of Mayo Clinic's group practices.

Evaluation
To ensure that you acquire adequate knowledge and develop your technical skills, your performance will be monitored carefully during the course of your residency.

Residency training that merely provides you an opportunity to learn is insufficient. We share the responsibility to ensure that you are actually acquiring the knowledge and skills that will enable you to continue learning and serving your patients throughout your career. We accomplish this by several means:

  • Regular, individualized faculty feedback based on direct observation
  • "360-degree" feedback, which draws on the assessments of allied health staff and patients
  • Portfolio-building, based on patient evaluation and management experiences that demonstrate your competency in key areas
  • Annual written and oral exams (modeled after Parts I and II of the ABPN certifying exams)

We also expect you to regularly evaluate the faculty and curriculum (via anonymous Web-based critiques, regular meetings with the program director, and the annual Residents' Retreat) to ensure that your educational needs are being met.

Additional Training
In recent years, more than 75% of our graduates have chosen to continue their medical education through fellowship training.

Recent graduates have joined highly competitive fellowship programs throughout the country. If you are accepted for a Mayo Clinic fellowship, you will continue to receive in-depth, daily, one-on-one training with a consultant. You also will have the opportunity to increase your own supervisory and administrative skills.

Didactic Training
Interactive lectures, seminars, small discussion groups, clinical conferences, journal clubs and one-on-one instruction are all integral parts of the Psychiatry Residency Program.

Core Curriculum
The entire four-year didactic curriculum has been redesigned, consolidated into a single afternoon each week, and deliberately protected from clinical interruption to enable residents to make the most of the lectures and small group discussions. Over the four years of residency, this series covers the entire spectrum of theoretical and practical psychiatric knowledge necessary for effective practice. After the didactic lectures every Tuesday afternoon, each class meets with their seminar leader, who remains with them throughout the academic year.

The PGY-3 residents participate in a weekly psychotherapy clinic which includes both a mini-didactic component and a forum for case presentations and interactive learning using videotaped psychotherapy sessions. PGY-1, 2 and 4 residents are also invited to attend.

Supplemental Opportunities
Each year, we invite a few prominent Grand Rounds guest speakers from outside the Mayo Clinic community to remain on campus and offer special lectures or seminars for the residents on Tuesday afternoons.

Other opportunities include:

  • Each July and August, a twice weekly seminar for PGY-1 residents introduces them to a broad review of clinical psychiatry topics coupled with practical tips for managing on-call and emergency room responsibilities.
  • Also in July and August, the PGY-2 residents have a weekly Critical Thinking seminar and the PGY-3 and PGY-4 residents have a weekly "mini-board review" course focused on material and sample questions that are likely to surface on the written board exams.
  • The Chief Resident coordinates a weekly clinical case conference for all residents and hospital consultants. The different clinical teams rotate responsibility for this series and the format varies to emphasize different teaching points.
  • A biweekly Journal Club is held on Wednesdays at noon with lunch provided by the department. Residents and faculty present current and classic articles accompanied by lively discussion.
  • Residents have initiated a monthly PsychCinema evening complemented by dinner (again, provided by the department rather than external commercial interests). Now in its fourth year, residents enjoy a variety of movies followed by a faculty-led discussion.
  • The various subspecialty fellowships at Mayo (Addiction Psychiatry, Child and Adolescent Psychiatry, Geriatric Psychiatry and Psychosomatic Medicine) also sponsor case conferences and journal club gatherings which interested residents attend alongside the fellows and faculty.

You may also take advantage of the wide range of conferences sponsored by other Mayo Clinic departments.

Some residents have selected courses in advanced neuroscience or research methodology offered by the Mayo Graduate School.

Teaching Opportunities
You will have the opportunity to teach Mayo Medical School students and visiting students from other medical schools through bedside instruction and formal didactic lectures. As a senior resident, you will have opportunity for teaching junior psychiatry residents in both informal and formal settings.

Research Training
Research opportunities at Mayo Clinic are outstanding. You will be encouraged to participate in research projects with the consulting staff. These include opportunities for case reports, literature reviews, clinical studies, and laboratory-based projects. There is tremendous institutional support for projects and presentations, ranging from extensive graphic art assistance to Mayo Clinic funding for trips to present posters and lectures at national meetings.

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