Residents in our program value the intensive learning / teaching that occurs in weekly supervision. PGY-2s have weekly outpatient psychotherapy supervision as they begin their work with outpatients. In addition, they have on site supervisors at each rotation site. All residents have experience with supervisors from different disciplines. As PGY-3’s, residents continue to work with a variety of outpatient psychotherapy supervisors. They are assigned to specialized supervisors who focus on psychopharmacology, cognitive-behavioral therapy, long-term dynamic therapy, short-term therapy, group therapy, and child psychiatry. As a member of an outpatient team they meet weekly with the team psychiatrist. While they are on the consultation-liaison service or on the outpatient addictions service they review cases with the attending psychiatrists.
As PGY4s, residents usually work on specialized teams or as chief residents. Residents are assigned supervisors on the basis of their area of expertise. Our supervisors are a diverse and experienced group of clinicians who, in many cases, volunteer their time to mentor trainees. Both supervisors and trainees report that this is an invaluable part of their participation in an academic program.
A PGY-4 seminar in supervision enhances the experience and helps residents begin the process of leaning how to supervise as they work with medical students and junior residents throughout the clinical rotations.
Evaluation and Competency Assessment
Increasingly, the assessment of competency in the psychiatric residency program requires a comprehensive and varied approach. Residents are evaluated on every clinical rotation, every seminar, and in every supervision. Evaluation is conceptualized in two phases: formative and summative. For each PGY group of residents, there is a standing faculty committee that reviews resident progress in the fall and in the spring of each academic year. In the fall session, each resident's clinical and academic work is reviewed, with recommendations for improvement and acknowledgement of strengths and accomplishments. Goals are set up with each resident and the Training Directors as a result of this faculty review, and used as a basis for the summative evaluation in the spring.
Competency evaluations are required for all clinical rotations, supervisions and didactic seminars. These forms are based on the six competencies required by the ACGME: Patient Care, Clinical Science, Practice-Based Learning, Interpersonal and Communication Skills, Professionalism, and Systems-Based Care. In addition, we assess competency in the five areas of psychotherapy: psychodynamic, supportive, cognitive-behavioral, integration of psychopharmacology and psychotherapy, and brief therapies.
Evaluation and competency assessment is complex, and requires more than a single mechanism for assuring high quality patient care and learning. We use portfolios to collect evidence of resident performance, clinical work, and academic achievement. Portfolios may include written work, video or audio tapes of clinical work, copies of initial evaluations and progress notes, letters and evaluations by supervisors and rotation directors, and when appropriate 360-degree evaluations in settings where residents interact with other professionals who can contribute to the assessment of competency.
Residents take the PRITE (psychiatry-resident-in-training-exam) each year of training. In order to graduate and be eligible to take the American Board in Psychiatry and Neurology, residents must take and pass three CSV’s (Clinical Skills Verification exams) conducted by board-certified faculty who provide detailed feedback and guidance for improvement. An annual clinical skills exam (ACE) is given each of the four years of training.