PGY-1

All psychiatry PGY-1 residents spend their first four-week block together on the Adult Inpatient Psychiatry units in what we call “Boot Camp.” This allows residents to get to know each other before being split into the traditional “psychiatry” block or “medicine” block, as well as eases their transition into residency by reducing the individual “cap” of patients per resident. Following boot camp, the class gets divided into two cohorts of six residents each. Cohort A continues to rotate on Inpatient Psychiatry while Cohort B rotates on Primary Care rotations, Emergency Medicine, and/or Neurology. After 3 four-week blocks, Cohort A switches to Primary Care rotations, Emergency Medicine, and/or Neurology, while Cohort B returns to Inpatient Psychiatry. The two cohorts switch back and forth every 3 blocks for the remainder of the year.

Adult Inpatient Psychiatry rotations

Each resident is assigned to one of three inpatient treatment teams during each four-week rotation on Adult Inpatient Psychiatry. Each team has one attending psychiatrist, one or two residents, and medical students. The residents change teams each rotation to give them an opportunity to work with attendings and learn different styles of practicing psychiatry.

There are two adult psychiatry inpatient units at Rush University Medical Center. There is a 13-bed General Adult Inpatient Unit. This unit cares for patients who suffer from a full range of acute psychiatric disorders that require inpatient treatment including psychotic disorders, mood disorders, and co-occurring substance use disorders. The second adult inpatient unit is an 11-bed Mood Disorders Unit. There is a strong emphasis on the use of group cognitive behavioral therapy as well as the use of psychopharmacological and neuromodulation therapy for people who suffer from major depression, bipolar disorder, and co-morbid anxiety disorders. Each team follows patients on both units.

Residents participate in daily walk rounds with their attendings and students on the inpatient teams. They also participate in formal multidisciplinary rounds several times a week. Residents work closely with a social worker, occupational therapists, nurses, and mental health workers to optimize the care and individualize the treatment plan of each of their patients.

The inpatient psychiatric rotations provide our residents with a strong introduction into the breadth and depth of Inpatient Psychiatry. Residents become adept at taking a psychiatric history and performing a complete mental status examination. They develop skills evaluating and treating psychiatric disorders. They learn to formulate and implement comprehensive treatment plans, including the use of psychopharmacological and psychotherapeutic approaches, and to coordinate aftercare planning as part of the multidisciplinary team.

Primary Care and Emergency Medicine

Residents complete

Two blocks of training in Internal Medicine,
One block in Emergency Medicine, and
One block of Inpatient Pediatrics or an additional block of Internal Medicine.

Both the Department of Medicine and the Department of Pediatrics and their respective training programs have earned Rush national recognition for clinical excellence. Likewise, residents speak very highly of their Emergency Medicine rotation.

Neurology rotations

The Department of Neurological Sciences has a national reputation for excellence and consistently provides a very well received and important educational rotation for our psychiatry residents. Our residents complete 2 four-week rotations in Neurology during their PGY-1 year on the General Neurology Service, Stroke Service, and Epilepsy Service

Call

PGY-1s have five or six calls per month. Each call is from 8 AM to 9 PM. Only one PGY-1 resident is assigned to call per day. There is a senior buddy who works each intern until they are ready to graduate to independent call. Residents cover acute issues on the inpatient psychiatric units and admit new patients to those units. Additionally, from 4-9 PM, they see new consultations on the general medical floors and pediatric units. They also see some consults in the Emergency Department. The latter was implemented based on resident feedback and has been instrumental in preparing our residents for their emergency psychiatry and night float rotations as PGY-2s. There is no night float or weekend call.

Didactics

Didactic lectures occur daily throughout the year around the lunch hour. PGY-1 residents are expected to attend the lectures of whatever service they are currently rotating on. For instance, if a resident is on a psychiatry rotation, they would attend psychiatry lectures with their psychiatry colleagues. If a resident is on neurology, they would attend the same lectures that their neurology colleagues attend. Psychiatry didactics are repeated in the PGY-1 year so that each cohort of psychiatry residents has an opportunity to learn the same material.