Rotation Plan

PGY-I

4 months of General Medicine: combination of two months Internal Medicine, one month of Primary Care, and one month Emergency Medicine

  • 4 months of Adult Inpatient Psychiatry
  • 1 month of Emergency Psychiatry
  • 2 months of Neurology
  • 1 month of Geriatric Psychiatry
  • 4 months of General Medicine

Residents entering our PGY-I year rotate to a number of different services at the VA Medical Center, the Banner - University Medical Center Tucson (BUMCT) and Banner - University Medical Center South (BUMCS) (public sector psychiatry).

While on Internal Medicine, PGY-I's are part of a team which includes medical students, medical residents, and an attending. The team has daily clinical and educational rounds, and residents are exposed to a wide variety of medical illnesses. The attendings round daily with the team and a substantial part of the rounds is devoted to education. Internal Medicine takes place at the VA Medical Center and BUMCS.

The Neurology rotation at the VA Medical Center allows PGY-I's to observe a wide variety of neurologic disorders. Residents join a team that includes an attending and a neurology resident. Rounds are daily Monday through Friday. During the rotation, residents will also participate in Neurology Consultation Services at the VA Medical Center under the supervision of a neurology resident and an attending. There is no night call on neurology rotations.

During the Emergency Medicine rotation at BUMCT, residents work directly under the supervision of attendings who are always present in the emergency room. Residents treat patients with medical problems that range from upper respiratory infections to major trauma resulting from motor vehicle accidents and gun shot wounds. Residents average 12-hour shifts in the Emergency Room each month. There is no additional night call duty.

PGY-I residents spend one month on the inpatient psychiatry service at the VA Medical Center. The 30-bed inpatient unit treats veterans with a wide variety of psychiatric problems. The predominant diagnoses are post-traumatic stress disorders, substance abuse disorders, and personality disorders.

The Emergency Psychiatry Rotation is at the Crisis Response Center, and includes the triage and 23 hour observation unit in the community based program.

PGY-I's rotate on the Consultation-Liaison Psychiatry service for one month at BUMCT (see PGYII, C-L description).

PGY-1's rotate for 2 months on the inpatient unit at BUMCS. This is a 56 bed unit for both voluntary and involuntary patients. PGY-I's work with a team of psychiatrists, medical students, social workers, and psychologists to care for patients with a spectrum of psychiatric illnesses treated in a publicly funded mental health system. While on this rotation, PGY-I's are exposed to civil commitment proceedings and other complex forensic psychiatric issues.

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PGY-II

  • 3 months of Adult Inpatient Psychiatry 
  • 2 months of Child Psychiatry (Inpatient and Consultation-Liaison)
  • 2 month of Consultation-Liaison Psychiatry
  • 1 month Geriatric Psychiatry
  • 1 month Addiction Psychiatry
  • 1 month Emergency Psychiatry 
  • 2 months of Night Float in Psychiatry
  • 4 conference days

The PGY-II residents rotate through the Consultation-Liaison psychiatry service Monday through Friday at BUMCT. During this rotation, residents see an average of 60 consults a month and attend daily teaching rounds with the Director of the C-L Service. By the end of the rotation, residents develop an intimate understanding of the interface between psychiatry and medicine.  They become familiar with the medical causes of psychiatric symptoms, use of psychotropic medications in the medically ill, management of delirium and dementia, and coarse brain disease (stroke, tumor, demyelinating diseases, complex partial seizures). They also gain experience in evaluation of the suicidal patient for in-hospital management, and legal issues, particularly the evaluation of competency to refuse medical treatment.  In addition, they are exposed to basic issues in the psychological management of the medically ill,  fundamentals regarding pain management (acute, chronic benign and malignant), and psychiatric issues in patients with a wide variety of illnesses including AIDS, substance abuse and those undergoing organ transplantation. There are no weekend clinical responsibilities during this rotation.

Another two-month rotation for PGY-II residents is the inpatient child psychiatry service.  Residents see a wide variety of disorders of children and adolescents. The residents learn to conduct a complete and comprehensive diagnostic interview with children and adolescents. In addition, they spend their afternoons in the Child Psychiatry Specialty Clinics based at BUMCT.

Finally, PGY-II's spend two months on the Night Float Rotation, which involves working 5 shifts per week, from 8 pm to 8 am. The Night Float resident is responsible for coverage of the Emergency Department, consultation in the hospital, and phone coverage of the VA. There are no weekend clinical responsibilities during this rotation.

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PGY-III

  • 12 months of outpatient psychiatry (includes one half day at the VA for outpatient clinic)
  • Optional Integrative Psychiatry Elective
  • Optional Perinatal Psychiatry Outpatient experience
  • 4 conference days

The entire PGY-III year is an outpatient rotation at the University Medical Center psychiatry outpatient clinic. The year focuses on the development of psychotherapy skills and the psychopharmacologic management of outpatients. Through individual supervision, case conferences and seminars, residents are expected to be familiar with pharmacological treatment, short-term and long-term dynamic psychotherapy, cognitive-behavioral therapy, group therapy, and couples and family therapies for the treatment of the major mental disorders. PGY-III residents are expected to co-facilitate one outpatient therapy group during the year. Residents receive on average five hours of individual supervision each week.  Additionally, residents have a weekly half-day clinic at the VA Medical Center where they receive direct supervision by a VA attending.  PGY-III's cover some weekend call responsibilities.

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PGY-IV

  • 1 ECT
  • 1 month of Junior Attending at the VA
  • 10 months of electives
  • 4 conference days

Ten months of the PGY-IV year are elective. PGY-IV residents receive considerable support from the faculty in tailoring their electives to obtain more experience and knowledge in their areas of interest. Some residents take administrative roles, while others want to sharpen their inpatient skills, outpatient skills, family therapy skills, etc. A number of residents use elective time for research. A wide variety of electives are available in behavioral neurology, sports psychiatry, student health, psychotherapy, research, public mental health, managed care, forensic psychiatry, neuropsychology, sleep disorders, child and adolescent psychiatry, mood disorders, ECT, rural psychiatry, and informatics.

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