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Training Opportunities include:
The Department of Psychiatry offers unique opportunities for active research involvement with close mentoring by award-winning research faculty. Research tracks can begin as early as the PGY-I year, and can be tailored to address individual interests and needs. Less formal involvement is also encouraged for those who select to participate in research at a more general level.
Research mentoring affords access to faculty members with outstanding credentials. In addition to our stellar research faculty, Nick Breitbord, PhD, serves as a direct mentor to residents with research interests. Richard Lane, MD, PhD, is world-renowned expert in the field of cognitive neuroscience. Eric Reiman, MD, the Scientific Director of the Samaritan PET Center in Phoenix and an Associate Professor of Psychiatry at the University of Arizona, recently received national press coverage when his research using brain imaging and genetic screening to test potential treatments of Alzheimer's was published in the New England Journal of Medicine. Residents in the research program have been very successful‚Äîwinning fellowships in Minority Research Training, fellowships to the American College of Neuropsychopharmacology, New Investigations Award to the New Clinical Drug Evaluation Unit, and NIMH-sponsored fellowships and awards.
A wide spectrum of research opportunities exists, including: clinical services and service systems research in the public sector; neurobiological research, primarily focused on the biological aspects of mood disorders and on PET studies; psychopharmacology research, exploring treatments for depression, anxiety, schizophrenia and bipolar disorder; emotion research; health psychology research related to the psychological aspects of medical illness and consult-liaison issues; crosscultural research with an emphasis on Hispanic and Native American mental health; and research in child psychiatry. Individualized research tracks can be created to accommodate any combination of interests in these areas.
At a recent American Psychiatric Association meeting, Robert Michaels suggested that psychiatric residency training programs need to train psychiatrists for 40 year careers, with the understanding that the health care system in which psychiatry is practiced may change every 15 to 20 years. Accordingly, it is important to educate psychiatrists in core concepts that will enhance their clinical abilities no matter what the reimbursement climate is at a given time. We believe that training our residents broadly is important to prepare them for life-long careers. Our residents develop an understanding of the basic concepts and theories of psychodynamically-oriented psychotherapy, cognitive behavioral therapy, couples and family therapy, group therapy, brief therapy, and crisis intervention.
During the PGY-I year attention is paid to the physician-patient relationship, and the basics of that relationship are addressed in an interviewing course. This course includes sessions on the structure and organization of a psychiatric interview and in-depth discussions of the clinical examination. A case conference is a part of this course.
During the PGY-II year a weekly course entitled "Conceptual Foundations of Psychodynamic Psychotherapy" is taught. This seminar focuses on clinical illustrations of psychodynamic concepts, including empathy, the therapeutic alliance, boundary management, the unconscious, repression and defenses, developmental lines, transference, countertransference, the drive and defense conflict model, object relations, self-psychology, insight, selecting patients for psychotherapy, and psychodynamic formulation. During the PGY-II year, residents begin seeing weekly outpatients with individual supervision. Group therapy training begins in the second year when residents conduct a daily inpatient therapy group at University Medical Center which is supervised by a faculty member.
During the PGY-III year, third year psychiatric residents are assigned to the outpatient division at University Medical Center where they see approximately 15 hours per week of ongoing outpatients, in addition to outpatient psychiatric consultations and emergencies. Residents have five hours per week of individual supervision. Three hours per week are for seeing new patients with a faculty member present, one hour per week is for supervision of long-term therapy patients, and one hour per week is for group therapy supervision. Residents see a wide range of patients both diagnostically and in terms of socioeconomic status. The resident's education is supplemented by a weekly outpatient case conference and several didactic seminars focusing on advanced psychotherapy topics, such as object relations and self-psychology. Additional seminars are taught in conducting brief psychodynamic psychotherapy. An intensive cognitive and behavioral therapy seminar series is taught during the second year where residents are taught the theoretical background of cognitive behavioral therapy and clinical applications, for depression, for relaxation, for systematic desensitization, for panic disorder and for generalized anxiety disorders, and for insomnia.
A year long continuous case seminar is taught in the third year, in which residents meet together with faculty to present video recordings of sessions with selected patients. In addition, reading for this seminar focuses on the clinical application of various psychodynamic concepts as well as basic principles of emotion-focused psychotherapy.
The third year residents observe a faculty psychiatrist conducting psychotherapy through a one-way mirror for one year, so that they see the beginning, intermediate, and termination phases of therapy.
Residents are required to follow families and couples in their third year. They learn the history of family therapy; the use of genograms in family therapy; family life cycle assessment; interventions using structural approaches, multigenerational approaches, strategic approaches; cognitive behavioral; and communication training approaches. Residents in the third year learn group psychotherapy by co-leading a group and by didactic and supervisory experience in group psychotherapy.
During the PGY-IV year, residents attend a year-long seminar on advanced psychodynamic concepts and the psychodynamic treatment of borderline and narcissistic character disorders. Residents also attend a weekly case conference that is also attended by third year residents. Residents carry five to six hours per week of psychotherapy patients, including several hours of long-term therapy patients throughout the fourth year. There are a number of electives available in psychotherapy during the fourth year.
The community psychiatric residency rotation provides a clinical experience within a continuum of differing services. This includes inpatient psychiatric care at University Physicians Healthcare Hospital, Tucson's county hospital under the supervision of faculty psychiatrists. During this rotation residents become familiar with the initial evaluation of both nonchronic and chronic psychiatric disorders, as well as their treatment in a publicly funded mental health system. In addition, they gain valuable insight into the civil commitment process. By the end of the rotation the resident has become skilled at establishing rapport and a working relationship with decompensated seriously mentally ill patients and their families.
In addition to the inpatient setting, the residents gain experience in caring for the seriously mentally ill, the dually (substance abuse or developmentally disabled) diagnosed, as well as the adult developmentally disabled with behavioral disturbances in different outpatient treatment settings. Within the outpatient experience the resident learns to coordinate mental health service delivery with case managers and to grasp the role of psychopharmacology in the care of the mentally ill.
Residents receive a rich exposure to forensic psychiatry during their residency. Barry Morenz, MD, Associate Professor of Clinical Psychiatry, is a Board-certified forensic psychiatrist who coordinates forensic experiences for the residents. He shares forensic responsibilities with Drs. Aimee Kaempf and Steven Herron. Residents have experience in their first and second years with civil commitment. During their third year, residents observe and participate in a wide variety of forensic evaluations, and receive a fifteen-week course in ethics and forensic psychiatry. The course is taught by Dr. Morenz. In the fourth year, residents may elect to receive more intensive exposure to forensic psychiatry. Finally, there are a number of psychologists and psychiatrists in the community and the department who do forensic consultations for various issues, both civil and criminal. These clinicians welcome residents to participate in their frequent evaluations.
The curriculum in biological psychiatry includes biological psychiatry, consultation-liaison, introductory psychopharmacology, and advanced psychopharmacology seminar series. The biological psychiatry seminar series covers neuroanatomy, neurochemistry, genetics, and brain imaging, and the biology of emotion, affective disorders, anxiety disorders, schizophrenia, childhood psychiatric disorders, and substance abuse. The consultation-liaison series and child psychiatry lectures review delirium, dementia, Tourette's, and psychiatric manifestations of AIDS, seizure disorders, head injury, stroke, and other neurological disorders.
Through the introductory and advanced psychopharmacology series, clinical supervision, the Northwest Medical Center's ECT program, readings, and clinical experience residents develop a working knowledge of each of the established somatic treatments of psychiatric disorders. The curriculum is designed to give each resident an understanding of the biological factors that are involved in the development and treatment of psychiatric disorders, an appreciation for emerging developments in research, and the knowledge and skills needed to address biological issues in the evaluation and treatment of patients with psychiatric problems.
Clinical neuropsychology is an applied science concerned with the behavioral expression of brain dysfunction. The neuropsychology program in the Department of Psychiatry provides comprehensive assessment of higher mental functions of patients with known or suspected brain dysfunctions. Follow-up counseling with patients and their families is often implemented.
Psychology interns and residents have the opportunity to work with a variety of cases that illustrate brain-behavior relationships. A neuropsychological assessment is a process evaluation in which standardized tests are used as a source of core information. Qualitative observations, which may involve non-standardized tasks, supplement this basic information to answer specific questions about brain functioning. Among the cases referred to the program are patients with intractable epilepsy, neuropsychiatric disorders, tumors, head injuries, strokes and degenerative conditions.