Rotations

PGY-1

Four months of General Medicine: a combination of two months Internal Medicine, one month of Primary Care, and one month of Emergency Medicine.

• Six months of Adult Inpatient Psychiatry at Banner – University Medical Center South (BUMC-S) and Southern Arizona Veterans Administration Health Care System (SAVAHCS)
• Two months of Neurology (Consults and Outpatient) at SAVAHCS
• Two months Internal Medicine at BUMC-S and SAVAHCS
  • Residents participating in a child and adolescent track may be able to replace one month of adult Internal Medicine with one month of inpatient Pediatric Medicine
• One month Emergency Medicine at Banner – University Medical Center Tucson (BUMC-T) and BUMC-S
• One month Outpatient Primary Care at SAVAHCS
• Twenty vacation days, five sick days, five CME days, and two Step/Level 3 days

While on Internal Medicine, PGY-1s are part of a team that 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 rounds is devoted to education. Internal Medicine takes place at SAVAHCS and BUMC-S. Residents participating in a Child and Adolescent Psychiatry Track may be able to replace one month of Internal Medicine with inpatient Pediatric Medicine.

The Neurology rotation at the SAVAHCS allows PGY-1s 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 SAVAHCS under the supervision of a neurology resident and an attending. 

During the Emergency Medicine rotation, 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 gunshot wounds. Residents average eighteen, 12-hour shifts in the Emergency Room each month. There is no additional on-call requirement.

PGY-1 residents spend two months on the inpatient psychiatry service at SAVAHCS. The 30-bed inpatient unit treats veterans with a wide variety of psychiatric problems, including post-traumatic stress disorders, substance abuse disorders, mood disorders, and personality disorders.

PGY-1s complete for four months on the inpatient units at BUMC-S. This is a 48 bed psychiatric hospital  for both voluntary and involuntary patients. PGY-1s 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-1s are exposed to civil commitment proceedings and other complex forensic psychiatric issues.

PGY-2

• Two months of Geriatric Psychiatry at Banner – University Medical Center South (BUMC-S) and Southern Arizona Veterans Administration Health Care System (SAVAHCS)
• One month of Inpatient Addiction Medicine at SAVAHCS
• One month of Inpatient Psychiatry at BUMC-S
• Two months of Emergency Psychiatry at BUMC-S

  • One of these two months is completed as Night Float

• Two months of Consultation-Liaison at BUMC-T

  • One of these two months is completed as Night Float

• Two months of Child & Adolescent Psychiatry including emergency psychiatry at the Crisis Response Center (CRC), and outpatient experience at BUMC-S
• One month of Toxicology at BUMC-S and BUMC-T
• ​One month of Inpatient/Residential Treatment at Sierra Tucson
• Twenty vacation days, five sick days, and eight CME days 

PGY-2 residents rotate through the Consultation-Liaison psychiatry service Monday through Friday at BUMC-T and the Emergency Psychiatry service at BUMC-S. 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.

During the two-month Child and Adolescent Psychiatry rotation, residents see a wide variety of disorders in children and adolescents. Residents learn to conduct a complete and comprehensive diagnostic interview in multiple practice settings and gain exposure to neuropsychological testing procedures. 

Finally, PGY-2s spend two months on Night Float, which involves working five shifts per week, from 8 pm to 8 am at either BUMC-S (emergency psychiatry) or BUMC-T (consultation-liaison psychiatry). The Night Float resident is responsible for coverage of the Emergency Department, consultation in the hospital, and remote coverage of SAVAHCS. There are no weekend clinical responsibilities during this rotation and residents do not travel between sites during night shifts.

PGY-3

• 12 months of outpatient psychiatry (includes one half day at SAVAHCS or Whole Health Clinic for outpatient services)
• Twenty vacation days, five sick days, and eight CME days 

The entire PGY-3 year is an outpatient experience at the psychiatry ambulatory clinic. The year focuses on the development of psychotherapy skills and the psychopharmacologic management of diverse clinical presentation. Through individual supervision, case conferences and seminars, residents develop the ability to provide 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-3 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 SAVAHCS or the Whole Health Clinic to provide exposure to varied ambulatory settings and patient populations. 

PGY-4

• One month of part-time ECT
• One month of part-time Forensic Psychiatry
• Nine months of electives
• Optional Integrative Psychiatry Elective
• One month of part-time Junior Attending at SAVAHCS (Inpatient)
• One month of part-time Junior Attending at BUMC-T (Consultation-Liaison)
• Nine months of electives
• Optional Integrative Psychiatry Elective
• Twenty vacation days, five sick days, and eight CME days 

Nine months of the PGY-4 year allow for completion of diverse elective rotations. PGY-4 residents receive considerable support from the faculty in tailoring their electives to obtain more experience and knowledge in their areas of interest. 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. Residents may also dedicate the majority of their elective time towards scholarly projects, including participation in the Psychiatry Trainee Research Track.