Description of the PGY Years
We offer seven PGY-I positions and expect that trainees will spend four years of residency with us. The Categorical Program provides the PGY-I trainees with an initial exposure both to psychiatry and to primary care. The year is divided into approximately seven months of psychiatry and five months of medical rotations. The psychiatric portion of the year consists of four months of Inpatient Psychiatry, two months of Emergency Psychiatry, and one month of training in substance abuse. Primary care medical rotations include general ward medicine, ambulatory medicine (adult and pediatric), medical emergency room, and ward neurology.
Membership on an outpatient multidisciplinary team of residents, faculty, psychologists, social workers, and nurses begins in the PGY-II year. Concomitantly, residents have exposure to inpatient work and may continue to work with these same patients in an outpatient setting. In addition, residents participate in outpatient psychiatric assessments; begin psychotherapeutic work with individuals, couples, and families; and monitor the need for psychotropic medications. Residents continue to work with many of these patients throughout their years of training, with ongoing case supervision. This integrated inpatient and outpatient experience early in training has been a priority for our program since 1996. The PGY-II year also includes the second neurology month, but it is neurology consults, not ward neurology.
As a PGY-III, residents have already developed a cohort of outpatients most of whom were admitted to the clinic by residents during their PGY-II year. During the PGY-III year, residents continue their longitudinal work with their patients, but their caseloads become more static as they are no longer adding new patients. The other PGY-III responsibilities include 4 months of child and adolescent psychiatry part time, five months of C&L part time, a full time month of geriatrics at the Westwood VA, a “selective month” where residents get to choose a clinical experience from a selection of existing services while they complete a Quality Improvement project, and a month of forensic. Finally, there is a half-day psychotherapy experience at a local health maintenance organization, where the patient population complements what is seen in the Harbor outpatient clinic.
Our PGY-IV year is characterized by flexibility. The goal is to provide trainees with the opportunity to place their individual stamp on their final year of training. Approximately 60% of the resident’s time is spent in team activities, including an experience in learning organizational and management skills in a multidisciplinary setting. The remaining time is reserved for electives planned by the resident. Usually residents pursue an intensive exposure in a particular area, e.g., a research project, in-depth work with a particular patient group, an administrative experience in public mental health, teaching medical students, working on innovative projects in the psychosocial rehabilitation of the chronic mentally ill, etc. Our close affiliation with UCLA allows residents to choose from among the many activities, clinical and/or research, within the UCLA/NPI Department of Psychiatry in addition to those at Harbor. PGY-IVs also take the lead in presenting at our journal club, and they participate in our yearlong neurology review course.