In the PGY-2 year, residents join the outpatient clinic on a half-time basis, working alongside faculty, psychologists, social workers, and nurses.  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. Concomitantly, residents continue their inpatient work, also spending a month each on the consultation-liaison psychiatric service and the neurology consult service. This integrated hospital-based and outpatient experience early in training has been a priority for our program for three decades.

Our PGY-IV year allows flexibility for residents to choose electives part-time during their final year of training, while continuing the other part-time in the outpatient clinic. Usually, residents pursue intensive exposure in a particular area.  For example in recent years, residents spent their time participating in a research project, doing in-depth work with a particular patient group, learning to practice therapy modalities such as DBT, enrolling in local psychoanalytic institutes, teaching medical students, working on innovative projects in the psychosocial rehabilitation of the chronic mentally ill, delving into the role of a junior attending in the psychiatric emergency room, or gain skills in transcranial magnetic stimulation (TMS).  Some residents have also been able to utilize our affiliation with UCLA to rotate in specialty clinics there, for example, learning more about the treatment of mood disorders, anxiety disorders, reproductive psychiatry, sleep disorders, and OCD.  They have also rotated with the DMH Street Psychiatry Team and have participated in the family medicine clinic as a consultant.