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, 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. Residents have exposure to inpatient work, and continue 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 an important change in our program. Additional rotations in this year include one month in the psychiatry emergency services area and a month on the neurology consultation service. This last rotation is complementary to the one month of ward neurology in the first year.
As a PGY-III, there are reduced ongoing longitudinal team responsibilities with opportunities for continued care of patients. The major rotations during this year are an in-depth child psychiatry experience in our fully accredited Child and Adolescent Psychiatry program and a rotation on the Consultation/Liaison Service, where the fascinating range of patients seen on the medical and surgical wards and outpatient clinics of our hospital provide an excellent learning opportunity. There is a one month Geriatric Psychiatry rotation at the West Los Angeles VA Hospital which combines outpatient and inpatient experiences in evaluating and treating the special problems of the aged. 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, and administrative experience in public mental health, teaching medical students, work 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.