Curriculum

Formal didactic instruction takes place on Tuesday afternoons from 1 to 5 p.m. Grand Rounds feature presenters from local, regional and national pools, as well as senior residents, whose presentations are part of the graduation requirement. Residents meet weekly for Resident Council.

Each fall, residents take the Psychiatry Resident in Training Examination, or PRITE, to identify strengths and areas for improvement. Clinical skills exams are held annually to assess progress and provide feedback.

PGY-1 and PGY-2 residents attend a one-hour weekly Rotating Topics Conference. PGY-3 and PGY-4 residents use their didactic time for Grand Rounds, scholarly preparation or board review. All residents take part in a PRITE review session on alternating weeks throughout the year.

Curriculum

• PGY 1

  Sample PGY I Rotation Schedule:

  First Column	Second Column	Third Column	Fourth Column
  July Inpatient Psychiatry	Aug. Inpatient Neurology	Sept. Inpatient Psychiatry	Oct. JCMC Inpatient Internal  Medicine
  Nov. VAMC Emergency Psychiatry	Dec. Outpatient Neurology	Jan. Inpatient Psychiatry	Feb. JCMC Inpatient JC Family  Medicine
  Mar. Outpatient Primary Care	Apr. VAMC Emergency Psychiatry	May Outpatient  Primary Care	June Inpatient Psychiatry

• PGY 2

  The PGY-2 year builds on fundamentals with an introduction to supportive psychotherapy, as well as child psychiatry, consultation-liaison psychiatry, inpatient psychiatry and geriatric inpatient psychiatry, which align with the primary rotations of the year. Residents develop more complex inpatient care plans, informally mentor first-year residents on these units and provide night float call coverage.

  Sample PGY 2 Rotation Schedule:

  First Column	Second Column	Third Column	Fourth Column
  July Inpatient Psychiatry	Aug. 2 weeks Consult/Liaison  Psychiatry 2 weeks Night Float	Sept. Inpatient Psychiatry	Oct. Child Inpatient Psychiatry
  Nov. Inpatient Geriatric Psychiatry	Dec. 2 weeks Night Float 2 weeks Consult/Liaison Psychiatry	Jan. Child Inpatient Psychiatry	Feb. 2 weeks Night Float 2 weeks Consult/Liaison Psychiatry
  Mar. Consult/Liaison Psychiatry	Apr. Inpatient Psychiatry	May 2 weeks Consult/ Liaison  Psychiatry 2 weeks Night Float	June Inpatient Psychiatry

   

• PGY 3

  The PGY-3 year places a strong emphasis on advanced psychotherapy training and individual therapy supervision. Residents participate in direct viewing through cameras, one-way mirrors or in-room interview sessions, as well as reviewing videotaped sessions and discussing their cases. Training includes supportive, cognitive behavioral and psychodynamic therapies. Advanced psychopathology and psychopharmacology, including substance abuse, are also covered.

  Rotations in multiple outpatient clinics give residents opportunities for more independent roles with diverse patient exposure and supervision. Didactic time is also available for work on Grand Rounds or a scholarly project.

  Sample PGY 3 Rotation Schedule> July-June Outpatient Clinics:
  

  First Column	Second Column	Third Column	Fourth Column	Fifth Column
  Monday a.m. ETSU Psychotherapy Clinic	Tuesday a.m. VAMC Mental Health Clinic	Wednesday a.m. Community Mental Health Clinic	Thursday a.m. ETSU Behavioral Health and Wellness Clinic,  University Health Clinic or other	Friday a.m.  Outpatient Tele-Psychiatry Clinic. Pain Medicine, Sleep Medicine, or other
  Monday p.m. VAMC Mental Health Clinic	Tuesday p.m. Didactics	Wednesday p.m. VAMC or ETSU Substance Use Clinic	Thursday p.m. ETSU Medicine Management	Friday p.m. Research

  Note: All residents complete Adult Outpatient Psychiatry at both the university and Veterans Affairs Medical Center, as well as Substance Use Disorder, Community Mental Health, Psychotherapy and Medication Management clinics. They also rotate through one or more outpatient specialty clinics.

  Orientation curriculum begins in the second half of June to prepare incoming interns for their year of rotations. The PGY-1 year emphasizes interviewing, diagnostic and treatment skills, which expand as residents rotate through emergency psychiatry, inpatient psychiatry and inpatient internal medicine. Residents also gain experience in outpatient neurology and primary care. They are expected to pass Step 3 during the PGY-1 year.
• PGY 4

  The PGY-4 curriculum focuses on consolidating prior learning, with residents taking on more senior roles in inpatient and consultation-liaison psychiatry while mentoring junior residents. They also spend a half day each week in a Medication/Therapy Continuity Clinic. Six months of electives round out the year, allowing residents to pursue interests that guide subspecialization or career choices.

  Recent electives have included hospital psychopharmacology, Veterans Community Living Center consultation, the Mental Health Intensive Case Management program for veterans, telepsychiatry, consultation-liaison psychiatry, electroconvulsive therapy, substance abuse, pain management, sleep medicine, serving as a junior attending on an inpatient unit and a one-month research elective. Residents are encouraged to develop new electives tailored to their interests.

  During this year, residents complete their scholarly project and are strongly encouraged to present it at a national meeting. Senior residents also teach a basic psychopharmacology course to PGY-1s and present relevant psychiatry topics to internal medicine residents. Transition to Practice, along with continued psychotherapy supervision, prepares them for board certification and employment.

  Sample PGY 4 Rotation Schedule:

  First Column	Second Column	Third Column	Fourth Column
  July ER or Inpatient Unit with interns, weekly half-day Medication/Therapy Continuity Clinic	Aug. ER or Inpatient Unit with interns, weekly half-day Medication/Therapy Continuity Clinic	Sept. ER or Inpatient Unit with interns, weekly half-day Medication/Therapy Continuity Clinic	Oct. ER or Inpatient Unit with interns, weekly half-day Medication/Therapy Continuity Clinic
  Nov. ER or Inpatient Unit with interns, weekly half-day Medication/Therapy Continuity Clinic	Dec. ER or Inpatient Unit with interns, weekly half-day Medication/Therapy Continuity Clinic	Jan. Elective, and weekly half day Medication/Therapy Continuity Clinic	Feb. Elective, and weekly half day Medication/Therapy Continuity Clinic
  Mar. Elective, and weekly half day Medication/Therapy Continuity Clinic	Apr. Elective, and weekly half day Medication/Therapy Continuity Clinic	May Elective, and weekly half day Medication/Therapy Continuity Clinic	June Elective, and weekly half day Medication/Therapy Continuity Clinic

DIDACTICS

• PGY I COURSES

  • Crash Courses at the start of the year
  • Interview Skills
  • Basic Psychopharmacology
  • DSM-V-TR
  • Rotating Topics Conference
• PGY 2 COURSES

  • Child Psychiatry and Child Psychopharmacology
  • Introduction to Psychotherapy: Supportive, CBT, and Psychodynamic Psychotherapy
  • Rotating Topics Conference
• PGY 3 COURSES

  • Advanced Psychopharmacology
  • Advanced Psychopathology
  • Advanced Psychodynamic Therapy
  • Transition to Practice
  • Grand Rounds Preparation/Scholarly Project Development Time/Research/other scholarly ativity time.
• PGY 4 COURSES

  • Transition to Practice
  • Teaching Basic Psychopharmacology for PGY-1s
  • Scholarly project development, psychiatry board review, research, lecture preparation, Stahl's coursework, internal medicine lecture preparation, and other scholarly activities
• COMBINED COURSES/TOPICS

  • Journal Club
  • Quality Improvement
  • Chair Rounds
  • M&Ms
  • Internal Medicine Topics
  • Neurology
  • Forensics
  • Research Lectures

TRAINING SITES

We offer residents a diversity of experiences with our various sites in a university town that services a large patient catchment area including rural areas of Tennessee, as well as veterans through the VAMC.

• Veterans Administration Medical Center (VAMC)

  The James H. Quillen Veterans Affairs Medical Center in Mountain Home, TN provides a variety of health services to meet the needs of our nation's veterans. Services are available to more than 170,000 veterans living in a 41 county area of Tennessee, Virginia and Southeast Kentucky.

• ETSU Quillen College of Medicine

  ETSU Psychiatry Building - Residents have outpatient general adult medication management and psychotherapy clinics as well as didactics at this site, which is housed off campus across State of Franklin Rd. from Johnson City Medical Center and close to Woodridge Hospital and the Veterans Administration Medical Center (VAMC). Residents also have the opportunity to be involved with Child and Adolescent patients at this site.

  ETSU Psychology Clinic - The ETSU Psychology Behavioral Health and Wellness Clinic treats patients from Johnson City and surrounding counties ranging in age from early childhood through late adulthood. PGY3 Residents provide medication consultation.

  University Health Center - This is a general medical clinic through the Nursing department for university students where faculty and psychiatry residents provide medication management.

  Family Medicine Clinics - Residents have outpatient primary care experience in one or more of the three nearby family medicine clinics as part of a team with family medicine residents and medical students.

• Woodridge Hospital

  Woodridge Hospital is an 84-bed inpatient provider of mental health and chemical dependency services for adults, adolescents and children ages 6 and older. Psychiatrists lead teams that include mental health therapists, discharge planners, expressive therapists and psychiatric nurses who help patients find the most appropriate level of treatment. The hospital, which provides both inpatient and outpatient adult psychiatric and chemical dependency care, is a primary teaching facility for the Department of Psychiatry and Behavioral Sciences.

• Johnson City Medical Center (JCMC)

  Johnson City Medical Center is a 445 bed regional tertiary referral center for the entire service area and one of the six Level 1 Trauma Centers in the state of Tennessee. JCMC is a major medical referral center and offers advanced surgical services, including orthopaedics, general surgery, a specialized heart center, cancer center, and advanced diagnostic imaging services.

• Frontier Health

  This is an outpatient clinical experience in an underserved area in a community mental health center that serves seriously mentally ill patients with board certified psychiatrist supervision. These CMHCs also have 24 hour walk-in, provide medication assisted treatment and residential care. Residents are involved in assessment and treatment with medications, but also work with inter-professional staff in the care of these patients. Forensic Evaluation Observation is also done with Frontier Health.

• Other Program Highlights:

  Tennessee has offered stipends that residents can apply for to augment their yearly residency salary in return for similar years of service in areas of high need.

  Mentors: Each resident meets with a mentor throughout residency.

  Resident regional or national conference presentations: Funds are typically  available to help cover  some of travel and registration for one presentation during the residency.

  Other Education Funds: Yearly funds are available for books or other education materials.

  Education Day: Residents are able to join faculty off site for a half-day intensive review of the program to address areas of improvement and recognize areas of strength

• Call Duty: 

  PGY I - No overnight call until spring when PGY1s take a few Saturday Night Float rotations each to prepare for PGY2 year Night Float. Weekend day call approximately one weekend in every four or five weekends at VAMC or Woodridge Hospital.

  PGY 2 - Approximately seven to eight weeks total of Night Float in two week intervals and occasional overnight call during the rest of the year at VAMC.

  PGY 3 - Weekend day call at VAMC and Woodridge--approximately one weekend in every five or six weeks.

  PGY 4 - Weekend day call at VAMC and Woodridge--approximately one weekend per quarter.

• Moonlighting

  If desired may start in PGY 3 year or later after obtaining a full Tennessee State License (with the permission of the Residency Program Director).