Rotations

Residents in the Idaho Advanced Clinician Track complete two years of training in Seattle in an academic university environment, followed by two years in the smaller community setting of Boise, Idaho. Clinical rotations are designed to provide exposure to a wide variety of patient populations, increasing levels of responsibility under supervision, and the opportunity to explore elective opportunities.

PGY-1 year
During the PGY-1 year in Seattle, residents complete a 6-month "internship" consisting of 4 months of Medicine and/or Pediatrics and 2 months of Neurology. Residents interested in child psychiatry may do 2-4 months of Pediatrics and one month of Pediatric Neurology as part of this 6-month block. The other 6 months is spent on inpatient psychiatry services at Harborview Medical Center, the University of Washington Medical Center, and/or the VA Puget Sound Health Care System hospitals, learning assessment of and treatment planning for acutely ill inpatients.

PGY-2 year
The PGY-2 year in Seattle includes additional experience in inpatient psychiatry, as well as rotations in emergency psychiatry at Harborview Medical Center, child and adolescent psychiatry at Children's Hospital and Regional Medical Center, addiction psychiatry at the Seattle VA's national Center for Excellence in Substance Abuse Treatment and Education, geriatric psychiatry at Harborview, basic inpatient consultation-liaison psychiatry, and an elective month. In the PGY-2 year, residents begin a half-day-per-week outpatient continuity clinic and complete basic psychodynamic and cognitive-behavioral therapy seminars.

PGY-3 and PGY-4 years
The PGY-3 and PGY-4 years in Boise focus on honing the resident's skills in consultation-liaison psychiatry and in outpatient treatment. Residents will have outpatient clinics and supervision at the Boise VA Medical Center, St. Alphonsus Outpatient Behavioral Health clinic, Boise State University Health Services, and the Terry Reilly Health Services (community mental health). These rotations will include treating selected outpatients over the full course of the PGY-3 and PGY-4 years, crisis intervention training, group and family therapy, outpatient substance abuse treatment, and public psychiatry. There will be a strong emphasis on consultation liaison psychiatry on the medical and surgical wards of St. Luke's, St. Alphonsus, and the Boise VA, and on providing outpatient psychiatric consultation to family physicians and residents at the Family Medicine Outpatient Clinic. Each resident will have the opportunity to work with an outpatient chronic pain management team consisting of an anesthesiologist, neurologist, and psychiatrist. Residents can serve as consultants to sleep medicine and neurology clinics, and can also choose from electives in forensic psychiatry, inpatient psychiatry, and inpatient and outpatient child psychiatry programs at St. Alphonsus and with the State of Idaho. Each resident will have 2 hours per week of psychotherapy supervision provided by skilled psychotherapists and psychiatrists, as well as supervision and teaching from their attendings on clinical rotations.

Throughout all four years of the program, one half day per week is devoted to didactics. In Boise didactics will be taught by local and visiting Psychiatry and Family Medicine faculty.

SUMMARY OF ROTATIONS BY YEAR

PGY-1
4 months Medicine/Pediatrics
2 months Neurology
6 months Inpatient Psychiatry Didactics

PGY-2
4 months Inpatient Psychiatry
2 months Child and Adolescent Psychiatry
2 months Addiction Psychiatry
1 month Geriatric Psychiatry
1 month Emergency Psychiatry
1 month Consultation-Liaison Psychiatry
1 month Elective
Continuity clinic
Didactics

PGY-3
Outpatient Psychiatry (including Continuity Clinic)
Consultation-Liaison Psychiatry
Didactics

PGY-4
Outpatient Psychiatry (including Continuity Clinic)
Consultation-Liaison Psychiatry
Elective rotations
Didactics

Residents entering in the PGY-2 year spend one year in Seattle and two years in Boise. The schedule of rotations is modified for these residents, depending on their past training and experience, to ensure that all residency and Board requirements are met. Of note, the American Board of Psychiatry and Neurology requires 2 months of Neurology for Board eligibility in Psychiatry. If residents entering at the PGY-2 level have not already completed Neurology rotations, these will be included in their elective time.

CRITERIA FOR GRADUATION
To graduate from the program, and to be eligible to sit for the American Board of Psychiatry and Neurology examinations in Psychiatry, residents must complete 48 months of approved training, including a PGY-1 year (see Application Procedures for a description of acceptable PGY-1 experiences for those residents entering at the PGY-2 level). To graduate, each resident must also:

1. Complete, in a satisfactory manner, all required clinical rotations, as well as sufficient electives to total 48 months of training, and all required psychotherapy training.
2. Pass an oral examination that includes interviewing a patient and answering examiners' questions about diagnoses, formulation, assessment methods, and treatment planning.
3. Be approved for graduation by the program's Education Committee. In considering residents for graduation, the Committee takes into account clinical competence, interpersonal skills, ethical standards, and professional conduct.