Psychiatry Residency

Rotations

PGY-1

Lectures and supervision supplement the first year. Lectures are a half-day each week throughout the residency. Interns are matched with a faculty supervisor to meet with for general guidance throughout the residency. Additionally, each intern is assigned a medication supervisor with whom they meet regularly to discuss various aspects of pharmacotherapy and answer any questions that may arise on the inpatient unit. At the end of the first year, interns can begin seeing patients in the outpatient clinic.

PGY-2

Second-year residents rotate through various services to gain experience in different areas in the field of psychiatry. In the second year, residents can also begin seeing additional clinic patients to follow as outpatients. Clinic clientele includes both medication management patients and psychotherapy patients. Residents meet regularly with psychotherapy supervisors for guidance in their therapy training. Second-year residents have the opportunity for teaching activities, including medical student lectures and evaluations. Rotations and lectures become more intense during the second year, but most rotations allow ample time for self-guided study.

PGY-3

Third-year residents are provided with their own office space, and the frequency of call duties continues to decline. Most of the third-year schedule is dedicated to outpatient clinic work from 8 a.m. to 5 p.m. On the majority of these days, PGY-3 residents work at the Baylor Scott & White Mental Health Clinic, where they conduct a variety of patient encounters, including new evaluations, transfer of care appointments, medication management visits, and psychotherapy sessions. One day each week, some residents spend the day seeing patients at the Temple VA Mental Health Clinic. Additionally, residents spend a half-day per week working at community clinics located in Temple and/or Killeen. Supervision for both medication management and psychotherapy is maintained throughout.

PGY-4

Fourth-year residents spend half of their day at the Baylor Scott & White Mental Health Clinic, where they provide continuity of care by following established outpatients. The other half of the day is divided between three months of inpatient psychiatry, two months of VA electives, and seven months of other electives chosen by the residents. The program offers a variety of elective options, and residents also have the option to design an elective tailored to their specific interests. Examples of available electives include private practice, ECT, cognitive testing, intensive outpatient therapy, TMS, and palliative care. The fourth year offers significant flexibility, allowing residents to explore diverse areas of interest within psychiatry.

Didactics

Alongside hands-on clinical training, residents participate in weekly seminars designed to help them develop a strong foundation of knowledge and experience. Each PGY level is allotted one half-day per week dedicated to lectures.

These seminars are considered protected time, during which residents are relieved of clinical and inpatient responsibilities.

Each seminar series follows a syllabus with weekly assigned readings, most of which are supplied through the resident library or journal articles, reducing the need for purchasing multiple textbooks.

Additional learning opportunities come from clinical case conferences, grand rounds, ethics meetings, journal clubs, and consultation-liaison case conferences.

The tables below provide an overview of the seminars for each training year. Each row corresponds to a one-hour time block for that year (or, in PGY1, for the six months spent in psychiatry). Only formal courses are included in these diagrams; case conferences and other teaching sessions are scheduled separately and are not displayed here.

PGY-1 lectures

• Introduction to Psychiatry
• Introduction to Interviewing
• Evolution of Psychiatry
• Emergency Psychiatry
• Introduction to Therapy
• H&Ps
• Meditation
• Wellness Group
• DSM-5
• Ethics/Professionalism
• Forensic Psychiatry
• Psychiatric Treatment
• Patient Safety Group Supervision
• Resident Wellness Activities

PGY-2 lectures

• Addiction Psychiatry
• Child Development and Family Systems
• Consultation Liaison Psychiatry
• Treatment of Mental Disorders
• Evidence Based Medicine
• Personal Finance
• Teaching Psychiatry
• TMS/Spravato/ECT
• Patient Safety Supervision
• Resident Wellness Activities
• Telepsychiatry

PGY-3 lectures

• Neuroscience
• Reproductive Psychiatry
• Book Club
• Tools and Techniques for Therapy
• Short-Term Psychotherapy
• CBT
• Diversity in Healthcare
• Psychopharmacology
• Psychodynamic Psychotherapy
• Patient Safety Supervision
• Resident Wellness Activities

PGY-4 lectures

• Career Transitions
• Book Club
• Psychopharmacology
• Board Review
• Health Psychology
• Personality
• Grief and Bereavement
• Clinical Psychology Topics
• Patient Safety Supervision Conference
• Resident Wellness Activities

Conferences

Department of Psychiatry Grand Rounds

Grand Rounds is hosted by speakers that include guest lecturers, faculty members and fellow residents. The topics presented include clinical issues, research topics and projects, mental health policy issues, psychopharmacology and psychotherapy.

Ethics Conference

The ethics conference is held once per month and includes all psychiatric residents and a faculty member. A wide variety of ethical issues and dilemmas psychiatrists encounter in practice are discussed in this seminar.

Journal Club

Residents present articles from a recent psychiatric publication. All residents will read the article(s) prior to discussing them as a group with a faculty mentor, with an emphasis on evaluating the article’s background, methodology, interpretation and significance of findings.

Advanced Psychopharmacology Seminar

Our PGY-3 and PGY-4 residents meet with a faculty member once each week to review various advanced pharmacology topics. Each week, a psychopharmacology article is reviewed with an emphasis on reviewing evidence-based guidelines and practices.

Outpatient Case Conference

Once per month, PGY-3 and PGY-4 residents and psychology post-doctoral fellows discuss mutual patients and collaborate care.

Consultation-Liaison Case Conference

Residents and faculty meet to discuss a case from the consultation and liaison service. At each conference, the resident assigned to the consultation-liaison service presents an unusual or interesting case. The topics covered include unusual presentations of psychiatric conditions, end-of-life issues, organic brain syndromes, somatoform disorders and pain management.

Board review

Residents meet weekly for faculty-led board review. The class emphasizes material that is not only important for the written boards and the in-training exam (PRITE) but also reviews clinical information involving patient care.

Practice Improvement Meeting

This is a quarterly conference that is attended by all faculty and residents within the department to discuss a difficult case or outcome from a risk management perspective.

Call Schedule

Call responsibilities start during the first six months of the first year in which new residents have four "buddy" calls. During buddy calls, PGY-1 residents are paired with a designated PGY-2 or PGY-3 resident. The trainers are responsible for educating interns on the various aspects of being on-call. This training provides a unique opportunity to work one-on-one with upper-level residents and exposes PGY-1 residents to different ideas and styles while getting to know upper-level residents better. Interns are not cleared to start taking overnight calls until the resident and program director are confident that the resident possesses the skills necessary to succeed.

Call Break Down

Weekend call shifts and night float weeks make up call obligations.

While on-call, residents benefit from the support of attending psychiatry staff. Residents are never expected to make decisions about patient care without faculty support and supervision.

Weekend Call

The weekend call shifts are divided between the available residents in the pool. Forty-eight hours are covered on the weekend, which is split up into four shifts. The weekend call shifts are split evenly between all pool residents, including PGY-1 (starting in January), PGY-2, and PGY-3 (up until December). Some residents elect to "stack" their call responsibilities to form a 24-hour shift and therefore have fewer weekends on call.

Day call will consist of rounding on our inpatient unit at Canyon Creek Behavioral Health.

Night call will cover consults from the Baylor Scott and White Emergency Department from home via telepsychiatry. They will also cover floor calls from our unit at Canyon Creek Behavioral Health.

Night float (Weeknight call)

A night float resident covers night call shifts to avoid 24-hour call shifts during the weekdays. The PGY-1 residents only take night float weeks in January-June and PGY-2 residents in July-December.

Night call will cover consults from the Baylor Scott and White Emergency Department from home via telepsychiatry. They will also cover floor calls from our unit at Canyon Creek Behavioral Health.

Moonlighting

Moonlighting is a way residents at BSW can supplement experience and income. Beginning in PGY-3, residents in good standing may moonlight. Moonlighting requires written pre-approval from the program director.

Opportunities to moonlight in Psychiatry are readily available throughout Central Texas. One of the opportunities residents most frequently take advantage of is the outpatient clinic moonlighting at the BSW Mental Health Clinic. This moonlighting occurs before or after regular clinic hours, and additional malpractice insurance is not required (your BSW malpractice insurance is acceptable). Most current residents who choose to moonlight do so at Cedar Crest Hospital, telepsychiatry for East Texas Behavioral Health Network, Ascension Providence DePaul Center, and Austin State Hospital.

Residents have also been able to sign individual contracts for other moonlighting opportunities, including telepsychiatry consulting for county jails and telepsychiatry inpatient work on a geriatric unit.

Research

Psychiatry research at Baylor Scott & White Health is designed to offer residents as much research experience as they wish. Residents may choose to join existing projects or collaborate with a creative project team to develop their own research initiatives. The program supports residents by providing medical writing editors, assistance with submitting grant applications to the institutional review board, and training in ethical research practices to help ensure their success.

Baylor Scott & White conducts both clinical and basic science research at its main campus in Temple, as well as at the VA campuses in Temple and Waco. The Graduate Medical Education office offers up to $1,500 to cover some travel expenses for residents whose poster or paper abstracts are accepted at scientific meetings.