Goals and Objectives: General Adult Psychiatry Clinics

The General Adult Psychiatry Clinics provide diagnostic evaluation and treatment for a range of psychiatric disorders in adults, including bipolar and unipolar affective disorders, anxiety disorders, adjustment disorders, attentional disorders, personality disorders and some psychotic disorders. The general clinics provide medication management and limited psychotherapy, but can refer within the clinic for short and long term psychotherapy and neuropsychiatric testing. The clinics collaborate with primary care providers in the evaluation and treatment of medical problems which may intersect with psychiatric presentations, such as sleep disorders, some cortical and subcortical dementias which are comorbid with affective disorders, and the common renal, thyroid, hematologic and hepatic consequences of medications commonly used in psychiatric practice.  PGY-3 residents spend twelve months in the General Clinics.

Please note: the Goals and Objectives listed here apply not only to the General Adult Clinics but also to all the Adult Outpatient Subspecialty Clinics, though the latter may have additional specific Goals related to the subspecialty of each clinic.

Patient Care:

At the end of the twelve-month rotation, the resident will have acquired:

  • the ability to complete a thorough general psychiatric diagnostic assessment
  • the ability to formulate a case, integrating biological, psychological, and social issues
  • the ability to generate and carry out a plan of care, including pharmacological, psychological and social interventions
  • the ability to identify issues and patterns better approached by psychotherapy than by medication

Medical Knowledge:

The resident will know and understand:

  • the various presentations of depression, bipolar disorder, anxiety disorders and adjustment disorders and other disorders mentioned above, and how to differentiate among them.
  • the pharmacologic management of these disorders, and the complications attendant to the use of SSRI's TCA's, MAOI's, mood stabilizers, stimulants, and atypical antipsychotics
  • the treatment of refractory mood and anxiety disorders
  • the types of psychotherapy, and their indications, which are effective in managing the problems seen in a general psychiatry clinic.

Practice-based Learning and Improvement

The resident will be conversant with standards for metabolic screenings, assessment of movement disorders, Depression and Anxiety written inventories, and other standards of care, and will incorporate these measurements into patients' medical records.  The resident will be observed  in many patient interactions by the attending, and will receive feedback on those observations including issues of rapport, adherence, patient education and formulation of a treatment plan shared with the patient.

Interpersonal and Communications Skills:

The resident will be able to:

  • create a collaborative relationship with a wide variety of patients, some difficult to engage, so as to gain essential information and build and implement a therapeutic plan
  • educate patients and their families
  • demonstrate an understanding of the stresses involved in having a chronic psychiatric illness
  • supervise and educate medical students about psychiatric illnesses, interviewing techniques and presentation skills.

Professionalism:

The resident will demonstrate:

  • respect for patient autonomy and choice
  • willingness to seek supervision for psychotherapeutic and pharmacologic assessments and interventions

Systems-Based Practice

When appropriate and only with the written consent of the patient, the resident will communicate with ancillary medical providers, mental health providers, and other relevant sources of information or providers of education, structure and/or care to the patient, to establish and maintain an optimal treatment plan.