PGY-1 and PGY-2 Inpatient Rotations at Evanston Hospital Northshore University Health System and Mercy Hospital

Patient Care

The PGY-1 resident will be able to:

  • Obtain information from the patient interview, family contact, old charts, outpatient providers to complete a thorough assessment of the following areas:
    • History of Present Illness-Complete assessment of symptomatology, chronological order of events, recent stressors and precipitants, level of functioning
    • Past Medical History
    • Past Psychiatric History
    • Substance Abuse History
    • Family History
    • Social History
    • Developmental History
  • Complete a comprehensive mental status examination
  • Assess for dangerousness to self and/or others
  • Use precautions appropriately including close observation, suicide precautions, and one to one
  • Understand and appropriately apply criteria for inpatient hospitalization
  • Determine if a patient is medically stable enough for psychiatric hospitalization
  • Formulate a basic treatment plan including the following:
    • Acute stabilization
    • Medication management and/or ECT
    • Psychosocial interventions
    • Group and individual therapy
    • Psychoeducation
    • PT/OT/Art therapy
    • Discharge planning
  • Document the full history, mental status examination, hospital course, basic differential diagnosis, basic diagnostic formulation and basic treatment plan in the discharge summary
  • In addition to the list above, the PGY-2 resident will have participated in ECT assessment and delivery of treatment to at least 2 patients
  • The PGY-2 resident will demonstrate and be able to explain to medical students a basic understanding of individual, group and family treatment as it relates to inpatient psychiatry
  • The PGY-2 resident will be able to discuss and provide appropriate documentation on patients seen in the ER (if applicable) including a complete HPI, MSE, and clinical rationale for triage decisions and treatment recommendations

Medical Knowledge

The PGY-1 resident will be able to:

  • Make a reasonable differential diagnosis based on a basic understanding of DSM-IV criteria to include all 5 axes
  • In addition, the PGY-2 resident will be able to discuss treatment strategies for major psychiatric disorders such as schizophrenia, bipolar disorder, depression, anxiety disorders, dementia, delirium, and substance abuse, and the management of refractory psychiatric presentations in those diagnostic areas.

Systems Based Practice

The PGY-1 resident will be able to:

  • Elicit and utilize information from other disciplines
  • Demonstrate an understanding of the economic and social forces which impact health behaviors and availability of treatment options
  • Demonstrate a basic understanding of medical-legal issues as they relate to inpatient psychiatry, including voluntary and involuntary admission procedures, certification paperwork and issues of confidentiality
  • In addition, the PGY-2 resident should demonstrate a more comprehensive understanding of medical legal issues including an understanding of the rights of, and obligations toward, court-ordered patients; the use of forced medication; and the process of testifying in hearings
  • The PGY-2 resident should demonstrate an understanding of cost-containment strategies balanced by the clinical needs of the patient, including length of stay issues, medication panels, generic versus non-generic medications and the rationale for the use of each.
  • The PGY-2 resident should display an understanding of multiple levels of care, including day treatment, supported housing, inpatient and outpatient options, co-morbid substance abuse treatment, and should understand the limitations of treatment based on health care policy and cost.

Interpersonal and Communication Skills

The PGY-1 resident will be able to:

  • Demonstrate interdisciplinary team leadership
  • Co-lead community and team meetings on the unit
  • Demonstrate capacity to be empathic and develop rapport with patients and their families
  • Demonstrate capacity to relate and work well as a team player with peers, supervisors and other staff
  • Demonstrate the capacity for introspection
  • In addition, the PGY-2 resident will demonstrate an increased self-awareness, especially in understanding and appreciating transference and countertransference issues

Professionalism

The PGY-1 and PGY-2 resident will be able to:

  • Understand and appreciate a biopsychosocial formulation that includes basic psychodynamic, psychosocial and cultural elements
  • Demonstrate adequate supervision of medical students
  • Exemplify personal and intellectual integrity, and demonstrate an understanding of the ethical values and codes of a member of the medical profession