Year 1  |  Year 2  |  Year 3   |  Year 4 

     PGY 2 - Clinical Assignments

• Neurology 1 mo (C/L). The resident serves as a member of the MUH neurology C/L service. Additionally, a neuropsychologist provides an overview of neuropsychological evaluation, including a practical demonstration of the administration of several common tests.
• IOP 3N General Psychiatry & ECT 1 mo (inpatient). See description in year 1 above. Resident caseload avg 8.
• IOP 1N Psychiatry 1 mo-(acute inpatient). See description in year 1 above. Resident caseload avg 8 in 2nd year. Residents assigned to this service in 2nd year also spend one afternoon/wk with the Charleston Mental Health Center's (CMHC) Mobile Crisis Program, a field-based emergency outreach service. 
• VA General Psychiatry 2 mos (inpatient). See description in year 1 above. 2nd year resident caseload is 11 inpatients . 2nd yr residents also see patients in consultation and follow discharged inpatients one afternoon/wk in their continuity clinic (see VA Outpatient Psychiatry Clinic below). 
• Emergency Psychiatry 2 mo (night float). See description in year 1 above.  
• IOP BICU Geriatric Psychiatry 1 mo (inpatient). The Behavioral Intensive Care Unit (BICU) at the IOP is a 10-bed inpatient service that provides clinical management of geriatric patients with a variety of psychiatric disorders (Dr. Weiss, attending). Prevalent dx's include major depression 20%, Alzheimer's disease (35%), Vascular dementia (15%), other organic syndromes (15%), and other diagnoses (15%).  Residents have weekend rounds one weekend day per week.  There is no night call duty during this rotation.  Cross-coverage for night calls is provided by the psychiatry float team. Average 2nd yr resident caseload is 10 inpatients.
• IOP 4N Addiction Psychiatry 1 mo (inpatient). This is a 10-bed service (Dr. Roberts, attending) where the clinical population usually has co-occurring mental illnesses and substance abuse disorders. Average resident caseload is 10 inpatients. Residents have weekend rounds one weekend day per week. There is no night call duty during this rotation.  Cross-coverage for night calls is provided by the psychiatry float team.
• VA SATC Addiction Psychiatry 1 mo (outpatient). The resident works with an attending psychiatrist (Dr. Cluver) at the VA’s Substance Abuse Treatment Center (SATC), an intensive outpatient treatment, support and rehabilitation program.  Residents gain experience with the identification and treatment of intoxication, withdrawal, and dependence and abuse for each substance, the clinical use of benzodiazepines and anticonvulsants in detoxification, Antabuse and Naltrexone in treatment, and Zyban and nicotine replacement therapy, familiarity with commonly available clinical and self-help resources.  Residents have weekend rounds one weekend day per week.  There is no night call duty during this rotation.  Cross-coverage for night calls is provided by the psychiatry float team.
• Consultation-Liaison Psychiatry  2 mo. This is a two-month block rotation occurring in the 2nd year where residents respond to  consultation requests from physicians caring for patients at the MUH hospital and clinics. Patients evaluated include those with a known psychiatric diagnosis as well as those with psychiatric issues that impact their medical treatment. Forensic experience is included for patients requiring capacity evaluations and right to refuse treatment evaluations. Residents see patients individually and then with the attending psychiatrist (Dr. Pelic). An average caseload is 1-2 new patients each day and 4 ongoing cases. 
• VA Outpatient Psychiatry Clinic  ½ day/wk.  The average resident caseload in the 2nd year VA clinic is 45 outpatients. The attendings are Drs. Haren, Albanese, Wright, Cusack, and Huber). Treatment modalities include individual support and case management, individual or group psychotherapy with or without cognitive-behavioral interventions, and the range of state-of-the-art psychopharmacotherapy. Patients can also be referred for more specialized evaluation and treatment (neuropsychological testing, substance abuse treatment, couples therapy, ECT, group PTSD therapy, etc.) as part of their overall mental health treatment. Prevalent diagnostic groups are major depression, schizophrenia, bipolar illness, schizoaffective illness, substance use disorders, anxiety disorders, and borderline personality disorders.

     PGY 2 - Lecture/Seminars

• Neuroscience and Clinical Neurology.  Year 2 lectures begin with a review of basic neuroscience in order to provide a solid foundation for understanding the neurobiological etiology of mental illness and its treatment. The year is rounded out by a series of lectures focused on clinical neurology. Consultation-Liaison Psychiatry.   Series of lectures focusing on assessment, diagnosis, and treatment of common psychiatric conditions encountered in other medical specialties including delirium, substance withdrawal, factitious disorders and malingering, and somatoform disorders.
• Psychopathology II.  This series builds on the 1st year series and expands the knowledge base on the epidemiology, etiology and related neurobiology, genetics, course and prognosis of psychiatric disorders.  The pharmacological treatments available for each of the following disorder will be discussed, emphasizing receptor-level function of psychotropic agents and treatment of refractory cases: Personality Disorders, Substance Use Disorders, Nonpharmacological Somatic Therapies, Fundamental Psychopharmacologic Principles, Mood Disorders, Psychotic Disorders, Cognitive Disorders, Sleep Disorders, Anxiety Disorders, Eating Disorders, Disorders First Diagnosed in Childhood, Adjustment Disorders and Bereavement, Impulse Control Disorders, Sexual and Gender Identity Disorders, Dissociative and Amnestic Disorders, Somatoform Disorders, Factitious and Malingering Disorders, Pain Disorders, and Consult/Liaison Psychiatry. Implications for diagnosing and treating these disorders in childhood and adolescence will be discussed when appropriate.  The course director will conduct quarterly reviews of covered material to evaluate retention and comprehension of material presented. 
• Evaluation and Management of Geriatric Patients.  Series of lectures focusing on assessment, diagnosis, and management of geriatric patient in psychiatry. Residents learn how to perform a thorough cognitive examination of a geriatric patient, specific cognitive disorders and their treatment, evaluation and management of common movement disorders, and management of aggression in a geriatric patient.
• Introduction to Psychotherapy.  Series of lectures focusing on basic theoretic framework of main schools of psychotherapy and practical aspects of becoming a psychotherapist. Residents learn about theoretic basis of crisis intervention, supportive psychotherapy, brief psychotherapy, psychodynamic psychotherapy, and cognitive-behavioral psychotherapy.
• Developing Therapeutic Alliances.  In-depth discussion about the psychiatric interview and mental status exam with follow up of patients by use of rating scales and standardized interviews as well as application of case formulation.