PGY 2: Inpatient Psychiatry at NNAMHS

Student Handbook, Appendix A

PGY-2 Three Month Rotation in Inpatient Psychiatry at NNAMHS

Resident Expectations on NNAMHS Inpatient Unit

To attend morning nursing report daily and treatment team twice weekly (which starts at 9am)

To be on hospital grounds from 8 am to 5 pm, with one hour lunch

Patient load expectations:

  • PGY1—maximum of 6 patients
  • PGY2—maximum of 8 patients

Daily/Weekly Duties:

  • Psychiatric evaluations within 24 hours of admission
  • Along with psychiatric evaluations, a full H & P to be completed on weekend call
  • Sign charts weekly in medical records
  • Discharge summaries to be dictated within 72 hours of patient discharge
  • Daily notes in either DAP or SOAP format

Charts, in medical records, need to be complete (discharge summaries dictated and all required signatures completed) within 30 days of the end of the rotation. Failure to do so could lead to a decreased professionalism score for this rotation and a report to the program director.

All admission, discharge and daily plans (ex: med changes) need to be discussed and approved by attending

Answer pages promptly

Competencies to be achieved by the end of the rotation:

Patient Care

  1. Demonstrate the ability to appropriately develop and execute treatment plans using medication regimes.
  2. Demonstrate the ability to develop and execute treatment plans using individual psychotherapies.
  3. Demonstrate the ability to develop and execute treatment plans using group psychotherapies.
  4. Demonstrate the ability to relate history and clinical findings with relevant biological, psychological and social issues in developing treatment plans.
  5. Demonstrate the ability to collect appropriate data to include or exclude differential diagnosis.
  6. Demonstrate the ability to modify treatment plans based on changes in diagnosis.
  7. Demonstrate the ability to evaluate effectiveness of treatment plans based on patient’s symptomatology.

Medical Knowledge

  1. Show knowledge of the criteria for major psychiatric disorders by consistently generating differential diagnosis
  2. Know how to adequately evaluate a patient with psychiatric symptoms to exclude physical conditions which may mimic psychiatric conditions by using medical history and physical examinations.
  3. Know how to adequately evaluate a patient with psychiatric symptoms to exclude physical conditions which may mimic psychiatric conditions by using laboratory data.

Practice Based Learning and Improvement

  1. Demonstrate the ability to learn independently by identifying one knowledge deficit and appropriately collecting new information in that area.
  2. Demonstrate the ability to appropriately collect new information in knowledge deficit area.
  3. Demonstrate the ability to apply to knowledge to patient care issues.

Interpersonal and Communication Skills

  1. Demonstrate the ability to work with treatment team staff by appropriately receiving input for team members.
  2. Demonstrate the ability to uses communications skills to moderate differences between team members in treatment team meetings.
  3. Show advanced use of communications skills in promoting positive behavioral change.
  4. Demonstrate adequate communications skills in dealing with patient family members.

Professionalism

  1. Show respectful and professional behavior by being on time to team meetings.
  2. Show respectful and professional behavior in resolving conflicts in treatment team.
  3. Demonstrate appropriate diligence to paper work by completing all dictations and notes in a timely fashion.
  4. Complete patient logs and work assignments prior to the end of the rotation.
  5. Appropriately notify work site and program of all absences.

System-based Practice

  1. Know how to refer to other agencies within the system as demonstrated by making such referrals when appropriate
  2. Demonstrates the ability to work with formularies to minimize costs to patient.
  3. Appropriately follows procedures to procure needed medical treatment when necessary
  4. Works with health care managers to improve quality of and access to patient care within the facility.