PGY 3: Goals and Objectives

Student Handbook, Appendix A

Patient Care

  1. Consistently performing a Comprehensive Diagnostic Interview on patients new to the resident as documented in the medical record and evaluated by supervisor.
  2. Provide Targeted Neurological Examinations when appropriate to evaluate for medication side effects and suspected medical / neurologic disorders as documented on the Training Skills Checklist.
  3. Demonstrates the ability to establish rapport with patients as documented during ACOE.
  4. Maintain rapport with patients over a sustained treatment time frame including during periods of resistance or change.
  5. Routinely demonstrate interview skills comparable with community practitioners including the ability to interview difficult patients as documented during ACOE and supervisor evaluation.
  6. Consistently provide a comprehensive and well articulated treatment plan which:
    • Is done in collaboration with the patient.
    • Involves applicable evidence based practice guidelines, especially in regard to medications and therapies.
    • Addresses the need for laboratory testing, psychological evaluation, and imagery.
    • Addresses issues in starting medications including informed consent.
    • Includes consideration of need for community resources including other medical evaluations and treatment, social and vocational needs.
  7. Always provide timely and appropriate follow-up which includes: Reviewing ordered labs. Gathering and reviewing collateral information. Monitoring response to therapy assess compliance. Identify and adapt to emerging issues. Receive therapy plan based on new information. Evaluate for and identify S.E.’s. Consistent use of appropriate rating scales / objective and subjective evidence of response. Decide how long to treat. Informed consent and how to stop therapy. When and how to change therapies. Maintain alliance.
  8. Psychotherapy referral skills as evidenced by three successful referrals documented on the PGY-3 Training Skills Check List.
  9. Psychotherapy skills.

Medical Knowledge

  1. Know diagnosis criteria for major DSM diagnosis.
  2. Know diagnosis criteria for every diagnosis they make or DDx.
  3. Know and identify medical conditions which can cause / modify psychiatric symptoms and conditions.
  4. Inheritability and genetics of psychiatric disorders.
  5. Know evidence basis for medication therapy for major DSM diagnosis.
  6. Know the pharmacodynamics and pharmacokinetic of drug, drug interactions and side effects.
  7. Know evidence based practice guidelines.
  8. Be able to cite the epidemiology including prevalence of major DSM diagnosis and significant psychiatric symptoms including suicide.
  9. Demonstrate knowledge of assessment methods including psych testing, rating scales and screening tools by:
    • Know (describe) different types of psychotherapies.
    • Know evidence for therapy matching for specific populations:
      • Brief-supportive
      • CBT
      • Psychodynamic
  10. Know basic theoretical principles for psychodynamic / psychoanalytic therapy.
  11. Basic knowledge of statistical analysis as evidenced by satisfactory participation in the EBM seminar series in PGY-3.
  12. Understand NNT analysis as evidenced by satisfactory participation in the EBM seminar series in PGY-3.

Practice Based Learning and Improvement

  1. Independently identify problems and independently develop a plan for correction.
  2. Independently use supervisors and consultants.
  3. Autonomously use literature searches with each identified problem.
  4. Use internet based drug interaction tools.
  5. Use of list serves.
  6. Seek feedback from supervisor.
  7. Self monitor no show rates.
  8. Self monitor counter transference.
  9. Process their patient alliance – Scott Miller measures.
  10. Q.I. Frontiers of discipline

Interpersonal and Communication Skills

  1. Manage counter-transference.
  2. Modulate communication to person and setting.
    • Consent
    • Public settings
    • Vernacular
    • Technical vocabulary
  3. Patient communication is:
    • Effective
    • Questions
    • Culturally sensitive
    • Checks for misunderstandings and rephrases

Professionalism

  1. Maintain professionalism in all public domains.
  2. Be responsive to the needs of colleagues, supervisors and subordinates.
  3. Demonstrate the ability and willingness to appropriately report unprofessional conduct.
  4. (Educate) – Practice base learning.
  5. Show adherence to all of the APA Standards of Ethics including role conflicts confidentiality standards.

System Based Practice

  1. Demonstrate knowledge of insurance formularies to treat patients effectively and efficiently in an outpatient setting.
  2. Demonstrate knowledge of patient reimbursement plans sufficient to formulate an appropriate therapy plan within the restrictions of the patients benefit plan.
  3. Appropriately manage split care cases with outside psycho therapists and other mental healthcare providers.
  4. Appropriately manage integrated care cases with primary care physicians and other providers.
  5. Demonstrate the ability to both blend and respect diverse community and cultural resources and philosophies in the treatment of individual patients.
  6. Demonstrate commitment to systems approach to patient care by completing all clinical reminders including screenings and preventative interventions.