PGY 3: Twelve Month Rotation in Outpatient Psychiatry at VAMC

Student Handbook, Appendix A

PGY 3: Twelve Month Rotation in Outpatient Psychiatry at VAMC

  1. This is a half time PGY 3 position located in the VA Mental Health Clinic. The rotation is twelve months in length.
  2. The supervisors are staff psychiatrists. Supervision will formally be scheduled for one hour a week. However, the resident is encouraged to discuss questions and difficulties with any staff psychiatrist at any time.
  3. Responsibilities of resident:
    1. Work hours are from 8:00 am to 4:30 pm with half-hour lunch. No patients are scheduled from 12:00-1:00. The resident is expected to remain at the worksite even if there are no patients scheduled or there are “no-shows”. If you need to leave the VA during the day please let the clerk know and be available by pager.
    2. Residents are expected to help out if able with “walk-in” and triage outpatients.
    3. Notes are to be completed the day of the visit.
    4. VERY IMPORTANT: Encounters must be entered the day of the visit.
    5. The resident is expected to assist patients and clerks regarding scheduling follow-up appointments with their patients and use “paperwork” slots to “overbook” as necessary for appropriate follow up.
    6. If the resident is sick, he or she must call the scheduling office (three numbers to try are (775) 786-7200 ext. 1097 or ext. 1092 or (775) 326-5720 and Dixie at (775) 326-5712. You may leave a message for Dixie if she does not answer, but do not leave a message if a clerk doesn't answer. Please call Dr. Drymalski on cell phone, (775) 233-5348, if you cannot connect with a "live" person. The sooner the staff knows a doctor is out sick the sooner they can contact patients to cancel appointments. A voicemail message may not be received as quickly as direct contact.
    7. Residents are expected to respond to pages in a timely manner.

By the end of the PGY-III VA outpatient psychiatry rotation the resident will:

  • Conduct a thorough clinical examination of psychiatric patients in the limited time available to see a patient.
  • Formulate a diagnosis and differential diagnosis for all conditions in the DSM-IV.
  • Demonstrate competence in relating historical and clinical findings to the relevant biological, psychological and social issues associated with etiology and treatment.
  • Recommend and assist in implementation of appropriate treatment for specific patient populations.

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 new knowledge to patient care issues.

Interpersonal and Communication Skills

  1. Demonstrate the ability to work with ancillary staff by responding quickly and professionally to staff requests concerning patient care issues.
  2. Demonstrate appropriate and effective communication with primary care physicians involved in care of the residents patients.
  3. Demonstrate appropriate communication with other treatment providers involved in the care of the resident’s patients.
  4. Effectively communicate patients condition and needs when making referral to other treatment providers


  1. Show respectful and professional behavior by being on time to team meetings and patient appointments.
  2. Demonstrate appropriate diligence to paper work by having all notes and write-ups completed by time of supervisor’s weekly review.
  3. Demonstrate at all times appropriate boundaries in M.D. – Patient relationship.
  4. Always notifies site personnel when sick, late or delayed for duties.

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.