Spring 2016
Resident Round-Up

synapse: University of Nevada, Reno School of Medicine

Angie Shaw and David Carlson, M.D.

Positive Changes: Angie Shaw, residency coordinator, and David Carlson, M.D., residency program director, are making changes in the Reno psychiatry program. Photo by Anne McMillin.

Psychiatry Residency Undergoes Changes

Story by Anne McMillin, APR

Good things are happening in the Reno psychiatry residency program that can be attributed to teamwork between faculty and residents working together to improve the program for the betterment of mental health care in northern Nevada.

That's according to David Carlson, M.D., the new residency program director, who arrived in Reno in the fall of 2014, and, after a time of observing the program, is initiating changes for improvement.

"We've redone the didactic curriculum from an organizational standpoint across all four years of the program," he said. The reorganization brings about several new programs and clinics with learning opportunities for residents.

One of the didactic changes is an expanded psychotherapy program for first through third-year residents that has been reorganized and standardized in concert with faculty and resident input. The program has new curriculum for first-year residents, more advanced instruction in years two and three and allows fourth-year psychiatry residents to practice the art of teaching psychotherapy to their colleagues in years one through three.

"This enhanced curriculum takes advantage of our excellent faculty and their ability to teach psychotherapy," Carlson said.

A half-day psychotherapy clinic now is available, which allows new opportunities for third-year residents to be observed and receive feedback on their patient encounters. This is accomplished by having faculty psychologists observing residents' interaction with patients and then providing immediate feedback through a group debriefing session. Residents continue to receive individual weekly supervision for psychotherapy encounters in their other outpatient clinics.

Finally, a new department residents' clinic for third-year residents permits attending faculty, including Carlson, to review each patient with the resident and again, provide constructive feedback to the resident while the patient is still in clinic.

Carlson hopes the half-day clinic will grow and bring in more faculty seeking an opportunity for teaching residents and providing patient care in the community.

These changes and program additions will take advantage of the new accreditation standard in psychiatry residencies across the U.S. that are required to evaluate residents in 22 sub-competency areas, including treatment planning and management, the practice of psychiatry and community-based care.

Another strategy of Carlson's is to grow the psychiatry residency program from four residents annually across all four years of the program to six per year.

"This will help us meet the needs of Nevadans and is part of the graduate medical education strategic planning process for the medical school," he said.

Brian Kirkpatrick, M.D., psychiatry department chair in Reno, said Carlson also has been using a different approach to selecting the program's residents.

"He is being more selective with the screening process from the hundreds of residency applications we receive and inviting fewer, but higher quality, applicants to interview with us," he said, adding that current residents also are becoming more involved in the recruitment process under Carlson's leadership.

Carlson, who spent 20 years in academic medicine as the director of psychiatry residency and director of undergraduate medical education in neurosciences programs at the University of North Dakota, said family ties drew him to Nevada, since his wife was working at University Medical Center in Las Vegas.

"I wanted to be involved in growing this forward-looking department in Reno, and when I came and looked, I fell in love," he said, adding that when he talked to northern Nevadans about living in Reno, no one said they liked Reno. "They all said they loved it and they ended up staying here after only intending to stop for a brief time."