Didactics

Didactics

A strong didactic program is critical to the training experience. Our residents have protected didactic time (1 half day/week in the PGY–I year and 2 half days/week in the remaining years) that integrates a balanced curriculum with developmental learning based on the PGY level.  PRITE and board–relevant teaching with specific courses on test prep are included. Residents are exposed to psychotherapy and subspecialty topics in the PGY–I year; the subsequent years of training build upon this foundation.  All members of the academic staff, including several volunteer faculty members and the chair of our department, Dr. Petros Levounis, are extensively involved in teaching.

Year–by–Year

Text Box: First Year Didactics Goal    Consolidating the knowledge gained in medical school and establishing your identity as a psychiatry resident.  PGY–I: Getting Started

PGY–I resident didactics provide a primer for psychiatric interviewing and history taking. Residents should expect to learn the basics with regard to the diagnosis, treatment, and management of inpatient and emergency issues. Residents are also introduced to the basic concepts of psychotherapy.

Courses

PGY–I Orientation –  This course takes place in the first two weeks of the intern year and covers history taking, mental status exam basics, presenting, and triaging – topics necessary for successful early first calls.

Crash Course Series – This course continues after orientation and covers typical cases and management for common emergency, consultation–liaison, and child & adolescent psychiatry cases.

Foundations: Psychiatric Diagnoses – This course covers the basics of psychiatric diagnoses, including a comprehensive review of DSM 5 criteria for major disorders, taught primarily by our PGY 4 residents.

Foundations: Psychopharmacology – This course covers the basics of psychopharmacology, including a review of major classes of medications, mechanisms, side effects, and dosing algorithms, taught primarily by our PGY–IV residents.

Core Skills – This course covers core skills with regard to interviewing techniques and the subtleties of performing a mental status exam. It includes a didactic session, in addition to observed resident interview with direct feedback. This serves as an introduction to clinical skills verification (CSV).

PRITE Skills This course is an extension of the PRITE skills workshop for all classes, with specialized, individualized sessions only for PGY–Is to review testing basics and high yield topics most pertinent for 1st year residents.

Introduction to Psychotherapy – These didactic sessions serve as an introduction to psychotherapy techniques, including differentiating dialectical from cognitive to psychodynamic and supportive. Residents gain an understanding of the different modalities and indications.

Resident Wellbeing – These didactic sessions focus on providing residents evidence–based, short and effective exercises that decrease burnout and increase resiliency and happiness. The possible neurobiological mechanisms for the efficacy of these exercises are discussed. These sessions lay the foundation for the weekly experiential sessions that run throughout the residency.

Getting started on Scholarly activity – The goal of these sessions is to facilitate the scholarly activity process by identifying barriers to lack of productivity and delineating specific techniques for tackling these barriers. Residents are provided with guidelines on how to identify novel and relevant cases, undertake a literature search, find the most appropriate format for conveying ideas (poster, case report, letter), and start the writing process. These classes focus on scholarly activities most attainable for busy residents and departments without significant grant support. 

Professionalism – These classes lay the foundation of professionalism for incoming psychiatry residents. The sessions are interactive discussions of real life based vignettes and what constitutes a breach of professionalism.

 

Text Box: Second Year Didactics Goal    Building on the foundational knowledge gained in the first year and getting comfortable teaching medical students at different treatment sites.  PGY–II: Clinical Knowledge Advancement

PGY–II year resident didactics provide a more comprehensive review of the major psychopathologies with regard to diagnosis, treatment, and management. Residents should expect to learn more about sub–specialty topics and begin to gain exposure to psychotherapeutic modalities.

Courses

Psychiatric Disorders and Their Management – This course builds on already existing knowledge from the previous year. This course covers the epidemiology, diagnosis, treatment, and management of all major DSM diagnoses, including mood disorders, substance use disorders, personality disorders, psychotic disorders, dementias, and child & adolescent related disorders.

Interviewing Skills – Building on foundations laid by the PGY Core Skills course, this course allows residents to perform observed interviews (CSV–style) with faculty supervision and direct feedback.

Neurology Summer Series – A review of neurology basics, taught by neurology faculty, including diagnostics and imaging studies relevant to the neurology component of the psychiatry boards.

Psychological Testing – These didactic sessions cover neuropsychological testing with regard to indications for consulting, differences between relevant tests, and basics of deciphering scores.

Basic Consultation–Liaison – This course covers basic topics in consultation–liaison psychiatry, including diagnosis and management, and builds upon the foundation laid in the PGY–I primer crash course. Topics discussed include delirium, decisions making capacity, somatoform disorders, drug and alcohol withdrawal and somatoform disorders.

Supportive Psychotherapy – This course covers the indication for and basic tenants of this modality of therapy. It is meant as a primer for beginning with individual psychotherapy patients in the PGY–II year.

Introduction to Research Methods – This course serves as an introduction to basic research methods and is designed to assist with resident’s own scholarly activity and searching/processing of the literature. It is meant to serve as a foundation for the evidenced based mental health course of PGY–III year.

Emergency Psychiatry – These didactic sessions cover basic topics in emergency psychiatry, including suicide and violence risk assessments, managing of agitation, and triaging patient needs in a complex system. It is meant to build on foundations laid in the emergency psychiatry crash course of PGY–I year.

Neurostimulation – Theses didactic sessions serve as a primer for future exposure to Transcranial Magnetic Stimulation (TMS) and electroconvulsive therapy (ECT) including indications, contraindications, and basic premises necessary for assisting in these procedures.

Human Development – These didactic sessions cover developmental milestones, attachment and developmental theories.

 

Text Box: Third Year Residency Goal    Developing confidence in your knowledge and its application in all settings and consolidating your identity as a teacher of these skills and knowledge.    Learning about different subspecialties and planning post residency career.  PGY–III: Independence and Choosing a Specialty

PGY–III year resident didactics provide a more in–depth exposure to the psychotherapeutic modalities. Residents learn how to apply these techniques to individual therapy patient cases. Residents are also exposed to sub–specialty topics and evidenced based mental health with a focus on using and evaluating literature.

Courses

Neurology Summer Series – A review of neurology basics, taught by neurology faculty, including diagnostics and imaging studies, relevant to the neurology component of the psychiatry boards.

Leadership Seminar – This course serves as an introduction to administrative aspects of the practice of psychiatry with didactics and resident projects reinforcing important concepts.

Career Paths – This course serves as an introduction to the different subspecialties in psychiatry, including geriatrics, addiction, consultation–liaison, child & adolescent, and forensic psychiatry. It is meant to provide a description of the type of positions, general psychopathology seen, and application process for each of the subspecialties.

Evidenced Based Mental Health – This seminar serves as an opportunity to work alongside psychology interns in evaluating the literature with regard to important topics in psychiatry. This is meant to assist with using the evidence base in future practice and foster collaboration between the fields of psychology and psychiatry.

Forensic Psychiatry – These didactic sessions provide an overview of the basic tenants of psychiatry and the law as it pertains to practice and an introduction to common psychopathology and practice issues related to the field of forensic psychiatry.

Psychodynamic Psychotherapy and Medication Management – This course serves as an introduction to psychodynamic psychotherapy, including the basic tenants of this modality, indications for use, and how to incorporate into medication management sessions.

Psychodynamic Psychotherapy Seminar 1 – This course continues to build upon the psychodynamic principles taught in the psychodynamic course with the adjunctive addition of case discussion. Each PGY–III resident will have the opportunity to present and discuss one of their individual therapy cases and receive feedback from our attending supervisors and senior residents.

Clinical Formulation – These didactic sessions serve as a follow–up to the initial mental status exam and interviewing courses of the PGY I and II years. The goal is to assist residents in creating a bio–psycho–social framework for patients to assist in treatment planning and formulating cases.

Cognitive Behavioral Therapy Seminar – This course serves as an introduction to cognitive behavioral therapy (CBT) techniques, including the basic tenets of this modality and the indications for implementing. Didactic material will be supplemented with case discussion presented by PGY–III residents regarding their individual therapy patients.

Teaching to Teach – These didactic sessions serve as an introduction into developing a skill set to teach psychiatry to various populations, including a lay audience, medical students, other residents, and ultimately a larger psychiatric audience, i.e. colleagues in the field at national conferences and grand rounds.

Text Box: Final Year Residency Goal    Consolidating the knowledge gained throughout the residency, establishing your identity as a psychiatrist and preparing for life outside of residency in chosen subspecialty/or setting.    Teaching and supervising your junior colleagues in both formal and non formal settings.  PGY–IV: Professionalism, Uniqueness and Identity

PGY–IV year resident didactics provide a more sophisticated experience with regard to formulating cases, implementing therapeutic techniques, and interviewing patients. Residents should expect the didactics in this year to also focus on board–relevant information, skills to bridge to future psychiatric practice, and develop skills in teaching juniors.

Courses

Neurology Summer Series – A review of neurology basics, including diagnostics and imaging studies, relevant to the neurology component of the psychiatry boards.

Leadership Seminar – This course serves as an introduction to administrative aspects of the practice of psychiatry with didactics and resident projects reinforcing important concepts.

Career Paths – This course serves as an introduction to the different subspecialties in psychiatry, including geriatrics, addiction, consultation–liaison, child & adolescent, and forensic psychiatry. It is meant to provide a description of the type of positions, general psychopathology seen, and application process for each of the subspecialties.

Forensic Psychiatry – These didactic sessions provide an overview of the basic tenants of psychiatry and the law as it pertains to practice and provides an introduction to common psychopathology and practice issues related to the field of forensic psychiatry.

Psychodynamic Psychotherapy Seminar 2 – This course continues to build upon the psychodynamic principles taught in the psychodynamic course with the adjunctive addition of case discussion. Each PGY–III resident will have the opportunity to present and discuss one of their individual therapy cases and receive feedback from our attending supervisors and senior residents.

Child & Adolescent Psychiatry – These didactic sessions serve as a follow–up to the child & adolescent psychiatry primer course in PGY–II year. This course focuses on child/adolescent related material and management necessary for adult psychiatrists.

Clinical Neuroscience – This course serves as a review of basic neuroscience as it relates to psychiatric disorders and their treatment. A review of relevant literature and clinical applications is highlighted.

Motivational Interviewing Seminar – These sessions serve as an introduction to motivational interviewing (MI) and focuses on the basic tenants and indications for the modality. It incorporates didactics with residents observing MI–style interviews completed by Dr. Levounis.

Dialectical Behavior Therapy Seminar – This course serves as an introduction to dialectical behavior therapy (DBT) and focuses on the basic tenants and indications for this modality. It incorporates didactics with discussion of patient cases.

Interpersonal Therapy Seminar – This course serves as an introduction to interpersonal psychotherapy (IPT). the basic tenants and indications for this modality are discussed.

Advanced Consultation–Liaison Psychiatry – These didactic sessions serve as a follow–up to the basic C/L course in PGY–II year. They build upon basic concepts and discuss the nuances of typical and difficult presentations, including information relevant for all psychiatrists in practice and board–relevant material. The course addresses medication management in patients with comorbid medical illnesses and diagnosis and treatment of psychiatric disorders during and breastfeeding.

Advanced Interviewing Seminar – This course is the final installment in the interviewing series. It includes observed interviews by PGY–IV residents with feedback from the chair of our department.

Group Psychotherapy Seminar – This course serves as an introduction to group psychotherapy. The basic tenants and indications for this modality are discussed in the first class. The didactic session is followed by 6 sessions that are experiential.

Geriatric Psychiatry – These didactic sessions serve as a follow–up to the geriatric topics discussed in PGY–II year and cover relevant issues for all general psychiatric practitioners and board–relevant review of geriatric psychiatry.

Psychoanalysis Seminar – (4 sessions) – This course serves as an introduction to psychoanalysis. It covers patient cases, basic tenants, and indications for this modality.

All Residents

Courses

Psychiatry Grand Rounds & Lunch Discussion – Rotates among faculty, invited speakers and residents – Weekly for 11 months of the year, excluding holidays

PRITE Review – This course reviews key topics in neurology and psychiatry in preparation for the national PRITE. Residents in the PGY–II, PGY–III, and PGY–IV levels attend four one–hour classes split between neurology (led by the CUMC Neurology Chief Resident) and psychiatry content. This course includes both didactic instruction and related sample PRITE questions presented in an interactive format. The review continues with daily emails highlighting PRITE topics in the week just prior to the exam.

Crisis Prevention Skills – This course serves as a primer/refresher, respectively for our PGY–I and senior residents focusing on non–violent crisis intervention and verbal de–escalation skills.

Sleep and Fatigue Mitigation – This didactic session serves as an introduction and yearly review of sleep hygiene and fatigue mitigation with regard to taking care of self during residency.