The Third Year
A few words from . . .
Brant Hager, MD
PGY 4 and Chief Resident, UNM Psychiatric Center – Outpatient (2011-2012)
The third year of training is an immersion in the outpatient treatment of psychiatric patients. Residents learn the specific skills involved in outpatient treatment in multiple settings. Residents work in general adult assessment clinics and treatment programs as well as clinics with a more specialized focus. Residents are involved in all aspects of the bio-psychosocial assessment and treatment. This includes pharmacologic management, couples and family interventions, and multiple formats of individual and group psychotherapy. Residents are taught by enthusiastic faculty often with national and international expertise in the area in which they practice and teach. Residents work with providers from multiple disciplines in the capacity as a leader of the treatment team.
The third year is also a time for looking ahead. In the fall, residents begin planning for their individually-tailored PGY 4 year based on their personal interests. By the spring, a preceptor is chosen and approved, and the groundwork for the last year of residency – with its many elective opportunities – is finalized.
General Assessment Clinic:
Residents in their third year spend time during their outpatient training in the General Assessment Clinic at the UNM Psychiatric Center (UPC). Their work involves evaluation of new patients, development of treatment plans in conjunction with the attending faculty in the clinic, and treating patients for acute psychiatric symptoms. The General Clinic has a didactic curriculum focused on specific issues of assessment, psychopharmacology, supportive psychotherapy, and referral. Residents meet weekly in their treatment teams to discuss clinic issues and particular patients. All patients are staffed by faculty members who teach residents and medical students throughout the clinic day.
Specialty Clinics
Residents rotate through specialty clinics during the course of the year. This involves working with a group of patients refractory to initial interventions. Patients in these clinics generally carry chronic psychiatric diagnoses and are managed by an interdisciplinary team of providers. Trainees develop expertise in the management of psychotic disorders, affective disorders, and psychiatric presentations of traumatic events, among other diagnoses.
Dual Diagnosis Clinic
Residents train with nationally recognized leaders in the area of substance use treatment to treat patients who carry a diagnosis of substance use as well as a second psychiatric diagnosis. Residents learn to manage both issues concurrently in conjunction with a treatment team and modalities that include psychopharmacology, case management, and specific individual and group psychotherapies.
The didactic work in the third year focuses on the development of expertise in outpatient psychiatry. It begins with a course in which residents develop their own research proposals. It then centers on such areas as community psychiatry, quality improvement, and psychiatric disorders across the lifecycle. A central experience for the year is a case conference in which residents present their psychotherapy cases to renowned therapists across the nation through a teleconference. This work is supported by further exposure to models of short term evidenced-based therapies, depth psychodynamic psychotherapy, models of couples and group psychotherapy, and organizational leadership.