Residency Programs in Psychiatry: The Training Experience
Post-graduate education in psychiatry consists of four years of residency training of which at least 36 months are in psychiatry. Many psychiatrists elect to begin their psychiatry residency immediately after medical school in a four-year residency program. This provides experiences in general medical care (at least four months in internal medicine, family medicine and/or pediatrics), neurology (at least two months), and emergency care, in addition to time in psychiatry.
Many programs are flexible about allowing entry after the first year, so that students who are undecided may have a "transitional" first year or a first year in another clinical specialty. Since, some psychiatry programs do not have the resources to provide adequate first year educational experiences in general medicine or other specialties, they accept residents only at the PGY-II level.
Although the patterns of rotations differ from one program to another, they all share a focus on the clinical care of patients with both psychiatric and general medical illness.
Post-Graduate Year One (PGY-I)
The first post graduate year usually consists of four months of internal medicine, surgery, pediatrics, OB/GYN or some combination thereof, plus two months of neurology. The remaining six months varies with the specific training program and may consist of time on psychiatry services (such as Emergency Psychiatry, Substance Abuse, Geriatrics, etc.) or additional experiences on medical and surgical units.
Post-Graduate Year Two (PGY-II) & Post-Graduate Year Three (PGY-III)
All psychiatry residents spend at least two years in the basic general residency ("double-Board" programs, for example leading to Board eligibility in general psychiatry and internal medicine may be exceptions). This time includes rotations on an inpatient service (9-18 months), with full and partial hospitalization, emergency room and/or walk-in or crisis clinic coverage, and ambulatory services. These experiences are complemented by didactic and participatory seminars, as well as case supervision. Introductory experiences in public health/community psychiatry, child psychiatry, forensic psychiatry, geriatric psychiatry, and consultation/liaison psychiatry are also usually included in PGY-II and III.
Post-Graduate Year Four (PGY-IV)
The final year of psychiatry residency training (PGY-IV) generally offers opportunities for electives. Some residents serve as the chief residents while others may choose to focus on special clinical and/or research experiences.