The Menninger Department of Psychiatry at Baylor College of Medicine has established a coordinated sequence of clinical and didactic experiences to facilitate achievement of the specific educational goals of each post graduate year level. Residents are apprised of the educational goals for each clinical rotation. Feedback on the resident's progress is provided at regular intervals and a more focused review of each resident's performance occurs semiannually. At the time of the semiannual reviews, time is also allotted for program feedback collected from each resident. Careful attention to resident feedback enables the continuous improvement of Baylor College of Medicine’s academic programs.
The first postgraduate year in psychiatry includes four months of primary care, two months of neurology, and six months of psychiatry and occur at the Harris Health System, Michael E. DeBakey Veterans Affairs Medical Center, and Texas Children's Hospital. Psychiatry residents rotating on medicine, neurology, and pediatrics rotate on specific services chosen through a collaborative agreement with the residency directors of the respective departments. While on non-psychiatry rotations, residents function as a level I trainee of the host department. However, regular contact with the Department of Psychiatry is maintained through a monthly luncheon with the residency director, associate director and chief resident(s), as well as participation in departmental social activities.
The six month psychiatry rotations for first-year residents occur at the Harris Health System and the Michael E. DeBakey Veterans Affairs Medical Center. For two months, the first-year resident is responsible for up to five inpatients under the daily supervision of a full-time Baylor faculty member at Ben Taub General Hospital. Baylor medical students, a psychologist, a social worker, an occupational therapist, and a psychiatric nurse are also members of the treatment team. The first-year resident performs the initial evaluation of newly admitted patients and implements the treatment plan developed collaboratively with the attending psychiatrist. Additionally, the first-year resident spends one month at the Ben Taub Psychiatric Emergency Room. The first year resident also spends one month in the MEDVAMC Emergency Room, on a focused addiction psychiatry rotation, and on the acute inpatient psychiatry service. The supervision of patients on these rotations is by full-time Baylor faculty and senior residents of the Department of Psychiatry and supported by the collaboration with allied health professionals and other learners..
The core curriculum for Baylor residents provides an intensive educational experience in the skills and knowledge base required to be an effective clinical psychiatrist. The seminars occur in six tracks across all four years of training: psychopharmacology, psychotherapy, neurosciences, ethics, research and descriptive psychiatry. Formal didactic instruction of the core curriculum begins during the first weeks of the rotation on Psychiatry. First year seminars include Psychopharmacology, Emergency Psychiatry, Ethics, Behavioral Neuroanatomy, Cultural Psychiatry, Neuropsychiatry, Forensic Psychiatry, Geriatric Psychiatry, Psychosomatic Medicine, Psychiatric Interviewing, Addiction Psychiatry, Evidence Based Psychiatry, Imaging in Psychiatry, Psychological Testing and Descriptive Psychiatry (Psychiatric Diagnosis).
Each resident is assigned to one faculty member for individual supervision and to one faculty member for group supervision, in addition to the clinical service supervisors. All residents attend the weekly Departmental Grand Rounds and twice monthly Journal Club.
During this year, the resident completes a basic curriculum in general hospital psychiatry that concentrates on the diagnosis and treatment of more severely disturbed individuals. The PGY2 year introduces consultation/ liaison services as well as subspecialty services, including child psychiatry and geriatric psychiatry. In addition, second-year residents begin to follow long-term psychotherapy patients at the Baylor Psychiatry Clinic. There is a one-month elective rotation that can be used to pursue a research interest, participate in the Assertive Community Treatment Program, learn about neuropsychology, mental health courts, or integrated care.
Clinical rotations for inpatient psychiatry during PGY-II are at The Methodist Hospital, The Menninger Clinic, Ben Taub Hospital and the MEDVAMC. Consultation/liaison psychiatry assignments are at the MEDVAMC, the Methodist Hospital and Ben Taub Hospital. Each resident rotates for one month on geriatric psychiatry at the MEDVAMC. A one month child psychiatry assignment is at Texas Children's Hospital.
The didactic curriculum in the second postgraduate year includes seminars in Advanced Ethics, Hypnosis, Advanced Evidence Based Psychiatry, Cognitive-Behavioral Therapy, Group Therapy, Short-term Psychotherapy, Geriatric Psychiatry, Advanced Psychopharmacology, Psychopathology, Empathy, Child Development and Psychopathology, Paraphilias and Sexual Disorders, Sleep Disorders, Pain Management, Brain and Behavior, Perinatal Mental Health, Eating Disorders, Cultural Psychiatry, Professionalism, and basic Psychodynamic Theory. The resident is assigned two psychotherapy supervisors who assist the resident in the evaluation and initial phases of psychotherapy.
Clinical assignments in the third year emphasize longer term care in outpatient settings. The resident divides his or her time between assignments at an outpatient clinic for adult patients with severe and persistent mental illness at MEDVAMC or HHS , a wide variety of subspecialty outpatient clinics, and the Baylor Psychiatry Clinic for an increased assignment in psychotherapy. At the outpatient clinics, emphasis is placed on the development of integrative skills with special attention to interdisciplinary, psychosocial, and cross-cultural parameters of mental health. Clinical experience and supervision are provided in consultation, mental health administration, and program planning/evaluation. Residents provide direct patient care, supervise staff members and medical students, and serve as resource persons for in-service training exercises.
Two or three residents from each class may elect to take a research rotation during the third postgraduate year. These residents devote up to one quarter time throughout the academic year to a clinical research project under the supervision of a research mentor.
The didactic curriculum for the third year includes seminars in Human Development, Family Therapy, Leadership, Group Psychotherapy, Brain and Behavior, Couples Therapy, Mentalization-Based Therapy, Advanced Ethics, The History of Psychiatry, Advanced Psychopharmacology, Brief Psychotherapy, Forensic Psychiatry, Gender, Trauma, Professionalism, Cultural Psychiatry, Psychiatry and Religion, and Advanced Psychodynamic Psychiatry. Each clinical service provides a minimum of one hour of supervision for each four hours of clinical activity. In addition, two individual supervisors provide ongoing education and supervision for long-term individual psychotherapy cases.
This year allows flexibility so that the resident is able to pursue areas of interest discovered in the first three years of training. The residents continue to treat ongoing patients at the Baylor Psychiatry Clinic and serve as senior administrative or chief resident. In the administrative chief capacity, the resident has a significant teaching role for first- and second-year residents and medical students. Fourth-year residents may also choose a variety of advanced elective and selective rotations: subspecialty programs of Houston Methodist Hospital, the MEDVAMC, The Menninger Clinic, and the Baylor Psychiatry Clinic, clinical research initiatives with a faculty mentor, assignments at Assertive Community Treatment at the MEDVAMC, Intensive Outpatient Program at Ben Taub Hospital, Perinatal mental health at TCH's Women's Pavilion, and many others. A new away elective at Rusk State Hospital is under development for the 2014-2015 academic year.
The didactic seminars in PGY-IV include Psychopharmacology Case Conference, Professionalism, Advanced Psychodynamic Psychotherapy, Transition to Practice, and a Board Review Course in Neurology and Psychiatry.
Senior residents also have the option of attending and/or presenting cases at the monthly Live Psychotherapy Consultation and weekly CBT Group Supervision.