Curriculum

First Year:

The first year of the general psychiatry residency consists of work in a combination of community-based and academic settings in the areas of inpatient and emergency psychiatry, neurology, and primary care. Inpatient psychiatry is located at Laureate Psychiatric Clinic and Hospital and the Tulsa Center for Behavioral Health, where residents also obtain their emergency psychiatry experience. Two months of neurology are completed at the OU Physicians Neurology Clinic at the Wayman Tisdale Specialty Health Clinic. The primary care rotation consists of two months inpatient and two months outpatient work in the OU Family Practice, Internal Medicine, or Pediatrics Clinics. Each resident will also have a research elective month, which may be used to begin work on a scholarly product. Required psychiatry call for first year residents includes every other weekend while assigned to inpatient psychiatry service at Laureate only. Required call for inpatient primary care is determined by the specific department in which residents do their primary care rotation.

Second and Third Years:

The second and third years of residency training follow a 2+2 miniblock schedule, wherein the first two weeks of each month are outpatient psychiatry and the second two weeks of each month are another rotation (or vice versa). Combined, these 24 months consist of 12 months total of adult outpatient psychiatry and 12 months of consultation-liaison, child and adolescent, geriatric, addictions, inpatient, and assertive community treatment rotations. While on non-outpatient rotations, residents maintain two hours of outpatient clinic each week in order to ensure continuity with weekly psychotherapy patients. The impetus to move to the 2+2 schedule in 2019 was to enhance resident wellbeing as well as patient continuity in the clinic. To our knowledge, our program is unique in offering this schedule format in psychiatry.

The adult outpatient psychiatry experience occurs at the OU Physicians Psychiatry Clinic on our main campus. On this rotation each resident spends four days per week in the outpatient clinic and one day per week devoted to psychotherapy one-on-one supervision, clinic conference, and academic afternoon. Having the 2+2 schedule in the outpatient clinic allows each resident to follow all of his/her patients over the course of two years for continuity of care. In this setting residents evaluate and treat patients with a range of psychiatric disorders. These include anxiety disorders, depression, bipolar disorder, personality disorders, substance abuse, psychotic disorders, and others. During the PGY-2 year, residents begin psychotherapy training in the outpatient clinic.

The other psychiatry rotations in the second and third years of residency training afford further opportunities to refine diagnostic and therapeutic skills in a variety of settings, while working closely with attending physicians on a wide range of cases. Residents will spend time on the consultation-liaison service at Saint Francis Hospital, child and adolescent psychiatry at Positive Changes, inpatient geriatric and adult psychiatry rotations at Laureate, IMPACT service at OU, and addiction psychiatry at the Laureate Intensive Outpatient Program.

Required call during the second and third years includes four to five total weeks of telephone call per year for the OU outpatient clinic, four to five weekends per year of inpatient psychiatry service coverage (while on rotation at Laureate), and telephone call for the Laureate inpatient service (approximately 1:10 for PGY-2 residents and 1:12 for PGY-3 residents).

Fourth Year:

The fourth year of residency training includes completion of any required rotations; experience in Forensic Psychiatry; IMPACT, C-L, and child psychiatry service coverage as needed; and electives. Fourth year residents also take on additional teaching and formal evaluation responsibilities, providing selected lectures to medical students studying psychiatry and engaging in a unique rotation we call “Float.” The Float Rotation is a month-long clinical rotation that places the advanced resident on the inpatient or outpatient psychiatry service, providing direct clinical supervision and instruction to PGY-I or -II residents during their first month of inpatient or outpatient psychiatry. Most residents have several months of electives in their training, and residents are encouraged to choose electives in line with their special interests in the field of psychiatry. For electives, residents may choose from a wide variety of clinical, self-directed study, and research opportunities, or they may create their own unique experience with approval from the program director. This is a time when residents are able to fine-tune their training and work toward their ultimate practice goals. Supplementing these elective experiences, PGY-IV residents participate in a year-long seminar, the Practice of Psychiatry, which meets once per week under faculty supervision, and which focuses on preparing senior residents for board examination, maintenance of certification requirements, job application, and unsupervised practice. Senior residents continue to see their long-term psychiatry patients in the University of Oklahoma Psychiatry Clinic one half day per week, with ongoing assistance from faculty to develop advanced skills in interviewing and assessment of patients.

Required call during the fourth year includes approximately 1:20 telephone call for the Laureate inpatient service, and, if assigned to inpatient psychiatry service at Laureate, every other weekend while there (rare).

Didactics:

The Psychiatry Department Academic Afternoons are held every Wednesday, affording a time for all residents and faculty to come together on a weekly basis. During this time residents participate in formal lectures, team-based learning modules, departmental Grand Rounds, Morbidity and Mortality conferences, and journal club. While our lecture series cover all major areas of psychiatry, our didactic curriculum is continually evolving to address new ACGME milestone areas and the ever-changing landscape of psychiatric practice. We have enhanced our incorporation of material addressing areas such as cultural formulation, systems-based practice issues, evidence-based psychiatric practice, wellness, and neuroscience. Whenever possible, lectures are interactive, incorporating principles of adult learning. For the first six months of training, PGY-I residents have one hour of core psychiatric didactics. In addition, one lecture hour each week is dedicated to beginning psychotherapy for PGY-I and PGY-II residents, advanced psychotherapy for PGY-III residents, and the practice of psychiatry for PGY-IV residents. Currently all didactic content is occurring virtually via Zoom, due to the COVID-19 crisis. Our program quickly and easily adapted to this new format and plans to continue utilizing virtual learning for the foreseeable future.