Inpatient Rotation Overview
Each PGY1 completes six total months of off-service rotations where they function in the same capacity as categorical medicine and neurology interns. Off-service rotations are done in three month blocks which alternate with three month blocks of psychiatry training. Core rotations are spread between University of Utah Medical Center (UUMC) and the George E Whalen VA medical center (VAMC). Residents may also rotate through Primary Children’s Hospital if they prefer to do a month of child neurology or pediatrics. All rotations are inpatient with the exception of a one month elective in either emergency medicine at UUMC or outpatient internal medicine at the VA.
While on-service, PGY1s rotate between our program’s home base, the Huntsman Mental Health Institute (HMHI—formerly University Neuropsychiatric Institute or UNI), a medical-psychiatry service at UUMC (5W/IMP), and the VAMC. Typically, PGY1s spend most of their time at HMHI, accumulating two or months of general adult inpatient experience, one month of specialized inpatient addictions training and several weeks of day float admitting experience. They also spend a month at the VA adult inpatient psychiatric unit (IPU) and on medical-psychiatry at 5W/IMP.
On-service PGY1s carry a decreased cap of 6 patients. They focus on the fundamentals of psychiatry, including interviewing skills and diagnosing patients within the framework of the DSM-5. They also practice biopsychosocial formulation and case presentation. They are expected to read independently about the evidence-based management of their patients’ pathology and propose appropriate psychopharmacologic management.
PGY2s continue to rotate through our general adult inpatient units, with additional rotations in consult-liaison psychiatry (UUMC and VAMC), crisis management (UUMC ED), geriatrics (VA clinics), and child psychiatry (HMHI). They also have more flexibility to travel for electives or seek out their own educational experiences. The night float rotation, in which residents are responsible for all HMHI admissions and cross-cover of 120+ beds, is described by many residents as one of the most formative experiences of their first two years, a capstone of their inpatient portion of training.
PGY2s carry 8-10 patients. Second year residents further incorporate psychotherapeutic concepts from the PGY2 didactic curriculum into their interviews. They begin developing autonomy in sophisticated medical decision-making and in leading an interdisciplinary team. They also start to see their first psychotherapy patient.