University of Utah Health is the Mountain West’s only academic health care system. Its lively flagship hospital provides care for a five state catchment area, meaning that residents are exposed to a variety of acute and unusual conditions in addition to bread-and-butter learning cases.
Residents each spend 1-2 months on a medical-psychiatry unit (5W/IMP) over their first two years in the program. 5W affords medically compromised individuals requiring psychiatric stabilization direct access to the resources of UUMC in the event that interdisciplinary management or urgent medical attention is required. Residents learn to establish a broad differential diagnosis for patients who present behaviorally, to care for patients who require careful medical evaluation and to co-manage these patients with other medical specialties.
PGY2 residents spend a month on the consult-liaison (CL) service at UUMC. Residents learn the consultation process and the liaison role, while being exposed to different manifestations of psychiatric illness in medical and surgical patients. They evaluate whether behavioral presentations have non-psychiatric etiologies. They gain insight into the psychological impact of medical illness on patients and into the barriers psychiatric illness can present to accessing and accepting medical care. Residents practice determining which pharmacologic and therapeutic interventions are appropriate for a given medically-ill patient. There is a second month of CL that takes place at the VAMC.
PGY2 residents additionally complete a crisis rotation set in the UUMC Emergency Department, assessing high acuity patients and developing appropriate treatment plans for them. Residents work closely with social workers and emergency medicine physicians in a consult role.