Psychiatry and
Behavioral Sciences

Education

Clinical Rotations

Our four-year clinical curriculum gives residents the opportunity to rotate on inpatient, residential and outpatient services in multiple settings, including a university hospital, a VA health care system, a county hospital, a managed care consortium, and a university student health center. Residents participate in an extensive system of individual and group supervision, dedicated case conferences, and didactics, in addition to being integral parts of the varied, often multidisciplinary, patient care teams.

The PGY-1 year is designed to foster residents' identity as physicians and to build a solid foundation of skills and knowledge in the assessment, diagnosis, and treatment of common medical, neurologic, and psychiatric disorders.

In the PGY-2 year, residents develop competency in managing complex psychiatric disorders and providing expert consultation to other health care providers, primarily within the inpatient arena. They also begin to practice long-term psychotherapy, get exposure to a wide range of assessment methods in psychiatry, and have an opportunity to explore their specific areas of interest.

As PGY-3s, residents focus on psychiatric ambulatory care, developing knowledge and skills in both psychotherapy and psychopharmacology for the treatment of patients in a variety of outpatient settings, including a university health care system, a VA clinic, and a variety of community-based centers.

Finally, the PGY-4 year allows an increased amount of flexibility for residents to pursue more advanced training in areas of particular interest, helping to optimally prepare them for life after residency.

Click on the 'Clinical Rotations' link above for more details.

Basic Rotation Structure

Year 1

4
Months

2
Months

4
Months

1
Month

1
Month

Internal Medicine

Neurology

Inpatient
Psychiatry

Emergency Psychiatry

Night
Float

Year 2

3
Months

2
Months

2
Months

2
Months

1
Month

1
Month

1
Month

Inpatient
Psychiatry

Geriatric
Psychiatry

Consult-Liaison
Psychiatry

Scholarly
Concentration

Assessment Methods Rotation (includes research, neuropsychology, and forensics)

Addiction Psychiatry

Night
Float

0.5 day per week Outpatient Psychiatry (long-term Psychotherapy cases)

Year 3

12 Months

Full-time Outpatient Psychiatry
(includes ongoing psychotherapy cases, ~20% Child & Adolescent Psychiatry)

0.5 day per week Scholarly Concentration for 6 months

Year 4

6 Months

6 Months

Selective 50%
Scholarly Concentration 50%

Selectives

0.5 day per week Outpatient Psychiatry (long-term psychodynamic cases)

|Top|

Scholarly Concentration

Residents may choose an area of clinical interest, ranging broadly by demographics, diagnosis, and treatment modality. Alternatively, residents may select a research area of interest with an appropriate mentor for close supervision and educational support. All concentrations require the development of clear goals and objectives with appropriate supervision by a mentor, to be approved by the Program Director. Residents have individual supervision weekly with their mentor(s).

Examples of recent clinical concentrations: VA Trauma Recovery Program, HIV Clinic, Integrative Behavioral Health/Primary Care Consultation, Couples and Family Therapy, Integrative Medicine, Dialectical Behavioral Therapy, "IPC Plus" (Dynamic Psychotherapy), Psychooncology, Center for Survivors of Torture

Examples of recent non-clinical concentrations: Global Mental Health, Child Neurodevelopment and Neuroimaging, Psychosomatic Medicine, Autism, Physician Burnout in Residency, Bipolar Disorders, Neuropsychiatry Education, Effect of Depression on Cognitive Function, Acupuncture for Psychological Symptoms

Scholarly Project

The scholarly project is designed to be a culmination of scholarly work done during the course of residency and should be of publishable quality. It may reflect work done during scholarly concentration time or work done outside of scholarly concentration, and is due in the spring of the PGY-4 year.

Group supervision for project development occurs within Thursday afternoon course time in the PGY-3 and 4 years.

Pathways

The Pathway Program offers residents a way to "specialize" in one of a number of different concentration areas within psychiatry. To date, the residency program offers the following pathways:

Residents may apply to a specific pathway as early as spring of the PGY-1 year. To fulfill a pathway requirement, the resident must engage in a combination of scholarly and clinical activities. The scholarly activities should culminate in a scholarly project by the end of the PGY-4 year. Clinical activities must include two selections above and beyond any required rotation. Selective rotations may count towards the pathway clinical activities. All attempts will be made to give priority to those selectives that are associated with a resident's identified pathway. Furthermore, all pathway candidates must engage in some teaching opportunity associated with the pathway concentration as well as participating in curriculum development for relevant rotations including maintaining the Wiki site for those rotations. Also, pathway residents are required to be involved in leadership either through participation in a residency, hospital or institutional committee, regional organization and/or apply to a national fellowship/award opportunity within the 4 years of residency. Furthermore, a pathway resident is required to participate in at least one relevant, extra-curricular educational experience. Mentorship will be provided within each pathway.

Didactics

Residents attend Grand Rounds and formal didactic instruction weekly on Thursday afternoons when they are excused from clinical duties. The didactic and clinical curricula provide residents with a thorough and well-balanced presentation of the fundamentals and theories of psychiatric illnesses, clinical decision-making, and therapeutic modalities, as well as ethical, cultural, legal and systems-based understanding of mental health issues.

In addition, residents also participate in individual and group supervision in association with their psychotherapy patients, where they learn to apply theoretical concepts outlined during Thursday didactics to their clinical casework. Regularly scheduled rounds and case conferences on the inpatient wards and outpatient clinic supervision and case conferences are also considered an essential part of the learning process.

Click on the 'Didactics' link above for more detail.

Call Duties

During their first three years, residents are required to take call at the Palo Alto VA or at Stanford Hospital, in decreasing amounts over time. When on-call, the resident has three clinical responsibilities:

  1. to evaluate all psychiatric patients in the emergency room and if needed admit them to the inpatient units
  2. to respond to any urgent psychiatric consults called in by another medical service
  3. to respond to any urgent issues on the inpatient units

Supplemental Educational Opportunities

Extracurricular Learning Opportunities

There are a wide range of learning opportunities offered by groups within the university and the community and available to residents. Some current ones include:

Psychotherapy:

Global Health:

Stanford Center for Innovation in Global Health Resident Seminars

Teaching:

Stanford Faculty Development Center for Medical Teachers Teaching Workshops

Weekly Process Group

Beginning in the PGY1 year, residents participate in a weekly process group with their classmates. The goal of this experience is for residents to learn more about each other, find support, and to explore interpersonal dynamics and how these affect interactions with patients.

Arbor Free Clinic

Arbor Free Clinic is an acute care clinic primarily serving patients who lack medical insurance. Arbor has physicians and Spanish-speaking translators on staff to treat children, adults, and seniors. The Mental Health Clinic offers assistance for psychiatric needs. Residents can volunteer their time to see patients under attending supervision in this clinic on a monthly basis.


| Top |

Stanford Medicine Resources:

Footer Links: