Curriculum: Overview

The ABIM and ABPN allow for seven years’ worth of graduation requirements to be met in five. This is accomplished by following a rigid curriculum structure, double-counting of select rotations and loss of twelve months of psychiatry elective time.

Logistical complexity is introduced by the differing ways that the internal medicine residency and the psychiatry residency programs schedule blocks (i.e. the 4+1 structure for internal medicine versus psychiatry's thirteen four-week blocks). 

Curriculum: Didactics

Residents are expected to attend internal medicine conferences and Monday didactics while on internal medicine rotations and Tuesday afternoon psychiatry didactics while on psychiatry rotations.

The chief resident will assist with identifying important educational sessions (i.e. simulation training, bootcamps, etc) for all residents and arranging their excused absences from clinical duties.

Tuesday Afternoon Conference

Held during primary care week and attended by all internal medicine and psychiatry residents. Content is arranged by the chief resident and typically includes case conferences, special lectures and led Training Group (aka "T-Group") group therapy sessions. 

Curriculum: Primary Care Clinic

Residents carry a primary care patient panel through all five years of the program at Parkland's Internal Medicine clinic site. While on internal medicine, residents spend five half-days every primary care ("plus one") week in clinic.

Those on psychiatry rotations are in clinic on Wednesday of their cohort's primary care week. They are excused from psychiatric clinical duties on these days. It is the resident's responsibility to communicate these excused absences with their supervisors and schedulers.

PGY2: Internal Medicine and Psychiatry Clinic

Starting PGY2, residents replace two half-days of their internal medicine primary care clinic with two half-days of a "Med Psych" primary care clinic held on Wednesday of primary care week. Resources should be reasonably spent to prioritize scheduling of those patients who benefit from primary medical and primary psychiatric care on this day so that appropriate psychiatric attending support can be present. 

PGY4: Transition to Outpatient Curriculum

In preparation for the transition to the twelve month block of weekly half-day Med Psych clinic, residents at the end of PGY3 may designate patients in their general primary care panel for reassignment to categorical internal medicine residents.

PGY5: Elective Longitudinal Clinics

After completing their twelve month outpatient block, PGY5 residents return to the primary care week model with two half-days of Med Psych primary care clinic on Wednesday and three half-days of general primary care clinic. Residents may elect to replace up to two half-days of general primary care clinic with elective longitudinal clinics in order to supplement their ambulatory internal medicine training.

These clinics can not be purely psychiatric in nature, need to be scheduled around existing programming (didactics, conference Med Psych clinic), must be arranged by the resident and are subject to chief resident approval.

Curriculum: Psychiatry Clinic

Residents spend one day a week during the twelve month outpatient block at the Parkland Outpatient Psychiatry Clinic ("POPC") caring for a large assigned panel of mediation management psychiatry patients. 

Curriculum: Psychotherapy

Residents may carry a panel of psychotherapy patients during the final three years of the program through the UTSW Resident Psychiatry clinic (patient application linked here). Sessions with patients and supervisors (ie individualized training with a senior psychotherapist) typically occur weekly.

The bulk of this training occurs during the twelve month outpatient block - this is the only point in training that residents have protected time dedicated to these activities. Scheduling therapy patients and check-ins with therapy supervisors outside of the outpatient block is restricted by residents other clinical duties, though arrangements may be made for brief absences at the discretion of their rotation supervisor.

PGY2: Motivational Interviewing

Residents receive a brief four-week training in motivational interviewing including didactics and observed motivational interviewing sessions with direct feedback while rotating on the Parkland Addiction service.

PGY3: Supportive Therapy

Residents will be assigned a therapy supervisor and 1-2 patients during the psychiatry portion of PGY3 and are strongly encouraged to begin sessions as early as possible while on psychiatry rotations to maximize these relatively accommodating rotations. Residents are encouraged but not required to continue regular patient and supervision sessions while on internal medicine rotations.

PGY4: Psychodynamic, CBT and Therapy Electives

During the twelve month outpatient block, residents will be assigned a psychodynamic therapy supervisor and a CBT supervisor and are expected to see four patients a week split evenly between both modalities. Residents are eligible and encouraged to participate in group therapy training and supervision as well as pursue additional psychotherapy training through use of their elective time.

PGY5

Psychotherapy training after completion of the outpatient block is optional; residents are strongly encouraged to continue training in a therapy modality of their choice for which a supervisor will be assigned through the psychiatry department. Residents are not limited to one supervisor or one modality. The PGY5 curriculum is built with the intent of accommodating therapy patient and supervisor sessions. Therapy patient panel maximums are at the discretion of the therapy supervisor.

Absences & Vacation

Vacation time is split proportionately each year between internal medicine and psychiatry rotations and scheduled as per the practice of each program - internal medicine vacation time is assigned before the academic year begins in one week (5 day) increments and psychiatry vacation time is taken on an ad hoc basis.

Scheduling vacation time while on psychiatry (colloquially referred to in that program as "PTO") is done following guidelines and restrictions described elsewhere by the psychiatry program, with three important differences:

1. Residents contact their program coordinator instead of the psychiatry program coordinator to confirm vacation day usage

2. A total of 5 days may be taken while on Parkland Addictions service

3. Vacation dates on psychiatry may not result in an absence from a scheduled medicine or Med-Psych continuity clinic

Paid absences beyond the twenty days of vacation time (i.e. sick days, STEP3, unexpected absences, extended bereavement) are managed under the same administrative rules for PTO and leave usage as internal medicine residents, outlined here. 

Backup

Residents participate in the backup systems for each of the categorical programs while on rotations associated with that program. 

Assignments to the EROC/Jeopardy pool are scheduled through the internal medicine residency program with a total of approximately 4 weeks EROC spread across the five year curriculum. PGY1 residents do not participate in EIOC.

Assignments to the psychiatry backup pool are scheduled through the psychiatry residency program at the level of their categorical PGY-equivalent class.

Chief Resident

The responsibilities executed by the chief resident (or chief residents) are essential to the success and well-being of the IMP program. Residents who are in their final year of training may fill the position of chief resident. The role itself and responsibilities thereof can be shared by and split between more than one resident. If no residents in their final year of training opt-in to the role, other PGY4 or PGY3 residents will be selected for the role by the program director. Residents who accept the position are eligible to receive a stipend as well as protected administrative time at the discretion of the program director.

The term of the chief resident runs from June 1 to May 31.

The chief resident is expected to be reasonably available seven days a week to address any resident-related questions or concerns. Responsibilities of the chief resident generally fall into the following three categories: administration, education and recruitment.

The below sections of listed responsibilities are representative but not exhaustive.

Inservice Exams

ITE

Internal medicine inservice exams are taken during PGY2 and PGY3. Residents on psychiatry rotations will be excused from clinical duties to take the ITE. Residents who score under 30th percentile will be required to take the exam again the following year regardless of PGY level.

PRITE

Psychiatry inservice exams are taken every year beginning PGY2 and are typically held during the afternoon of the first two Tuesdays in October. Residents on internal medicine rotations will be excused from clinical duties to take the PRITE.

Moonlighting

Information regarding moonlighting eligibility and opportunities for internal medicine is detailed here.

Opportunities to moonlight in psychiatry are permissible as outlined separately by the psychiatry department for those residents that have finished their PGY3 psychiatry rotations.

New Resident Onboarding

New residents complete all essential onboarding activities (EMR training, badging, parking, VA access) with the internal medicine residents and will also be scheduled to join select psychiatry onboarding activities. SAMA training is typically done with psychiatry residents during onboarding but can be delayed if necessary so long as it is completed before before residents begin their first psychiatry rotation.

The orientation schedule is created by the chief resident(s) in collaboration with leadership from the the categorical programs. 

Quality Improvement

Residents complete a year-long longitudinal quality improvement project during PGY4 as part of the psychiatry program's POPC conference curriculum.

Resident Benefits

In addition to those benefits provided via GME detailed in the 'Benefits' section of the internal medicine policy manual, residents of the internal medicine and psychiatry program receive the following:

Annual Education Fund $500 to use for anything related to resident education

Conference Travel Fund $250 towards travel & related expenditures for conferences where residents are presenting 

The Association of Medicine and Psychiatry – $100 towards Resident Fellow Annual Membership Fee

Internal medicine knowledge banks (NEJM Knowledge+ as PGY1, MKSAP beginning PGY2)

Internal medicine noon conference lunches regardless of current rotation

On call resident meal program 

Personalized white coats

Personalized scrubs

Resident Update Talk

Scheduled during internal medicine elective month, typically during PGY3.