The Oroville Hospital Residency clinical experiences will include:
- Major responsibility for caring for sufficient patients to demonstrate competence with acute and chronic psychiatric illnesses.
- Patient care assignments that permit appropriate treatment and that grant sufficient time for other aspects of their educational program.
- Structured clinical experiences that are organized to provide opportunities to conduct initial evaluations, participate in the subsequent diagnostic process, and follow patients during the treatment phase and/or evolution of their psychiatric disorders/conditions.
Duration and content of the experiences residents will have in the following areas:
Neurology: The residents will spend two months in their first year of training learning about Neurology at Oroville Hospital. They will provide quality care to patients with neurological diseases as a neurology consultation service. They will know how to diagnose and treat patients with neurologic disorders and understand the risks and management of these conditions. They will also attend bedside clinical teaching, didactic teaching, and grand rounds during the neurology rotation. They will receive daily supervision and at least one hour of individual supervision per week. They will also have the opportunity to consult on neurological questions from the psychiatric inpatient services; they will learn the connection between neurology and psychiatry.
Inpatient Psychiatry: As part of the Psychiatry Residency Program, residents must complete Inpatient Psychiatry rotations at Oroville Hospital in their first and second year of training. These rotations aim to provide residents with the knowledge, skills, and attitudes necessary for the optimal clinical care of patients with mental disorders who are admitted to the Inpatient Psychiatric Unit. The residents will work closely with psychiatry faculty, supervising them daily for at least two hours during rounds and providing them with at least one hour of individual supervision per week. The residents will also collaborate with other staff members, such as social workers, case managers, and nurses, who are part of the treatment team. The residents will be responsible for assessing, diagnosing, and treating general psychiatric patients, using evidence-based practices and following the standards of care. The residents will also attend didactic sessions for three hours per week and complete assigned readings and lectures. The residents will rotate among different teams for approximately one month each, which will expose them to a diverse clinical population with a wide range of psychopathology, including mood disorders, psychotic disorders, anxiety disorders, substance use disorders, and suicidal or homicidal ideation. The residents will have a maximum of six patients in their caseload in PGY-1 and eight in PGY-2, and their caseloads will be carefully monitored.
Outpatient Psychiatry: The Child and Adolescent Psychiatry rotation is a two-month experience for residents in their second year of training. The rotation helps residents learn to treat common psychiatric illnesses in children and adolescents and to identify more serious conditions that need specialty care. Residents are expected to become confident working with younger patients by the end of the rotation. Child-adolescent boarded psychiatry faculty provide daily supervision and at least one hour of individual supervision per week. Residents treat various Child and Adolescent Psychiatry disorders, such as anxiety disorders, mood disorders, obsessive-compulsive disorder, disruptive behavioral disorders (e.g. ADHD), schizophrenia, and other conditions. The caseload per resident is limited to six per day due to the increased complexity of this patient population. Case assignments for new evaluations are adjusted to ensure the resident has comprehensive exposure to the diverse clinical population we serve.
Geriatric Psychiatry: The Geriatric Psychiatry rotation is a one-month experience for residents in their second year of training. The rotation helps residents learn to evaluate, diagnose, and manage psychiatric illnesses and disorders in geriatric patients. The treatment team includes faculty psychiatrists, social workers, nurses, and case managers. Residents receive daily supervision from faculty and at least one hour of individual supervision per week. A particular emphasis is placed on managing geriatric patients and their medical comorbidities. Residents have a maximum caseload of eight patients per day. They conduct thorough diagnostic evaluations, including medical and pharmacological factors affecting mental status. They provide treatment that includes pharmacotherapy (with attention to drug interactions and side effects in geriatrics), supportive psychotherapy, and family interventions.
Addiction Psychiatry: The Addiction Psychiatry rotation is a one-month experience for residents in their second year of training. The rotation helps residents learn to evaluate and manage patients with substance abuse and dependence disorders, including those with co-occurring psychiatric disorders. Residents will practice various treatment modalities, such as detoxification, overdose management, and maintenance of pharmacotherapy; use of psychological and social interventions to address the impact of addiction, such as confrontation and intervention in chronic addiction rehabilitation across different stages of recovery; and self-help groups.
Residents will encounter patients with problems related to alcohol, methamphetamine, and opioids. The faculty includes a board-certified psychiatrist and a board-certified addiction medicine physician. Residents will be involved in all aspects of treatment and will attend group therapies with their patients to gain first-hand experience of this treatment modality. Residents will receive daily supervision from faculty and at least one hour of individual supervision per week.
Consultation/Liaison: The Consultation/Liaison Psychiatry rotation is a two-month experience for residents in their second year of training. The rotation helps residents learn to provide psychiatric consultation services for patients on various medical and surgical services. Residents will practice how to evaluate and treat psychiatric problems that are related to general medical conditions, such as suicidal patients, hysterical patients, and patients with other psychiatric illnesses. The consultation faculty assigns new consults to residents, who see them and follow up on them as needed. Residents then discuss the cases with the attending psychiatrist. Residents write a new consult note for each patient and a follow-up note for each subsequent visit. The treatment team includes psychiatry faculty, residents, and social services. Residents receive bedside teaching during rounds. Each consult is reviewed with a psychiatric faculty member who supervises interview techniques, diagnostic formulations, and treatment care. A particular emphasis is placed on the psychiatrist’s role in a medical setting. Consultations are requested for psychiatric difficulties that medically ill patients have, with or without pre-existing psychiatric conditions. The caseloads are manageable, with three new talks and eight patients per resident daily. Residents receive daily supervision from the attending psychiatrist and at least one hour of individual supervision per week.
Forensic Psychiatry: The Forensic Psychiatry rotation is a one-month experience for residents in their second year of training. The rotation helps residents learn to evaluate patients for their risk of self-harm and/or harm to others, their ability to make decisions about their care and treatment, their competency, disability, and civil commitment. Residents will prepare documentation for the court, such as capacity evaluations for civil responsibility and/or involuntary treatment. The supervision team includes faculty psychiatrists, social services, case management, and nursing. Residents receive daily supervision from the group and at least one hour of individual supervision per week.
Emergency Psychiatry: The Emergency Psychiatry rotation is a one-month experience for residents in their first year of training and another one-month experience for residents in their second year. The rotation helps residents learn to provide and manage the continuum of care for patients who need emergency psychiatric care. This includes diagnosing, treating, and managing acute psychiatric illness. Patients include those with substance abuse problems, psychoses, adolescent mental disorders, psychiatric trauma, crises, and those who are a danger to themselves and others. These patients may visit the clinic or the emergency department with urgent psychiatric issues. Residents receive daily supervision from faculty psychiatrists and at least one hour of individual supervision per week. A particular emphasis is placed on psychiatric evaluation and crisis management.
Community Psychiatry: The Community Psychiatry rotation is a continuous experience for residents in their third year of training as part of the outpatient psychiatry experience. The rotation helps residents learn about the history and theory of community psychiatry, how culture and ethnicity affect the presentation and course of mental illness, and what treatment resources are available for patients in the local community, especially those with severe mental conditions. Residents will also practice how to use community resources and services appropriately in planning patient care and how to consult and collaborate with case managers, crisis teams, and other mental health professionals. The faculty includes board-certified psychiatrists who provide at least one hour of supervision for every half day of the resident clinic and at least one hour of individual supervision per week.
Curriculum Key Pointers
The electives have written curricula with goals, objectives, and learning experiences that lead to specified learning outcomes.
There will be a program that provides at least two hours of faculty preceptorship per week: During each rotation, residents will have at least two hours of faculty preceptorship with their assigned attending and/or the Program Director. These meetings can include one-on-one sessions between residents and faculty for at least an hour. The topics of the discussions can cover current cases, treatment plans, etc.
Residents are projected to have an average of 65 hours of assigned clinical work and education per week.
For questions regarding the Oroville Hospital Psychiatric Residency Program, contact 530-532-8013 or ohgme@orohosp.com.