DEPARTMENT OF PSYCHIATRY, UTSOUTHWESTERN MEDICAL CENTER

Goals, Objectives and Criteria for Promotion in the General Residency Training Program

The Education Committee meets regularly to review the progress of residents, usually in the spring of each year.  In order to be considered for promotion, each resident is responsible for fulfilling the Goals and Objectives and Criteria for his/her training level as outlined below.  The ultimate decision for promotion and graduation is made by the Education Committee evaluating the resident’s overall performance and progress:

PGY 1

I. Patient Care

A.  Satisfactory overall rating on clinical evaluations from supervisors on each rotation, most especially primary care and neurology

B.  Maintenance of an accurate log of all psychiatric patients seen in treatment

C.  Achievement of at least a “beginner” ability to gather information, perform a mental status examination, develop a differential diagnosis, and form a treatment plan as judged on the Structured Clinical Assessment and supervisory evaluations.

II. Medical Knowledge

A.  At least 70% per year attendance at all required seminars and didactics, including Grand Rounds.

B.  Passing USMLE Step 3 by the end of the year

C.  Achievement of a minimum baseline standardized score on PRITE of no less than 2 standard deviations below the national mean.

D.  Demonstrates an awareness of when supervisory assistance is needed

III. Communication Skills

A.  Legible, relevant, and timely maintenance of all medical records

B.  Establishment of at least a “Beginner” level of interviewing skills as judged on the Structured Clinical Assessment.

C.  Demonstrates empathy for the experience of psychiatric illness, the role of caretaker for individuals with psychiatric illness, and beginner level of empathy for the inner life of patients

IV. Systems Based Practice

A.  Satisfactory demonstration of ability to work with a treatment team, mobilize community resources and get done what needs to be done for patients as evaluated on the Geriatric Psychiatry, Emergency Psychiatry, and Community Psychiatry rotations.

B.  Demonstrates awareness of cost-containment strategies as implemented on assigned services.

V.  Professionalism

A.  Demonstrates integrity, responsibility and respect for patients, families and fellow professionals as judged by peers and supervisors.

B.  Has earned the trust and respect of his/her peers

C.  Is reliable in executing responsibilities

D.  Is collegial and collaborative in clinical and learning relationships

VI. Practice Based Learning

A.  Demonstrates awareness of multiple sources of external information and how to access them in the service of patient care.

B.  Integrates clinical experience with empirical and scholarly literature

PGY 2

I. Patient Care

A.  Satisfactory overall evaluations from all rotations

B.  Maintenance of achievement for all objectives in the PGY1 year

C.  Successful achievement of independent licensure by Dec. 31 of the PGY 2

D.  Maintenance of an accurate log of all psychiatric patients seen in treatment

E.  Satisfactory overall ratings by psychotherapy supervisors

F.  Achievement, by year’s end, of at least an “advanced beginner” evaluation on Structured Clinical Assessment in the areas of information gathering, differential diagnosis and treatment planning

II. Medical Knowledge

A.  Maintenance of achievement for all objectives in the PGY1 year

B.  Improvement on Global Psychiatry PRITE standardized score over PGY 1 level, or, if new PGY 2, achieves an adequate baseline score

C.  Adequate baseline score on Columbia Psychotherapy Skills Test

D.  Demonstrates the ability to diagnose credibly DSM major mental disorders

E.  Attendance and participation in at least 70% per year of required didactics and teaching conferences, including Grand Rounds.

F.  Can construct a preliminary biopsychosocial treatment plan

III. Communication Skills

A.  Maintenance of achievement for all objectives in the PGY1 year

B.  Adequate maintenance of all medical records

C.  Achievement of at least “beginner” level on interviewing skills on Structured Clinical Assessment

IV. Systems Based Practice

A.  Maintenance of achievement for all objectives in the PGY1 year

B.  Satisfactory demonstration of ability to work with a treatment team, lead a treatment team, mobilize community resources and get done what needs to be done for patients as evaluated by supervisors and peers, especially in Addictions, inpatient psychiatry and Child Psychiatry

C.  Exhibits the “beginner” level of competence in working with/interviewing patients’ families

V. Professionalism

A.  Maintenance of achievement for all objectives in the PGY1 year

B.  Understands and respects the boundaries between professional relationships and personal relationships

C.  Maintains firm sense of medical responsibility

D.  Demonstrates familiarity with standards of professional/moral conduct in psychiatry

E.  Has achieved at least the “beginner” level in ability to recognize ethical issues in practice

VI. Practice Based Learning

A.  Maintenance of achievement for all objectives in the PGY1 year

B.  Makes extensive use of outside information resources

C.  Contributes to learning situations

VII. Psychodynamic Psychotherapy

A.  Adequate baseline score on Columbia Psychotherapy Skills Test

B.  Initiates supervised psychotherapy with at least two outpatients, one by September 1, the second by January 31.  Maintain at least two ongoing cases from then on.

VIII. Supportive Psychotherapy

A.  Achieves “Beginner” level of provision of non-specific factors in psychotherapy:  Empathy, Non-contingent positive regard, and therapist genuineness/authenticity

PGY 3

I. Patient Care

A.   Maintenance of achievement for all objectives in prior years

B.   Satisfactory overall evaluations from all rotations

C.   Maintenance of an accurate log of all psychiatric patients seen in treatment

D.   Satisfactory overall ratings by psychotherapy supervisors

E.   Achievement, by year’s end, of at least a “competent” evaluation on Structured Clinical Assessment in the areas of information gathering, differential diagnosis and treatment planning or passing level on Mock Orals in Patient Presentation, Differential Diagnosis and Treatment.

II. Medical Knowledge

A.   Maintenance of achievement for all objectives in prior years

B.   Improvement on Global Psychiatry PRITE standardized score over prior level

C.   Improvement on Columbia Psychotherapy Skills Test over prior level

D.   Attendance and participation in at least 70% per year of required didactics and teaching conferences, including Grand Rounds.

III. Communication Skills

A.   Maintenance of achievement for all objectives in prior years

B.   Adequate maintenance of all medical records

C.  Achievement of at least “Advanced Beginner” status on interviewing skills on Structured Clinical Assessment

IV. Systems Based Practice

A.  Maintenance of achievement for all objectives in prior years

B.  Satisfactory demonstration of ability to work with a treatment team, lead a treatment team, mobilize community resources and get done what needs to be done for patients as evaluated by supervisors and peers in an outpatient setting.

C.   Exhibits the “advanced beginner” level of competence in working with/interviewing patients’ families

V. Professionalism

A.   Maintenance of achievement for all objectives in prior years

B.   Commands respect of peers and senior colleagues (attendings)

C.   Has achieved at least the “advanced beginner” level in ability to recognize ethical issues in practice

D.  Maintains unwavering sense of medical responsibility

VI. Practice Based Improvement

A.   Maintenance of achievement for all objectives in prior years

B.   Has achieved at least the “advanced beginner” level in evaluating medical/scientific information quality

C.   Routinely educates others on clinical and professional matters

VII. Brief Psychotherapy

A.   Initiates at least one case of brief dynamic psychotherapy or Interpersonal Psychotherapy

VIII. Cognitive Behavioral Therapy

A.   Successfully completes 60 hours of supervised CBT

IX. Combined Psychotherapy/Psychopharmacology

A.   Demonstrates effective treatment collaboration with other mental health professionals

B.   Demonstrates ability to treat patients with both psychotherapeutic techniques and pharmacological techniques

C.   Demonstrates a “beginner” level understanding of how somatic treatment plays into psychotherapeutic treatment and vice versa.

X. Psychodynamic Psychotherapy

A.   Maintenance of achievement for all objectives in prior years

B.   Improved scores on Columbia Psychotherapy Skills Test

C.   Is able to maintain a therapeutic alliance with at least one patient for over one year

D.   Is able to facilitate self-exploration and set an appropriate frame for a patient

XI. Supportive Psychotherapy

A.   Maintenance of achievement for all objectives in prior years

B.   Demonstrates ability to provide competent-level supportive management

C.   Is able to discuss specific supportive techniques; begins developing a more sophisticated concept of support (beyond empathy, encouragement and advice)

PGY IV

I. Patient Care

A.     Maintenance of achievement for all objectives in prior years Satisfactory overall evaluations from all rotations

B.     Provides competent care to all patients

C.    Maintenance of a log of all patients seen in treatment

D.    Satisfactory overall ratings by psychotherapy supervisors

E.  Achievement, by year’s end, of at least a “proficient” evaluation on Structured Clinical Assessment in the areas of information gathering, differential diagnosis and treatment planning or passing level on Mock Orals in Patient Presentation, Differential Diagnosis and Treatment.

II. Medical Knowledge

A.   Maintenance of achievement for all objectives in prior years

B.   Improvement on Global Psychiatry PRITE standardized score over PGY 3 level.

C.   Is a clinical educator as well as clinical practitioner. 

D.   Improvement on Columbia Psychotherapy Skills Test over the PGY 3

E.   Attendance and participation in at least 70% per year of required didactics and teaching conferences, including Grand Rounds.

F.    Exhibits the “competent” level in describing the standard of care for most patients.

III. Communication Skills

A.  Maintenance of achievement for all objectives in prior years

B.  Adequate maintenance of all medical records

C.  Achievement of at least “Competent” status on interviewing skills on Structured Clinical Assessment

D.  Exhibits leadership skills in clinical activities

IV. Systems Based Practice

A.  Maintenance of achievement for all objectives in prior years

B.  Satisfactory demonstration of ability to work with medical and surgical treatment teams, lead a consultation/liaison team, mobilize community resources and get done what needs to be done for patients as evaluated by supervisors and peers.

C.  Exhibits the “competent” level in working with/interviewing  patients’ families

V. Professionalism

A.  Maintenance of achievement for all objectives in prior years

B.  Commands respect of peers, more senior colleagues and colleagues in other specialties

C.  Demonstrates the ability to discern ethical issues outside that addressed by the community’s ethical standard of care

D.  Has achieved at least the “competent” level in ability to recognize ethical issues in practice

E.  Maintains unwavering sense of medical responsibility

F.  Regularly raises ethical issues in patient care along with other clinical considerations

VI. Practice Based Improvement

A.  Maintenance of achievement for all objectives in prior years

B.  Demonstrates ability to become expert in a question raised by a clinical situation via utilization of outside information resources

C.  Has achieved at least the “competent” level in evaluating medical/scientific information quality

D.  Is a resource to colleagues in area(s) of particular expertise

VII. Brief Psychotherapy

A.  Maintenance of achievement for all objectives in prior years

B.  Demonstrates knowledge of how to establish and maintain a therapeutic focus and adhere to and use a termination date to complete brief psychotherapy, or demonstrates competence in IPT.

VIII. Cognitive Behavior Therapy

A.  Maintenance of achievement for all objectives in prior years

B.  Successfully achieves an acceptable level of competence in CBT as judged by videotape review of a session by certified CBT therapists.

IX. Combined Psychotherapy/Psychopharmacology

A.  Maintenance of achievement for all objectives in prior years Demonstrates effective treatment collaboration with other mental health professionals

B.  Demonstrates ability to treat competently patients with both psychotherapeutic techniques and pharmacological techniques

C.  Demonstrates a “competent” level understanding of how somatic treatment plays into psychotherapeutic treatment and vice versa

X. Psychodynamic Psychotherapy

A.  Maintenance of achievement for all objectives in prior years

B.  Achieves a minimally acceptable score on the Columbia Psychotherapy Skills Test

C.  Maintains an exploratory helping alliance with a patient for more than 18 months

XI. Supportive Psychotherapy

A.  Maintenance of achievement for all objectives in prior years

B.  Demonstrates sophisticated understanding of the nature of support and supportive psychotherapy.