The core curriculum of our residency program is rich, varied and innovative. Some seminars and opportunities are available to the entire residency group while others are designed specifically for the different levels of training. The core curriculum includes: didactic seminars, departmental Grand Rounds and Visiting Guest Lecturer series, specialty rounds (Professors Rounds, Departmental Case Conferences, Child Psychiatry Grand Rounds, Neurobehavioral Rounds, and Mood Disorders Rounds), journal clubs, Psychiatry Boards preparation, and special seminars (Hypnosis and Literature of Madness).

The Graduate Education Committed (GEC) provide regular feedback regarding the curriculum. In addition, there is an Associate Residency Training Director assigned to each residency year to ensure that all aspects of the curriculum are superior and running smoothly.

Didactic Seminars

PGY1
First year residents receive a "Crash Course" in psychiatry that covers essential information they will need to know in order to capably treat patients in the emergency rooms and wards. Thursday mornings are the "protected" seminars time. The morning begins with a 1-hour seminar on Adult Psychopathology and another 1-hour seminar on Interviewing, Communication Skills and Supportive Psychotherapy. These are followed by the Departmental Grand Rounds.

PGY2
Second year residents continue to attend the Thursday morning seminar series which expands on topics that were first presented in the PG1 year. Additional topics include: therapeutic interventions, geriatric psychiatry, consultation/liaison, child development and psychopathology, behavioral neurology, cross-cultural psychiatry, marital and family therapy, reading the literature and teaching skills. In addition there are 2 weekly seminars on psychotherapy: one on Cognitive-Behavioral Therapy and another on the "Foundation of Psychotherapy".

PGY3
Third year residents attend seminars, conferences, or rounds five mornings a week. This comprehensive and sophisticated series includes: in depth exposure to all contemporary forms of psychotherapy (supportive, group milieu, hypnotherapy, insight-oriented, marital and family, short-term dynamic, cognitive and integrative psychotherapy), outpatient psychopharmacology, Axis II disorders, ethics, forensic psychiatry, board preparation, cross-cultural/diversity issues, and human sexuality.

PGY4
Fourth year residents attend advanced level seminars on Thursday mornings in transition to private practice, history of psychiatry, neurology review and an advanced workshop on short-term dynamic psychotherapy. Senior residents are also invited to participate with departmental fellows in the advancedpsychopharmacology seminar. Each year, senior residents help develop their own modification and additions to their senior seminars based on the recognized needs and unique interests of each class.

GRAND ROUNDS AND VISITING GUEST LECTURERS
Grand Rounds is a department-wide educational activity. Directed by the chairman of the department and the residency training director, Grand Rounds includes clinical presentations by the residents as well as clinical and research presentations by faculty and visiting academic clinicians. Topics range from molecular biological approaches for psychiatric disorders to the public policy implications of international psychiatry. Grand Rounds is an exciting and stimulating teaching experience for all concerned.

SPECIALTY ROUNDS
A wide assortment of specialty rounds are available to the residents. PGY1 and 2 residents have the opportunity to present challenging cases to the chairman or other senior faculty in the forum of Professors Rounds. Clinical Case Conferences are hosted at each of the major sites of the program.

Residents are given preparation for the oral portion of the Boards through a series of mock board examinations in each year of the program. Both "live-patient" interviews and videotapes are used to fully simulate the experience of the actual Boards exams. Feedback on performance is given to the resident using the same format that is used by Board examiners. In the third year of training (PGY3), resident receive a board review course for the oral examinations (Board Part 2). In the fourth year of training, residents receive a board review course for the written examination (Boards Part 1).

PSYCHOTHERAPY TRAINING
In depth training in psychotherapy begins in the PG1 year and builds throughout the 4 years of training at UCSD. During the first year, Interns are taught basic principles of interviewing, communication and supportive psychotherapy in a weekly seminar that runs through the entire year.

During the second year, residents are assigned at least two long-term psychotherapy patients and provide on-going supportive psychotherapy in their psychiatry primary care clinics. They also act as co-therapists in group and family meetings on various inpatient rotations. In addition, residents attend 2 psychiatry seminars each week: Cognitive & Behavioral Psychotherapy and Foundation of Psychotherapy. Each resident is provided regular supervision with seasoned psychotherapists from our clinical faculty. Finally, all residents participate in an experiential process group.

The third year is a full-time, entirely outpatient year. An advance seminar in Insight Oriented Psychotherapy as well as seminars on other psychotherapy modalities compliment intensive supervision to provide residents with state-of-the-art didactics. Residents treat patients in individual and group psychotherapy, and also participate in treatment of several patients as part of multidisciplinary teams.

In the fourth year of training, residents are encouraged to continue psychotherapy with at least 4-6 patients from previous year, but many residents elect to devote considerably more effort to psychotherapy. Residents receive supervision from senior psychotherapy faculty and attend an advanced workshop on Intensive Short-Term Dynamic Psychotherapy as well as a Continuous Case Conference (if the senior class chooses to have one on any given year) and/or a History of Psychotherapy Colloquim.

In addition to the core activities, interested residents can take advantage of several psychotherapy enrichment activities. These include attending symposiums and conference in and out of San Diego, a number of special interest groups led by senior clinical faculty (e.g., psychoanalysis, cognitive behavioral therapy, short-term - dynamic psychotherapy), an advanced psychodynamic psychotherapy elective taught by the San Diego Psychoanalytic Association, and no-cost individual psychotherapy available to all residents.

By the end of training, all residents should be competent in the following 5 psychotherapies: supportive, dynamic, cognitive behavioral, short-term and integrative.

Summary of Psychotherapy Training

EXPERIENCES

DIDACTICS

Other opportunities currently available to all:

Additional psychotherapy patients and supervision

Occasional Grand Rounds, Journal Clubs, Literature of Madness, Special Lectures, Workshops and Symposia dedicated to psychotherapy

No Cost Psychotherapy "elective" for up to 12 months

Specialty Interest Groups:

Dynamic Psychiatry - Hassler
Cognitive Behavioral Psychotherapy - Fidaleo
Short-Term Dynamic Psychotherapy - Neborsky

Independent Study Projects on Psychotherapy

Advanced Psychotherapy Elective through the San Diego Psychoanalytic Institute

PSYCHIATRY PRIMARY CARE CONTINUITY CLINICS
To reinforce residents' medical skills and identities as physicians, all PGY2 residents maintain a psychiatry primary care continuity clinic, which is supervised jointly by psychiatry and internal medicine faculty. Patients are seen for both psychiatric and general medial needs and may be followed through the PGY3 and PGY4 rotations as well.

SUPERVISION
Supervision is a crucial part of our residency training. Our department includes over 100 full time, and 300 clinical/volunteer, faculty. Each resident has a minimum of three hours of assigned supervision per week. Usually this consists of one administrative supervisor, typically the attending on the service where the resident is based, and two clinical supervisors. Supervisory assignments are rotated, at six-month intervals, giving each resident exposure to as many faculty members as possible. Opportunities exist, however, for longer term, continuous supervision upon request.

We insist that part of the resident's supervisory experience include direct patient contact between the supervisor and patient with the resident observing, or between the patient and resident with the supervisor observing. Therefore, faculty-patient interviews and resident-patient interviews are integrated into all of the clinical experiences.

The supervisory experience for residents also includes their role as supervisor to third and fourth year UCSD medical students who rotate through the various services. In addition, one of the key components of the PG4 year is teaching and supervising PGY1 and 2 residents.

INDEPENDENT STUDY
The purpose of Senior Research Project is to develop critical thinking skills and provide a basis for continued learning and scholarly pursuit which will last throughout the trainee's career. This project represents an opportunity for residents to work closely with UCSD faculty who conduct leading research programs in every major area of psychiatry. Projects vary from scholarly case reports and literature reviews to original research.

NIGHT AND WEEKEND CALL
Residents cover the inpatient services at both hospitals. This includes responsibility for psychiatric consultation in the emergency room, consultation for all inpatients, and primary care for all psychiatric inpatients. Needless to say, this varied population provides a full spectrum of psychopathology that requires multiple psychopharmacologic and psychotherapeutic interventions. Given this exposure, residents become adept at handling virtually any psychiatric emergency.

While on call, residents can receive supervision by calling either their faculty back-up or the senior resident back-up. In addition, sign in rounds occur each morning Monday through Friday. These rounds are designed to review the on call experience and provide teaching, supervision and feedback to the resident.

The call schedule is compiled by residents. PGY1&2 residents take call about once a week; PGY3 residents take call approximately monthly, PGY4 residents take no in-house call, but provide phone supervision to the junior residents. From time to time, opportunities to take extra call for additional pay exist.

EXPOSURE TO FELLOWSHIP PROGRAMS
Please see Fellowship Programs for more information on each of the listed titles. Fellowship programs in the department include:

• Alcohol Research Program
• Consultation-Liaison Psychiatry
• HIV Neurobehavioral Research
• Geriatric Psychiatry
• Child and Adolescent Psychiatry
• Psychopharmacology and Psychobiology

Residents are invited to attend many of the seminars and rounds, which are an integral part of these fellowship programs. Additionally, there is interaction between fellows and residents during departmental functions and clinical experiences.