Educational Purpose and Goals

The Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine (KP-COM) Psychiatry Residency Program's mission is to prepare physicians with the necessary knowledge, skills, and lifelong learning habits to be excellent psychiatrists serving Veterans and the broader community in ethnically diverse St. Petersburg, Clearwater, and Tampa Bay regions of Florida. The program's goal is to develop board certified psychiatrists who are competent working primarily in the public sector within the psychiatrically underserved in the region with a special focus on the Veterans Health Administration. This will be accomplished by primarily training residents within the Bay Pines VA Health Care System and via training in large outpatient and community-based clinics. Residents will train with patients and faculty who are reflective of the ethnically diverse St. Petersburg, Clearwater, and Tampa Bay region. The program's objectives are to have:

100% of residents pass their board certification exam within 7 years or less of program completion
50% of graduating residents are initially employed in a Veterans Health Administration system
50% of graduating residents are initially employed within the St. Petersburg/Clearwater/Tampa Bay region program faculty reflect the ethnic diversity of the community in which they serve.

Rotation Schedule:

PGY-1

Internal Medicine – 16 weeks
Inpatient Psychiatry – 20 weeks
Neurology – 8 weeks
Consultation Liaison Psychiatry – 8 weeks

PGY-2

Consultation Liaison Psychiatry – 4 weeks
Emergency Psychiatry – 8 weeks
Community Psychiatry – 4 weeks
Geriatric Psychiatry – 4 weeks
Addiction Psychiatry – 4 weeks
Child/Adolescent Psychiatry – 8 weeks
Inpatient Psychiatry – 16 weeks
Addiction Consultation Liaison Psychiatry – 4 weeks

PGY-3

Outpatient Psychiatry – 52 weeks

PGY-4

Inpatient Psychiatry – 24 weeks
Electives – 28 weeks

EXAMPLE BLOCK SCHEDULE

Required Psychiatric Rotations:

Inpatient Psychiatry: The resident will focus on care in the inpatient psychiatric setting with responsibility for the patient’s psychiatric and functional improvement, and for the diagnosis and management of acute psychiatric illness. The resident will evaluate and treat patients, including those with severe mental illness, who may require additional psychosocial services to live successfully in the community. The Bay Pines VAMC and Central Florida Behavioral Hospital (CFBH) are Baker Act (Florida involuntary commitment statute) receiving facilities. Lake Correctional Institution is a state prison for men who require treatment for severe and persistent mental illness, including refractory conditions, catatonia, comorbid substance use disorders, and tardive dyskinesia. Florida Women’s Reception Center houses the major psychiatric inpatient and residential psychiatric programs for women in the state of Florida, including capability for involuntary commitments and treatment.

Outpatient Psychiatry: The resident will focus on treating psychiatric conditions over the long term and learn to appreciate how psychosocial factors play a role in a patient’s functional recovery. Residents will learn to use pharmacological regimens in the outpatient settings of Bay Pines VAMC and Community Based Outpatient Clinics (CBOCs), including the concurrent use of medications and psychotherapy under supervision. The Mental Health Clinic provides veterans with state of the art psychiatric, psychological, and social work evaluation and treatment that focuses on a comprehensive continuum of care through an integrated approach between inpatient and outpatient services. It is a partnership between the veteran and his/her mental health specialist based on a Recovery of Care plan that involves the veteran’s identifying personal treatment and recovery goals.

Consultation-Liaison Psychiatry: The residents will practice becoming effective psychiatric consultants to other healthcare providers to maximize patient quality of care in the healthcare system. The resident will learn about the interplay between medical and psychiatric illnesses and how incorporating aggressive targeted approaches will improve long- term outcomes.

Child and Adolescent Psychiatry: The resident will focus on treating psychiatric conditions in children and adolescents in both inpatient and outpatient settings at CFBH. Residents will have clinical experiences with a community patient population with psychiatric and substance use disorders in a for profit clinical system, complementing their training in VA and correctional settings. Residents will be exposed to unique age-appropriate techniques as they relate to psychotherapy and psychopharmacology. More globally, residents will gain a greater appreciation for how psychosocial and developmental factors play a role in a patient’s distress and recovery.

Geriatric Psychiatry: Under the supervision of a geriatric psychiatrist and geriatric psychologists, the resident will evaluate and treat older adults at the Bay Pines VAMC Community Living Center (nursing home level care) and participate as members of a Home-Based Primary Care team that serves patients in their homes. By evaluating and treating older adults, the resident will gain an appreciation for special medical needs in this population resulting from changing metabolism, increasing medical comorbidities, neurodegenerative disorders, medicine interactions, and unique psychosocial issues (e.g., retirement, bereavement, isolation, dementia).

Community Psychiatry: Residents will participate in the evaluation and treatment of Veterans with severe mental illnesses, caring for them in a VA interdisciplinary assertive community treatment team. Residents will also have experiences in a VA psychosocial rehabilitation and recovery program along with peer support specialists and vocational rehabilitation programs. Residents will gain a greater understanding for the cost of and disparities in mental health treatment, available community resources, and how such challenges can contribute to patient frustration, well-being, and ultimately recovery. Additionally, residents are expected to participate collaboratively with community mental health advocacy organizations such as NAMI and the Mental Health Association.

Emergency Psychiatry: The resident will work in partnership with other mental health providers in the evaluation and treatment of individuals with psychiatric concerns presenting to the Emergency Department and mental health Triage Clinics of the Bay Pines VAMC. Once cleared medically, patients will present for evaluation by the resident (with supervision provided by an attending). The resident will work to ensure the safety of all involved, obtain as complete an evaluation as possible, and formulate a treatment plan that may include discharge, admission to the inpatient unit, referral to community resources and/or continued observation in the Emergency Department area. Residents will become comfortable with treating psychiatric emergencies, including but not limited to catatonia, aggression/agitation, self-injury, serotonin syndrome, and neuroleptic malignant syndrome.

Addiction Psychiatry: The resident will work with faculty, including a board-certified addiction psychiatrist and an internist, who is board certified in additions medicine, to evaluate and treat individuals with substance use disorders. Residents will receive extensive training in and experience with detoxification, intervention, long-term management options, and therapeutic techniques at the comprehensive Bay Pines VA Substance Use Disorder Program. They will learn about substance use disorder clinics, intensive outpatient programs, residential programs, and inpatient units. They will participate in a substance use disorder intensive outpatient program and lead psychoeducational groups. They will also train in the Medication Assisted Treatment Clinic and learn evidence-based psychotherapeutic and psychopharmacological therapies for managing a variety of addictions, including but not limited to, alcohol and opiates. The resident will complete the Drug Enforcement Administration X waiver training that is required to prescribe buprenorphine and then provide medication assisted treatment in a VA substance use disorder clinic.

Elective Rotations:

Forensic Psychiatry: The resident will be supervised by a Board-Certified Forensic Psychiatrist in a variety of settings. The resident will gain experience by providing Forensic consultation to the inpatient psychiatric unit, evaluating individuals in the outpatient setting for civil and criminal matters and by participating in mock trials, involuntary commitment hearings and shadowing the attending during any testimony/courtroom appearances. Lastly, the resident will be encouraged to participate in local, national, and global professional organizations and research contemporary policy relevant to the practice of psychiatry.

Neuro-modulation (Elective): The resident will manage patients who are receiving neuromodulation for psychiatric illness. The resident will be given opportunities to practice procedures in the field of psychiatry and will be educated about the efficacy of different forms of neuromodulation including electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), and deep brain stimulation (DBS).

Research (Elective): Participation in scholarly activities is strongly supported. Residents are strongly encouraged to spend at least one designated month in scientific inquiry. Residents will work closely with a research mentor in various stages of project design, implementation, data collection, analysis and preparations for publication and/or presentation. Residents will submit regular updates to the Program Director, regarding project progress. The expectation is that residents will have a publishable and/or presentable product by rotation and/or year end, to be determined prior to the Research Elective month.

Telemedicine/Telepsychiatry (Elective): With appropriate supervision, residents will provide psychiatric care via a telecom/video platform. The patients treated will be veterans at remote/satellite offices around the state of Florida. Residents will gain an appreciation for this method of care delivery. Residents will be encouraged to explore the relationship between the format of care (i.e. telepsychiatry versus in-person) on patient adherence, patient disclosure, the therapeutic relationship and aspects of patient outcome.

Junior Attending (Inpatient Setting, Elective): This rotation will occur on the inpatient unit. The senior resident will function as the unit attending, with supervision available. In acting as the unit attending, the resident will lead a multidisciplinary team in the evaluation and treatment of adult patients with a variety of presentations and mental disorders. The resident will be exposed to the clinical and administrative aspects of inpatient psychiatry. Residents will gain sufficient experience to practice independently in similar settings.

Administrative Psychiatry/Chief Resident: One or two appointed senior residents will serve as Chief Residents; if two Chief Residents, each will serve for a 6-month period. In this role, the Chief Resident will participate in the planning and scheduling of PGY4 lectures, take a leadership role in resident affairs, cover any clinical needs in the event of an emergency, and be a vital member of the chain of command for addressing any resident specific issues. The Chief Resident will work closely with the Program Director. This designated month will occur at the start of any such leadership appointment to allow for adequate planning and preparation for the remainder of the year. In addition to the duties listed above, the Chief Resident will be invited to shadow Attendings in leadership roles. In doing so, residents will gain an appreciation for the infrastructure of psychiatric care delivery