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Department of Psychiatry

Residency Program Description

Introduction

The Psychiatry Residency Training Program at Texas Tech Regional Academic Health Sciences Center conforms to the traditional rotational model. All aspects of training, both clinical and didactic, are presented within the context of relevant and concrete goals subsuming specific tasks. For each period the achievement of a series of interconnecting goals of increasing complexity and difficulty is demanded of the resident. Such tasks and concrete goals serve to improve training, clinical service, and communication. The practice of evidence based medicine serves as a goal throughout the resident's entire training experience. The program goals and objectives are structured around the General Competencies outlined by the Accreditation Council for Graduate Medical Education (ACGME).

This is a four-year program in which half of the first year is devoted to medicine and neurology. Residents interested in child Psychiatry may choose Pediatrics. With approval of the Department Residency Committee, Family Medicine may be substituted in the first year curriculum. The remaining three to three and a half years will be spent studying in the field of Psychiatry.

Transcultural Aspects of the Program.

Texas Tech in El Paso is situated on the border of Mexico. El Paso has a unique blend of heterogeneous Spanish surnamed populations. The Mexican and the Mexican-American group comprises over seventy percent of the population. Within this population there are many degrees of acculturation, which vary on the one hand from families who have lived in El Paso for many generations and have English as their predominant language and Anglo-American values, to families who are recent arrivals in the United States and have Spanish as their only language with Mexican values, customs, and beliefs. There are other Hispanic groups as well as the Spanish-surnamed Tigua Native Americans who are indigenous to the area. The rest of the population is primarily of "Anglo-American" origin.

The Department of Psychiatry deals with these factors on a daily basis and the transcultural aspects and issues of the area are virtually built into the very fabric of the teaching program. The exposure the resident receives in transcultural Psychiatry is thus not that of an isolated program assigned out of a special division. The program has strengths that give the resident full capability to deal with patients in any part of the United States; i.e., it is basically traditionally structured and follows ACMGE, American Board of Psychiatry and other conventional guidelines. However, in addition to these traditional approaches to teaching (i.e., "state of the art" Psychiatry in North America), the Hispanic influence occurs in all populations seen by the resident in all settings in which the resident rotates. There is full exposure to the Mexican-American and Anglo-American populations that are seen in the Southwest and other parts of the United States.

Description of the Training Experience

The Psychiatric Residency Program is structured to meet the resident physician's need for post-graduate education by creating experiences that provide the resident with the ability to serve the community with quality care. The program trains residents in the basic elements of psychiatric theory and technique, as well as to develop into emotionally mature and intellectually inquiring practitioners. Close mentor/resident relationships benefit the physician trainee through a diversity of faculty role models and an integrated professional milieu.

The curriculum is oriented toward teaching both efficient and effective delivery of psychiatric services. The major philosophy of the program is eclectic. There is an emphasis on neurobiological aspects of Psychiatry in a synthesis with a psychodynamic understanding of human interrelationships, while paying close attention to transcultural and systems aspects of human existence. A balance is sought between theory and practice which allows attention to our most important goal of helping an individual cope with "being-in-the-world".

The Department encourages the resident's identification with the medical model and its implicit premise of psyche/soma interaction. In this regard, the resident is made aware of the mutual contributions of the neurosciences and the psychosocial sciences and their appropriate place in integrative and hierarchical theories of motivation and behavior. In summary, the department provides the resident with a training experience that reflects our balanced biopsychosocial approach to patient care.

The resident has practical experiences in inpatient and outpatient Psychiatry, consultation-liaison Psychiatry, individual, group and family psychotherapy, psychopharmacology, milieu therapy, child Psychiatry, mental retardation, emergency Psychiatry and crisis intervention, transcultural Psychiatry, and socioanthropologic aspects of the discipline. Experience in community Psychiatry, including agency consultation and working with allied professionals and paraprofessionals, is provided. The core curriculum is augmented with thorough exposure to critical sub-specialty areas such as legal and forensic Psychiatry, sleep disorders medicine, substance abuse medicine, and geropsychiatry. There is a required exposure to research methodology, primarily provided by resident participation in ongoing research projects in which department faculty serve as investigators.

The resident is provided a structured learning experience and curriculum based on the 6 General Competencies formulated by the ACGME: 1) Clinical Science/Medical Knowledge; 2) Patient Care; 3) Interpersonal Skills and Communication; 4) Practice Based Learning; 5) Systems Based Care; 6) Professionalism and Ethical Behavior. A broad range of psychotherapeutic skills are provided to the resident to help augment his/her biological and social interventions. Exposure to group and family therapy is provided. In addition, individual psychotherapy skills are provided in supportive, cognitive-behavioral, combined, brief and psychodynamic formats.

As part of a university medical setting, the resident has the responsibility to actively participate in the teaching of medical students. The resident is an Assistant Clinical Instructor, and is expected to demonstrate proper interview techniques as well as refer the students to appropriate literature resources, emphasizing evidence based medicine, in reviewing clinical cases. The resident can comment or briefly lecture on psychopathology, diagnostics, psychopharmacology and the biopsychosocial formulation process. Senior residents are required to participate in the formal medical student lecture series. The medical student program has been a highly successful one for many years. Enthusiastic involvement by resident staff has been a major reason for this success.

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