Millcreek Community Hospital Psychiatry
Program
Program Director: Max W. Gottesman, D.O.
Telephone: (814) 868-8217
Email: mchmeded@mch1.org
Mission
The mission of the Millcreek
Community
Hospital Psychiatry Residency Program is to provide Residents with a comprehensive
structured cognitive and procedural clinical education in both inpatient and outpatient settings
that will enable them to become competent, proficient, and professional osteopathic
psychiatrists.
Program Overview
 |
G. Renee Thomas-Clark,
D.O., F.A.C.N. Child Psychiatrist |
Millcreek community Hospital is the largest psychiatric inpatient facility in Northwestern
Pennsylvania (and only D.O. Hospital). Residents are exposed to all facets of Psychiatry that allow
the Residents to be well rounded in the field. The program also is active in the multiple supportive
services of mental health such as Crisis and Case Management.
The rotation schedule
represents a multifaceted approach which thoroughly accommodates the requirements for Residency as
put forth by the American College of Osteopathic Neurologists and Psychiatrists. Residents enjoy
the opportunity to gain proficiency of practice in a variety of clinical settings, including to
work in the public, private and rural sector. Also, the entire patient spectrum is represented in
terms of working with children/adolescents, adults and the elderly.
Rotation
Requirements:
2 months Neurology – inpatient or outpatient
12 months – 24 hour Resident responsibility for diagnoses, treatment (inpatient,
partial)
for OGME-4 –
12 months - outpatient (ambulatory) psychiatry
training –
community mental health, community based programs, individual, cognitive,
behavioral, biological
2 months – clinical and adolescent outpatient
4 months – consultation – liaison (medical & outpatient)
2
months – E/R Psychiatry
2 months – Geriatric Psychiatry
2
months – substance abuse and dual diagnosis
1 month – forensic
– elective
Neuropsychological testing – didactic
Managed Care – hand
on experience
4 months – Internal Medicine
2 month –
Geriatrics
3 months – VA (Surgery, Internal Medicine, E/R)
Residency
Evaluations: are written after rotation with Resident present and co-signed by attending, Resident
and Residency director. Resident and program director will meet every month. “Mock
Boards” Part II will be part of didactic teaching in outpatient clinic. Residents use the
provided program policy and rotation description. Residents are provided written information
regarding stipends, benefits and hospital policy.
2. Educational Program
In
addition to the curriculum, Residents are expected to attend a monthly journal club in which
articles from The American Journal of Psychiatry are reviewed. We have a monthly board review
program in which we review PRITE questions to help Residents prepare for the written boards. Every
month we have a four-hour didactic classes for Residents to attend that covers requirements for
Residency.We also have two-hour weekly didactic sessions specific to teaching psychotherapy for all
Residents in their OGME-2 year and beyond.Also to assist with the practice of psychotherapy,
Residents meet weekly with an assigned psychotherapy supervisor to discuss their individual case
load. Mentors provide sessions with both on-site and off-site supervisors that can provide
resources and discussion for the Residents.
Resident Responsibilities
1. Logs
Each Resident is expected to keep a monthly log consisting of the patients they see at each of
their identified sites, a list of reading material they have covered, and a list of didactic
sessions, conferences, meetings, and supervision sessions they have each attended. These logs are
submitted to the program director and to the Department of Medical Education monthly.
2.
Evaluations
Residents obtain evaluations based on the core-competencies of Residency training
from each of their supervisors every two months and are to be submitted as they are obtained
throughout the academic year to the medical education department. The program director will review
the evaluations with the Residents quarterly.In addition, the Residency director will fill out an
evaluation quarterly for each Resident. Residents are given evaluations with the evaluator (one on
one interaction) and are encouraged to have discussions regarding their progress in the
Residency.
3. Residents must submit an annual report to the American College of Osteopathic
Neurologists and Psychiatrists.
4. Residents must have a professional paper for the American
College of Osteopathic Neurologists and Psychiatrists (ACONP) during the last year of training.
5. The call schedule is formulated by the senior Residents and reflects a fair approach to call
distribution which allows for less time on call as each Resident progresses through the program.
The Resident on-call has around the clock access to an attending psychiatrist functioning as a
back-up for discussion of complicated cases or special circumstances.
6. Residents must
participate in the annual in-service examination (PRITE) that simulates Part II of the AOBNP Board
Certification Examination.
Affiliated
Institutions
Millcreek Community Hospital in conjunction primarily with
Dual, Stairways Behavioral Health, and many other agencies of Erie County, participates in the
education of Psychiatry Residents by offering specialty rotations to enhance the scope, volume, and
variety of cases for both core and elective rotations.
Goals and Objectives
General
- Provide an educational program that offers a thorough
understanding of the development, assessment, treatment, and prevention of psychopathology as it
appears from infancy through adulthood.
- Provide an introduction to this knowledge base
in psychiatry.
- Psychiatry for medical students and general psychiatry residents.
- Provide an interdisciplinary setting for the training of Psychiatrists to take a leadership
role in working with other mental health professionals in the prevention and treatment of mental
disorders in patients and understand the role of an effective consultant.
- Integrate
findings in developmental neurobiology and neuroscience to develop an understanding of fundamental
processes that may be involved in the etiology and treatment of psychiatric disturbances and
developmental disorders.
- Provide treatment to patients and families on a
non-discriminatory basis, always considering the welfare and perspective of the patient, family,
community and utilizing evidence based approaches to clinical problem solving.
Educational
- Skill in diagnostic interviewing, formulation,
treatment planning, and implementation of psychotherapeutic and pharmacological management.
- Familiarity with the theories of development pertaining to patients of all social and cultural
backgrounds.
- Skill in consultation with primary care, non-psychiatrist mental health
providers, schools, community agencies, and other programs serving patients.
- Skill in
administration and teaching
- Knowledge of the principles of research to encourage a
scientific approach to clinical problems and skill in critical reading of the literature as it
pertains to psychiatry and psychology
- Familiarity with the function and organizations
of health, education and welfare institutions to promote normal development.
- Understanding of legal and ethical issues in the practice of Psychiatry.
Psychiatry Inpatient Unit
Patient Care
- Interviewing skills/data gathering skills
- Recognize/manage psychiatric
emergencies
- Preparation for treatment and disposition
Clinical
Knowledge - Differential diagnosis
- Pharmacological interventions in
acute care setting
- Non-pharmacologic interventions in acute care setting
- Interaction between psychiatric diagnosis and psychosocial problems
Interpersonal Skills and Communication - Effective relationships with
multidisciplinary staff
- Therapeutic relationships with patients/families
- Succinct and thorough oral presentations
- Written reports and documentation
Professionalism and Ethical Behavior - Demonstrates professional
appearance/respectfulness/courtesy
- Punctuality/arranges coverage appropriately
- Maintains equilibrium under stress
Practice-Based Learning
- Self-evaluation/knows limits of own knowledge
- Incorporates new info into
practice/seeks out supervision and guidance
- Independently motivated/uses available
resources
Systems-Based Practice - Effective with outside
agencies/aware of resources and obstacles
- Advocates for patient/family
- Understands role of inpatient hospitalization in continuum of care
Affective Disorders Service
Patient Care
- Perform comprehensive psychiatric interviewing and history gathering
Clinical Knowledge - Diagnosis/formulation of affectively ill patients
- Pharmacologic interventions with affectively ill patients
- Non-pharmacologic
interventions with affectively ill patients and families
- Interaction of affective
illness and psychosocial problems
Interpersonal Skills and
Communication - Effective relationships with patients and families
- Succinct and thorough oral presentations
- Written reports and documentation
- Maintain effective relationships with multidisciplinary staff
Professionalism - Demonstrates professional
appearance/respectfulness/courtesy
- Punctuality
- Maintains equilibrium
under stress
Practice-Based Learning
- Self-evaluation/recognizes limits of won knowledge
- Incorporates new info into
practice/seeks out supervision and guidance
- Independently motivated/uses available
resources
Systems-Based Practice - Understands role of
inpatient unit for affectively ill
- Effective use of resources for Patient
Care/understands system of care
- Effective with outside agencies and advocates for
patient/family
Consultation Liaison Service
Patient Care - Perform psychiatric interviews on medically ill
- Recognize/manage psychiatric emergencies in medically ill
Clinical
Knowledge - Differential diagnosis and treatment planning for medically ill
- Pharmacologic/Non-pharmacologic interventions for medically ill
- Recognize the
interaction between medical and psychiatric and psychological problems
Interpersonal Skills and Communication - Effective relationships with
patients and families
- Effective relationships with primary care team
- Succinct and thorough oral presentations
- Written reports and documentation
Professional and Ethical Behavior - Demonstrate professional
appearance/respectfulness/courtesy
- Punctuality/arranges coverage appropriately
- Maintains equilibrium under stress
Practice-Based Learning
- Self-evaluation/knows limits of won knowledge
- Incorporates new info into
practice/seeks out supervision and guidance
- Independently motivated/uses available
resources
Systems-Based Practice - Understands role of
psychiatry consultant
- Effective use of resources for Patient Care
On-Call
Patient Care - Provide focused
emergency assessments of patient and families in crisis
- Ensure patient safety
- Identify at-risk situations
Clinical Knowledge
- Awareness of types of emergency situations in patients and families
- Ability to
diffuse and manage a crisis situation
- Understanding of statues regarding custody and
guardianship as it relates to emergency assessment, emergency petition, and voluntary/involuntary
admissions process
Interpersonal Skills and Communication
- Rapid establishment of therapeutic relationship in an emergency care setting
- Succinct written reports
- Cooperation with referral sources and disposition
resources
- Clear communication with staff
Professionalism and
Ethical Behavior - Maintain professional appearance and demeanor
- Demonstrate respect, compassion, integrity, and honesty
- Respond punctually to
requests for consultation
- Recognize limits of own knowledge/skills
- Arrange coverage as needed
Practice-Based Learning
- Seek out supervision
- Re-evaluate performance based on feedback
Systems-Based Practice - Learn about the resources available for patients in
need of acute psychiatric intervention
- Understand the public mental health care system
and obstacles to accessing care
- Learn about the relationship between pediatric care
providers and specialty services in an emergency care setting
- Learn to identify the
need for adjunct services
First and Second
Year Resident Continuity Clinic (Outpatient Clinic)
Patient Care
- Interviewing/data gathering
- Engagement in treatment/effective relationships
with patients and families
Clinical Knowledge - Diagnosis and
formulation
- Treatment implementation and sequencing
- Pharmacological and
psychotherapy interventions
- Balancing family/patient needs
- Management of
transference/counter-transference
Interpersonal Skills and
Communication - Succinct and thorough oral and written presentation
- Manages relationship with supervisor
Professionalism and Ethical
Behavior - Maintains equilibrium under stress
- Availability to
patients/families
- Arranges coverage appropriately
Practice-Based Learning - Self-evaluation/seeks out supervision
- Utilizes/incorporates new information
Systems-Based Practice
- Effective use of resources for Patient Care
- Aware of complex system of care
Second Year Clinical Rotations Educational Goals
Specialty Clinics
Patient Care
- Conduct comprehensive interviews and data gathering
- Recognizes and manages
psychiatric emergencies
- Provides pharmacological and psycho educational interventions
in integrated manner
Clinical Knowledge
- Diagnosis/formulation/treatment planning
- Recognizes relationship between diagnosis
and impairment
- Recognizes role of various interventions including individual, family,
CBT, and parent management training
- Aware of pertinent literature
Interpersonal Skills and Communication - Effective relationships with
patient and families
- Succinct and thorough oral presentations and
written reports
- Effective relationships with referral sources
Professionalism and Ethical Behavior - Demonstrate professional
appearance/respectfulness/courtesy
- Punctuality/arranges coverage
appropriately
- Maintains equilibrium under stress
Practice-Based Learning
- Self-evaluation/recognizes own limits
- Incorporates new info into
practice/seeks out supervision and guidance
- Independently
motivated/uses available resources
Systems-Based Practice
- Aware of complex system of care
- Effective use of resources for Patient Care
- Advocates for patient and family
Community
Psychiatry Program
CMHC Rotation:
Patient
Care - Perform comprehensive interviewing skills and data gathering
- Recognition/management of psychiatric emergencies
- Provides pharmacologic
management and psycho education to patients and families
Clinical
Knowledge - Understands role of child psychiatrist in community setting
- Diagnosis/formulation/treatment planning
Interpersonal Skills and
Communication - Effective relationships with non-M.D. clinicians
- Team
participation/oral presentations
- Written reports/routine documentation
Professionalism and Ethical Behavior - Demonstrates professional
appearance/courtesy/respectfulness
- Maintains equilibrium under stress
- Punctuality/arranges coverage appropriately
Practice-Based
Learning - Self-evaluation/recognizes limits of own knowledge
- Incorporates new information into practice/seeks out supervision
- Independently
motivated/uses available resources
Systems-Based Practice
- Recognition of obstacles to care in community care setting/understands system of care
- Aware of COMAR and other regulatory bodies in community mental health
- Effective
use of resources for patients/families
Psychiatry
Program
Patient Care - Perform comprehensive interviewing
skills and data gathering
- Recognition/management of psychiatric emergencies
- Provides pharmacologic management and psycho education to patients and families
- Clinical Knowledge
- Recognize the interplay between
psychiatric and learning problems
- Understands role of psychiatric consultant in school
setting and limits of school-based services
- Diagnosis/formulation/treatment
planning
- Interpersonal Skills and Communication
- Effective relationships with clinicians
- Team participation/oral presentations
- Written reports
- Professionalism and Ethical
Behavior
- Demonstrates professional appearance/courtesy/respectfulness
- Maintains equilibrium under stress
- Punctuality/arranges coverage
appropriately
Practice-Based Learning
- Self-evaluation/recognizes limits of own knowledge
- Incorporates new information
into practice/seeks out supervision and guidance
- Independently motivated/uses
available resources
F. Systems-Based Practice
- Indentifies obstacles to accessing care
- Aware of COMAR and other regulatory bodies
regarding services
- Recognizes obstacles to care
Forensics
Patient Care - Provide comprehensive
clinical assessments patient and family before the court
- Manage relationships with
patients and families in court setting
Clinical Knowledge
- Understand the difference between a clinical evaluation and a forensic evaluation
- Understand the different types of forensic evaluations and reports
- Understand the
legal statutes as they relate to patients and families
Interpersonal
Skills and Communication - Ability to write reports that convey the appropriate
information for judges
- Maintain relationships with court offices
Professionalism and Ethical Behavior - Demonstrate respect, compassion,
integrity, and honesty
- Maintain equilibrium under stress
- Complete
paperwork in a timely manner
- Prioritizes appropriately
Practice-Based Learning - Self-evaluation/seeks out supervision
- Incorporates new information into practice
- Demonstrates initiative
Systems-Based Practice - Work effectively in coordination with outside
agencies
- Understand the interrelationships between the multiple social agencies and
the court system as it affects patients and families
Millcreek
Community Hospital
Patient Care - To interview, diagnose
and effectively manage patients in need of detoxification from substances
- To provide
continuous follow-up care of these patients during their substance abuse treatment episode at
Millcreek Community Hospital
Clinical Knowledge - To acquire
Clinical Knowledge of Substance Use Disorders
- To develop a multimodal treatment plan
for patients with substance use disorders and co-occurring psychiatric disorders.
Interpersonal Skills and Communication - Routinely provide/accept input
to/for multidisciplinary team
- Respond to patient/family questions/concerns
appropriately and in timely fashion
Professionalism and Ethical
Behavior - To demonstrate respectful, courteous, compassionate, and ethical behavior
with patients, MCH staff, and related personnel
- Complete all necessary paperwork in a
timely manner
Practice-Based Learning - To implement
empirically supported behavioral interventions in the management of patients substance use
disorders
- Direct the services of the multidisciplinary team incorporating
feedback
Systems-Based Practice - Coordinate input from
related systems of care (e.g. previous treatment provider, family, etc.)
- Develop an
appropriate plan for further treatment, disposition, academic/vocational rehabilitation, as
directed
Please contact the following Psychiatry Resident for further
information:
- Jamie Fuhrer, D.O.
jfuhrer@mch1.org
To apply to MCH's Internships, OGME1
Programs, log onto the ERAS Website: www.aamc.org/audienceeras.htm.
Students need to register
with National Matching at: www.natmatch.com.
For more information, contact:
Marilyn Tracy,
Medical Education Coordinator
Medical Education
Millcreek
Community Hospital
5515 Peach Street
Erie, PA 16509
(814) 868-8217
mchmeded@mch1.org