Residency in Psychiatry: An Overview

The five-year residency training program in Psychiatry at the University of Manitoba is a well established, medium sized program designed to produce psychiatrists with broadly based academic and clinical orientations. We see our responsibilities as including the following:

1) To train psychiatrists who are fully qualified to practice within the complex, changing field that is modern psychiatry.

2) To provide a breadth of exposure and opportunity for in depth training in the many varied aspects of psychiatry appropriate to the candidate’s chosen community of practice.

3) To provide a formal education program which prepares the residents not only for success at the Royal College of Physicians and Surgeons (RCPS) specialty examinations but will also fulfill the many roles of a competent physician including:
a.  Medical expert/clinical decision maker
b.  Communicator
c.  Collaborator
d.  Medical manager
e.  Health Advocate
f.  Scholar
g.  Professional

4) To continue to change and evolve our training program in response to the changing needs of residents, community and the specialty of psychiatry.

The program is designed to meet these objectives through several overlapping approaches including clinical rotations, didactic seminar series, psychotherapy training program, research, community-based experiences and continuing education. Each of these components is described below.

CLINICAL ROTATIONS

The PGY 1 Year  The PGY-1 is a Basic Clinical Training (BCT) year preceding four years of formal psychiatric training. The PGY-1 consists of 52 weeks of training divided as follows:

4 Weeks

Addictions

4 Weeks

Emergency Medicine

4 Weeks

Family Medicine

4 Weeks

Internal Medicine

4 Weeks

Neurology

4 Weeks

Neuroradiology (strongly recommended)
or 1 additional Block in Neurology

8 Weeks

Pediatrics

4 Weeks 

Psychiatry

4 Weeks

Vacation

4 Weeks

Selectives (Up to 3 Blocks with a maximum of 2 Blocks per Selective):

  • General Surgery
  • Geriatric Medicine
  • Internal Medicine
  • Neurology (including Movement Disorders Clinic)
  • Neuroradiology (1 block maximum)
  • Obstetrics - Gynecology
    Palliative Care
  • Pediatrics (including Developmental Pediatrics
    and Child Protection
  • Research

4 Weeks

Electives (Up to 1 Block):

  • Any Medical or Surgical Specialty
  • Psychiatry

 

During the second half of PGY-1 residents begin psychotherapy training consisting of weekly psychotherapy sessions with one patient and supervision sessions in a group format. This is incorporated into the Academic half day and represents a unique and early exposure to psychotherapy training which reflects the department’s commitment to psychotherapy training overall.

The PGY-2 consists of one year of general adult psychiatry divided equally between adult inpatient psychiatry and adult outpatient psychiatry. The PGY-3 consists of six months training in Child & Adolescent Psychiatry and six months training in Geriatric Psychiatry. The PGY-4 consists of six months training in Consultation-Liaison Psychiatry and six months of Severe and Persistent Mental Illness training (which focuses largely on the care of patients with schizophrenia. The PGY-5 is six months of elective training and six months of selective training during which the residents are encouraged to further pursue areas of individual interest. A broad range of clinical, sub-specialty and research electives are available.

A 2 year subspecialty program in Child and Adolescent Psychiatry has been accredited by the Royal College of Physicians and Surgeons of Canada. Please contact the Program Director Dr. Sarah Fotti at 204-787-3914 or sfotti@exchange.hsc.mb.ca for general information related to the program or information related to applying to the program.

A 2 year subspecialty program in Geriatric Psychiatry has been accredited by the Royal College of Physicians and Surgeons of Canada. Please contact the Program Director Dr. Vishal Kaushik at 204-477-3556 or vkaushik@sbgh.mb.ca for general information related to the program or information related to applying to the program.

On-call duty is part of the clinical training of all residents throughout residency training. On-call frequency progressively diminishes as residents proceed through the PGY levels.

 

Didactic Curriculum:

There are protected academic sessions throughout all five years of the residency program. These usually take the form of weekly half-day seminars.

The PGY-1 seminars focus on developing relational skills with patients through interview observations, as well as a weekly group psychotherapy supervision experience provided in parallel to seeing patients in a therapeutic context. Seminars are provided which focus on an introduction to many of the different psychotherapeutic approaches and an introduction to research, diagnostic issues and biologic therapies.

The PGY-2 curriculum is subdivided into four areas. These include theoretical bases, psychopathology, therapeutic modalities and professional development. The theoretical bases stream covers basic theories in both psychological and biological spheres. The therapeutic modalities stream covers the various therapeutic techniques used in psychiatry. This includes modes of psychotherapy and psychopharmacology. The psychopathology stream covers phenomenology and classification. The PGY-2 seminar series has an adult psychiatry, problem-oriented focus.

The PGY-3 seminars have been developed to parallel the clinical rotations. Seminars will focus on developmental and psychiatric problems of the child and adolescent as well as geriatric Psychiatry. The seminars cover a broad range of topics including: child development, assessment of the child, adolescent and family, psychiatric disorders in childhood and adolescence, psychotherapeutic and pharmacological therapeutic interventions.

The PGY-4 didactic seminar series includes advanced topic seminars covering topics such as object relations therapy, mood disorders, schizophrenia, research methodology, cognitive behaviour therapy, family therapy and topics in professional development. A series of neurosciences lectures are also presented.

Psychotherapy Programs:

Training in various psychotherapies plays an integral role in the program. All residents are expected to achieve a level of competence in psychotherapeutic assessment and treatment. Towards this end, each year every PGY-3 to PGY-5 resident is provided with two psychotherapy supervisors, who provide intensive supervision on at least two ongoing cases. During PGY-2, residents are assigned to one psychotherapy supervisor and case as well as to a two hour Family Therapy Clinic. In addition during PGY-2 residents undertake supervised training in Supportive Psychotherapy. During the time spent in Child and Adolescent psychiatry, psychotherapy supervision focuses on treatment of an individual child, adolescent or their family. Training in brief psychotherapies, cognitive behaviour therapy, dialectical behavioral therapy, family, marital and group therapies is strongly encouraged and facilitated through the psychotherapies training program. Residents are now expected to achieve a range of competencies in many forms of psychotherapy as required by the Royal College of Physicians and Surgeons of Canada.

In addition, ongoing Advanced Psychotherapy Continuous Case Conference is offered to senior residents (PGY-3/4/5) as part of the academic half-day.

Research:

In keeping with the RCPS recommendations, residents are strongly encouraged to complete a research project during the course of the residency. As of the 2006/07 Academic year, all residents who began their training after July 2005 are required to prepare one research paper that meets the Canadian Psychiatric Association guidelines for submission to CPA journal. These projects may include, but are not limited to critical literature reviews, formal case review and discussion, program development and analysis, quality assurance as well as more formal and traditional scientific endeavors. In addition, residents are encouraged to develop their research projects so that they may submit them for publication and/or presentation at appropriate venues. Supervision and mentorship for such research is available through many of our teaching faculty.

Each spring, the department sponsors a Resident Research Day, at which time residents are strongly encouraged to present their various research interests in the form of an oral presentation. This protected, all day event is capped by an evening resident’s award dinner, hosted by the department. Distinguished visiting professors are invited to facilitate a learned dialogue.

 

Community Based Experiences

 

Many of the clinical rotational experiences have community oriented training opportunities available.  Residents are supported to further explore rural and remote community psychiatry as well as urban-based community endeavors.  PGY-2 to PGY-4 residents are required to complete eight visits (approximately 2½ to 3 hours) per year to a community clinic or one to two visits/year to remote placements for a total of four or five working days.  PGY-5 Residents will make four visits (approximately 2½ to 3 hours) per year to a community clinic or one to two visits/year to remote placements.  Residents must choose a second community placement to complete their community psychiatry training if they are on rotations where community components such as Child and Adolescent Psychiatry, Forensic Psychiatry and Psychogeriatrics/Consultation Liaison (CL) are already established unless negotiated with the Medical Director of Community Psychiatry.  During PGY-4 residents are matched to a Shared Care clinic to attend for one half day per week throughout the year.

 

 

Continuing Education

Departmental Grand Rounds, Visiting Professor Workshops and special academic programs and conferences are organized under the aegis of Continuing Education.

 

The Visiting Professor Program is particularly active, bringing in approximately twenty distinguished visiting faculty each academic year.  In addition to presenting at Ground Rounds, the visiting professors meet with the residents informally and present workshops, primarily attended by the residents.

Local faculty provide many additional Grand rounds presentations, both from within the Department of Psychiatry and from other University departments.  In addition, each resident is expected to present at Ground rounds at least once during their residency.  The department financially supports resident travel to one scientific meeting per year during available protected time.

 

 

 

Evaluation and Feedback

The process of informal and formal evaluation of the residents’ progress is continuous throughout the training program.  Similarly, the opportunity for residents to provide feedback on rotations, seminars and supervisors, goes on throughout the year.  In this way, both the functioning of the individual residents and supervisors, and more general organizational issues, can be addressed in what is a responsive and constructive manner.

 

Formal evaluation of clinical performance takes place four times per year in the PGY-2 to PGY‑5 years and are submitted on the E-Value web or PDA based program.  Evaluation of psychotherapy skills occurs twice each year.  Written exams occur annually, as do Departmental Oral Examinations (which are modeled after the RCPS oral exam).  A global evaluation, taking into account the various components of the evaluation process, occurs once each year.  Residents are required to challenge the national COPE exam annually each spring.

Residents are regularly asked to provide written, formal evaluations of supervisors, rotations, and seminars.  These are taken into account in planning for the subsequent year.

Evaluations are fundamental in the continuous process of program development.  As well, there is also an annual resident group evaluation day, which is protected time.  These group evaluations are also used to provide constructive feedback to the faculty as well as stimulate program development.

 

 

Competence Based Education Quick Reference Guides for Entrada and EPAs

"How to" Entrada

Core EPAs

Transition to Discipline and Foundations

Transition to Practice

 

Summary

The psychiatric residency is a critical period in the development of a psychiatrist, from learning new skills to enhancing the resident’s knowledge to the development of one’s own identity as a psychiatric specialist.  The residency sets the stage for an ongoing process of continuing education, growth and maturation, rooted in both scientific medicine and the humanistic traditions.

The above description is a brief summary of our training program.  Additional information on the selection process, program objectives and other aspects of the program are available to all potential candidates.  If any questions arise, or you wish to further discuss any aspect of our training program, please feel free to contact us.

M. Harrington, MD, FRCPC
Program Director
Postgraduate Education, Dept. of Psychiatry
University of Manitoba
Phone: (204) 787-3610

 S. Fotti, MD, FRCPC
PGE, Child and Adolescent Psychiatry Subspecialty Program Director
Health Sciences Centre
University of Manitoba
Phone: (204) 787-3914

 V. Kaushik, MD, FRCPC
PGE, Geriatric Psychiatry Subspecialty Program Director
Victoria General Hospital
University of Manitoba
Phone: (204) 477-3556

 M. Ratzlaff, MD, FRCPC
PGE, Psychiatry Site Coordinator
Victoria General Hospital
University of Manitoba
Phone: (204) 477-3445

J. Moody, MD, FRCPC
PGE, Psychiatry Site Coordinator
St-Boniface Hospital
University of Manitoba
Phone: (204) 237-2820

T. Sala, MD, FRCPC
PGE, Psychiatry Site Coordinator
Health Sciences Centre
University of Manitoba
Phone: (204) 787-3610

      

 

 

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PROGRAM SUMMARY

The psychiatric residency is a critical period in the development of a psychiatrist, from learning new skills to enhancing the resident's knowledge to the development of one's own identity as a psychiatric specialist.  The residency sets the stage for an ongoing process of continuing education, growth and maturation, rooted in both scientific medicine and the humanistic traditions.

FOR MORE INFORMATION CONTACT

Dr. Michael Harrington
Director, Postgraduate Education (PGE)
Department of Psychiatry
PZ277 PsycHealth Centre,
771 Bannatyne Avenue,
Winnipeg, Manitoba, Canada
R3E 3N4
Phone: 204-787-3610
Fax: 204-787-4879
E-mail: mharrington@exchange.hsc.mb.ca