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Program Coordinator

Linda Barkley
Sacred Heart Medical Center
on M, T, Th, F
Ph: (509) 474-4744
Fax: (509) 474-4746

Spokane Teaching Health Clinic
on Wed
Ph: (509) 626-9963

Rotation Structure by Year

Updated for 2018-19 Academic Year

PGY-1

  • Nine 4-week rotations at Providence Sacred Heart Medical Center (SHMC) consisting of Internal Medicine, Cardiology (x 1), Neurology Consults (x 1), Pediatrics (optional), Emergency Medicine (x 1), and Consultation-Liaison Psychiatry

  • Two 4-week inpatient psychiatry rotations at Eastern State Hospital (ESH) 

  • One 4-week outpatient neurology rotation at Veterans Affairs Medical Center (VAMC) 

  • Half-day didactic teaching per week.

Sample PGY-1 year rotation 13 BLOCK schedule

1: Internal Medicine - House Staff at SHMC 

2: Emergency Medicine at SHMC

3: Neurology - Outpatient at VAMC 

4: Pediatrics - Inpatient at SHMC

5. Neurology – Inpatient at SHMC

6: Psychiatry – Consultation-Liaison at SHMC 

7: Internal Medicine – Cardiology at SHMC

8: Psychiatry – Consultation-Liaison at SHMC 

9: Psychiatry – Adult Inpatient at SHMC

9: Internal Medicine – Night Float at SHMC

11. & 12.: Psychiatry – Adult Inpatient at ESH

13: Internal Medicine – House Staff at SHMC

PGY-2

  • Seven 4-week rotations at Providence Sacred Heart Medical Center (SHMC) consisting of Consultation-Liaison Psychiatry, Inpatient Psychiatry

  • Six weeks of Emergency Psychiatry at SHMC

  • Ten weeks of Collaborative Care experience during Primary Care Psychiatry at Spokane Teaching Health Clinic (STHC), including weekly buprenorphine addiction clinic experience

  • One 4-week rotation at Veterans Affairs Medical Center (VAMC) 

  • Two week block of Systems of Medicine - combined quality improvement training with internal medicine program

  • 1 ½ day elective rotation time during each Primary Care Psychiatry block.

  • Half-day didactic teaching per week.

  • Half-day Psychotherapy Continuity Clinic at Gonzaga University per week.

Sample PGY-2 year rotation 13 BLOCK schedule

1. & 2.: Psychiatry – Adult Inpatient at SHMC

3: Neurology – Outpatient at VAMC

4. & 5.: Psychiatry – Primary Care Psychiatry/Collaborative Care at STHC 

6. & 7.: Psychiatry – Consultation-Liaison at SHMC

8: Psychiatry – Emergency at SHMC

9: Psychiatry – Adult Inpatient at SHMC

10: Emergency Psych (2 weeks) and Systems of Medicine (2 weeks) SHMC

11: Psychiatry – Consultation-Liaison at SHMC

13: Psychiatry –Primary Care Psychiatry/Collaborative Care at STHC

PGY-3

  • 12 blocks - 1 day per week rotation at Frontier Behavioral Health for Outpatient Child and Adolescent Psychiatry

  • 12 blocks - 1 ½ days per week rotation in Primary Care Psychiatry (direct patient care) at Spokane Teaching Health Clinic (STHC) including ½ day of collaborative care consults. 

  • 12 blocks - 1 day per week longitudinal psychotherapy clinic at Gonzaga University

  • 12 blocks - 1 day per week Addiction Psychiatry at STHC

  • 1 block of Inpatient Geriatric Psychiatry at Eastern State Hospital

  • Half-day didactic teaching per week.

PGY-4

  • Two 4-week rotations of Forensic Psychiatry at ESH: 2 ½ total days per week

  • Two weeks of Emergency Psychiatry at SHMC

  • Year-long ½ day per week rotation at Gonzaga University Psychiatry Continuity Clinic

  • Year-long 1 day per week rotation in Primary Care Psychiatry (direct patient care) at STHC

  • Eight months ½ day per week of collaborative care consultation including STHC consults and rural telehealth consults

  • Four months ½ day per week of rural telepsychiatry clinic for Family Medicine Residency Spokane Rural Training Track in Colville, WA

  • Required for Chief Resident, otherwise elective: 4-week rotations as Junior Attending at SHMC, either on Inpatient Adult Psychiatry Unit or on Consultation-Liaison Service: 2 ½ total days per week

  • Half-day didactic teaching per week

  • Elective 4-week rotations of elective time: 2 ½ total days per week

ELECTIVES

  • Elective options can include any of previously completed required rotations

  • Elective options selected by AY 18-19 PGY4s

    • ECT/TMS

      • 8 week 0.5 FTE elective in PGY 4 alternating weeks between ECT and TMS

    • Frontier Behavioral Health E&T elective

    • Gonzaga University Primary Care elective

    • Healing Lodge of the Seven Nations psychotherapy elective

      • Residents provide psychotherapy to male and female adolescents in a 45 bed residential chemical dependency treatment center. This is a Native American treatment center founded by a consortium of tribes: Confederated Tribe of the Colville Reservation, The Spokane Tribe of Indians, The Kalispel Tribe of Indians, and The Kootenai Tribe of Idaho, The Coeur d’Alene Tribe of Indians, The Nez Perce Tribe, and The Confederated Tribes of the Umatilla.  The treatment center is one of 12 Indian health Services Regional Youth Treatment Centers around the country.

    • Junior Attending – Inpatient psychiatry elective

    • Pediatric Neuro-developmental clinic

      • ½ to full day elective per week for 2-3 months

    • Sleep medicine

      • ½ day longitudinal 2-3 month elective

    • Teaching Elective

      • ½ day a week for a variable rotation duration, expected to develop a curriculum for implementation at the end of the elective, and to teach at least 2 of those sessions themselves

ADDITIONAL ELECTIVES

Numerous additional electives are available to residents in addiction (Spokane Regional Health District, Daybreak adolescent addiction services), child and adolescent (Adolescent medicine clinic, Daybreak, CHAS, FBH), community psychiatry (FBH Adult Outpt, FBH Elder Services, FBH ACT team, CHAS Integrated Care), eating disorders (Emily Project), jail/correctional psychiatry, LGBTQ+ care (Odyssey Youth Movement), Native Health (Kalispel Tribe Camas Path Clinic, Spokane Tribe of Indians Clinic), neurology clinics (TBI, movement disorders), neuropsychiatry, psychotherapy (BAP, CBT, DBT, Group, MI, ISTDP), sports medicine psychiatry and quality improvement. More are available and can be developed!

QUALITY IMPROVEMENT CURRICULUM

Three four week 0.2 FTE block rotation in QI was added for 2017-18 to further augment QI experience (present in the systems of medicine PGY2 rotation) and address ACGME common program requirements effective July 1, 2017.   

Residents now meet weekly with a faculty mentor and implement a QI project during their rotation in collaborative care.  

PGY3 and PGY4 residents continue QI with requirement for an individual or group QI project. Expectation is that work will be presented at regional symposiums or conferences (NW regional research symposium, or Primary Care Update) or national conferences.  


PRS Supervision

PGY-1

During the PGY-1 year, on psychiatry rotations, each resident is required to have one hour per week of direct supervision with his or her inpatient attending, in addition to rounds. 

The resident also has one hour per week of direct individual/group or peer consultation supervision with an “off ward” supervisor.  This is a member of the faculty who meets with the resident or residents (if on a rotation in which there is a more senior resident working alongside a junior resident) to discuss cases from the resident’s inpatient caseload, case formulation and differential diagnosis, issues involved in working with the multidisciplinary inpatient team and with families, approaches to treatment, and/or papers from the psychiatric literature, depending on the resident’s needs and preferences.

PGY-2

In the PGY-2 year, each resident is required to have at least one hour per week of direct supervision by the attending supervising him or her of the clinical service (e.g. inpatient, consultation liaison, emergency psychiatry), in addition to rounds.

One hour per week of individual psychotherapy supervision.

PGY-3 through PGY-4

In the PGY-3 and PGY-4 years, each resident is required to have one hour of direct supervision (usually group) for outpatient clinic rotations, or one hour per week of direct supervision by the supervising attending for the rotation.

 At least one hour (with two preferred) of individual psychotherapy supervision per week.

On rotations in which there is a PGY-2 resident working alongside a PGY-1 resident (inpatient adult psychiatry) or where there is a PGY-3 resident working alongside a PGY-2 resident (inpatient child and adolescent psychiatry), they are required to have 1 hour per week of peer consultation supervision.  Both residents use each other for consultation with direct supervision from an attending, either on the service or an “off ward” supervisor.


Personal Psychotherapy

The Residency Program believes that it is important that psychiatrists understand the contribution of their own psychological and interpersonal characteristics to the doctor-patient relationship.

To foster such self-awareness, each psychiatry resident is required, by the time of Graduation, to have completed six months of either:

  • Weekly personal psychotherapy

OR

  • Weekly supervision focusing on the resident’s own contributions to doctor-patient relationships