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Saint Louis University 's psychiatry residency training program offers a robust curriculum to prepare informed and caring mental health practitioners.

Day in the Life of a Resident

Hear from current residents as they describe how they work and study as a part of their fellowship within the Department of Psychiatry and Behavioral Neuroscience.

Neil Chen, PGY-1

"Psychiatry interns spend half of their first year off-service (inpatient and outpatient medicine, neurology, emergency medicine) and half on-service. Off-service rotations take place at the VA hospital, a ten-minute drive from the main hospital site. You’ll work alongside residents from other specialties while staying connected to the psychiatry program through weekly protected didactics. The slightly slower pace at the VA hospital allows you to spend more time with individual patients, study, research or rest.

"On-service psychiatry rotations are more intense and exciting, split between inpatient behavioral health units and other psychiatry specialties such as geriatric psychiatry and consult/liaison psychiatry. Throughout most of the year, you’ll take evening calls about once a week (no nights), with even rarer Saturday or Sunday calls. This ensures you continue training as a psychiatrist even during off-service rotations. On call, you’ll cover emergencies, consults and admissions, fully supported by a PGY-3 mentor by your side and an on-call attending over the phone.

"Intern year is a tough transition anywhere, but here, you’ll be well-supported as you move from student to doctor."

Harrison Yu, PGY-2

"Our PGY-2 year is where we focus mainly on inpatient experiences. You’ll spend a total of about six months split between running the acute (2W), subacute (4W) and consult liaison services at the hospital from Monday through Friday. These rotations are the same as PGY-1 year, but you’ll take a more senior role on the team. You’ll typically start the day at 7 a.m., getting sign out from the night PGY-2, and finish with signing out to the evening intern at 4:30 p.m.

"You’ll also have five months of non-SLU rotations, which are split between child psychiatry, addiction psychiatry, forensic psychiatry and VA inpatient. These services are typically attending run, with generally more relaxed hours. There is an additional one month of night float, in which you cover mainly the emergency department and units alone from 9 p.m. to 7 a.m. Sunday through Thursday.

"While PGY-2 is objectively busier, there is more variety. Call burden is less, with each resident needing to take a weekend night call only five times a year. We continue to have protected time for didactics every Tuesday afternoon. In addition, we have our own outpatient clinic and therapy patients panel one afternoon a week (for me, Wednesday). There is also reserved time for clinical and therapy supervision typically on a weekly basis as well. These rotations allow second years to develop independence on the inpatient services, explore specialty interests and segue easily into outpatient year in PGY-3."

Vimita Patel, PGY-3

"Clinic schedules for third-year residents stay pretty uniform throughout the year, so I have been liking that my schedule is more structured this year than the variability of inpatient rotations the last two years.
 
"On Mondays, I am at BJC Behavioral Health Clinic, which is out in the community, and I work closely with patients and their case workers there. On Tuesdays through Fridays, I am at SLU outpatient clinic in Monteleone Hall. At both these sites, I see a combination of new and follow up patients typically from 8 a.m. to 4:30 p.m. At SLU, after seeing each patient, I staff with one of our excellent attendings who are on-site. I have learned so much about psychopharmacology and long-term therapeutic relationships through my in-depth discussions with the attendings. I also have specialty clinic patients on my panel including perinatal psychiatry clinic on Wednesday mornings and refugee clinic on Thursday afternoons.

"Every day, I get one hour of lunch break, which I spend chatting and eating with my amazing co-residents who are also on-site. I also have three hours of supervision per week blocked off in my calendar, which has been a great opportunity to get guidance for challenging cases and residency in general from my supervisors. I supervise intern calls a few weekdays per month from 4:30 to 9 p.m. and approximately one weekend day per month from 8 a.m. to 8 p.m. Otherwise, my workday typically ends by 5 p.m. and I'm free the rest of the day to cook, watch Netflix with my fiancé, read about interesting cases and relax." 

Resident Evaluation

Continuous, individual evaluation is an integral part of our residents' education throughout four years of training. Residents are formally evaluated by faculty after each rotation and on specific encounters during that rotation. Faculty members are also encouraged to provide ongoing feedback to residents about their attitudes, knowledge and skills throughout their time of interaction. In addition, residents are evaluated using the 360 degree evaluation method, including evaluations from resident peers, medical students, patients, nurses and self-evaluation.

Six-Month Evaluation

At six-month evaluation intervals, residents participate in a semi-annual evaluation with program leadership (either PD or APD). This summary is based on resident performance in their assigned rotations, their PRITE examination scores, psychiatry milestones assessed by the Clinical Competency Committee, patient safety and quality improvement modules/projects, scholarly activity, peer reviews and goals for the next six months of training.

Yearly Evaluation

The residents and faculty are encouraged to evaluate the program on a yearly basis. Residents also evaluate their rotations on a monthly basis. An anonymous, formal written evaluation of the faculty by the residents is elicited after each rotation and each clinical course. This information is provided in an anonymous format to faculty yearly, reviewed by the program and by the division lead/chair at faculty evaluation annual meetings.

Self-Assessment

Residents are encouraged to submit a self-assessment on a semi-annual basis prior to the semi-annual meeting with program leadership and reviewed during the meeting.

Core Competencies

Resident performance, in general, is also discussed at the semi-annual Clinical Competency Committee meetings as the basis for promotion to the next level and graduation of the chief residents.

Residents are evaluated using the core competencies provided by Accreditation Council for Graduate Medical Education (ACGME). These include patient care, medical knowledge, practice-based medicine, systems-based practice, professionalism and interpersonal and communication skills. Residents are then assessed using milestones, which are knowledge, skills, attitudes and other attributes for each of the competencies organized in a developmental framework from less to more advanced.

Interpersonal, Communication and Teaching Skills

Medical students, nurses, social work and other team members routinely submit their evaluations of the residents concerning their teaching performance. This is included in the Clinical Competency Committee review process every six months. Patients also evaluate the residents on professionalism and communication. Finally, the residents are evaluated by their peers. This 360-degree evaluation process evaluates the residents’ competence in interpersonal and communication skills and teaching skills.

Performance and Professional Development

Complaints concerning resident performance are referred immediately to the program director, who meets with the individual resident for constructive counseling. Residents regularly meet with the director and the associate director to discuss organizational issues, progress in training, performance and professional development. As a result of this process, most conflicts are prevented or resolved and the director continues to personally monitor progress. If deemed necessary, more formal confidential counseling is available at the medical school. When required, remedial work is assigned.

It should be noted that the director places equal importance in rewarding good performance. This is stressed at the periodic meetings with individual residents as well as during case conferences.