Internal Medicine and Psychiatry
Combined Residency Program
Medicine Psychiatry Inpatient Medicine 3-4 mo
Night-float 1 mo
Consult service 1-2 mo
- (Renal, GMed Consult etc)
Inpatient Psych 4 mo
(may include General psych UIHC or VA, geriatric psychiatry)
Specific Psychiatric Competencies
The Psychiatric training experience is well rounded and covers all the specific competencies required by the American Board of Psychiatry & Neurology. Some of these are described below:
Outpatient Psychotherapy: Second year residents are assigned a mentor with whom they discuss patients and their training in psychiatry. Second year residents also have their own specific psychotherapy supervisor. Third-fourth year residents follow two or more patients over the course of a year, and meet weekly with the faculty psychotherapy supervisor for feedback and learning. Dedicated Thursday teaching sessions address various techniques including cognitive-behavioral, interpersonal and psychodynamic psychotherapies. For additional information, see Psychotherapy Supervision.
IMPACT Psychiatry: Residents who choose to do an elective with IMPACT have the opportunity to experience a unique model for delivering psychiatric care to people with serious and persistent mental illnesses. Unlike other community-based programs, ACT is not a linkage or brokerage case-management program that connects individuals to mental health, housing, or rehabilitation agencies or services. Rather, it provides highly individualized services directly to consumers. ACT recipients receive multidisciplinary staffing within the comfort of their own home and community. To have the competencies and skills to meet a client's multiple treatment, rehabilitation, and support needs, ACT team members are trained in the areas of psychiatry, social work, nursing, substance abuse, and vocational rehabilitation.
ACT strives to lessen or eliminate the debilitating symptoms of mental illness each individual client experiences and to minimize or prevent recurrent acute episodes of the illness, to meet basic needs and enhance quality of life, to improve functioning in adult social and employment roles, to enhance an individual's ability to live independently in his or her own community, and to lessen the family's burden of providing care.
ACT participants usually are people with schizophrenia, other psychotic disorders (e.g., schizoaffective disorder), and bipolar disorder (manic-depressive illness); those who experience significant disability from other mental illnesses and are not helped by traditional outpatient models; those who have difficulty getting to appointments on their own as in the traditional model of case management; those who have had bad experiences in the traditional system; or those who have limited understanding of their need for help.
ACT clients spend significantly less time in hospitals and more time in independent living situations, have less time unemployed, earn more income from competitive employment, experience more positive social relationships, express greater satisfaction with life, and are less symptomatic.
Forensic/Legal Psychiatry: Residents have ample opportunity during all phases of their psychiatric and medical training to become familiar with issues of competency, capacity, and commitment.
Emergency Psychiatry: Residents become experienced in emergency psychiatry through their on-call experiences and through experiences in the emergency room, primary care, and consultation rotations. A psychiatry call night-float system ensures exposure to emergency psychiatry.
Community Psychiatry: Residents have the opportunity to rotate in the University of Iowa Student Health Mental Health Clinic and to evaluate patients at Chatham Oaks, a county mental health facility.
Geriatric Medicine/Psychiatry: Separate structured geriatric rotations are required in both departments. Geriatric Psychiatry experiences occur on an inpatient Geriatric Psychiatry unit. Geriatric medicine training occurs in the setting of a consultative Geriatrics clinic as well as an inpatient Geriatric Consultation service.
Substance Abuse: Residents receive specific training in detoxification and withdrawal on the general medicine and psychiatry services. Exposure to extended treatment for substance abuse can be obtained during a rotation at the Veterans Administration Medical Center.
Electro-Convulsive Therapy Service: The ECT service at the University of Iowa provides residents with the chance to learn about and administer this highly effective treatment under the supervision of an experienced faculty member, with the support of an anesthesia staff and resident. Residents assess patients for suitability for treatment with both medical and psychiatric criteria, and if appropriate, administer treatment three times per week, following response closely, along with the primary inpatient team. Additionally, there are also outpatients receiving continuation or maintenance ECT who the treating resident will see in clinic during this one month rotation.