Residency Program

Adult Inpatient Psychiatry

For many residents, the LAC+USC Adult Inpatient Psychiatry Service provides the first exposure to primary responsibility for psychiatric patients. The Department is presently operating a 40-bed service in Rosemead, CA, 6 miles east of the LAC+USC Medical Center. To provide supervision on the inpatient services, there are four faculty psychiatrists to supervise residents and medical students. In addition to the faculty and resident physicians, the psychiatric ward staff includes a faculty psychologist, a pharmacist, psychiatric social workers, medical caseworkers, occupational therapists, recreational therapists, and nursing personnel. Each ward emphasizes short-term acute psychiatric care with the goal of early discharge and continuation of treatment in an appropriate outpatient setting. Resident supervision is provided in ward rounds and on an individual basis. The patient load for each resident is capped to ensure there is adequate time to provide comprehensive evaluation and treatment of his/her patients. As part of the formal curriculum, residents are excused from their clinical duties to attend lectures, seminars, and case conferences. The resident is encouraged to participate in the teaching of medical students.

Emergency Psychiatry

The Psychiatric Emergency/Admitting area is located on the main floor of the General Hospital. During the three months spent in this extremely busy area, the residents assist several full-time faculty psychiatrists in the evaluation of two patient populations: a "walk-in" population, and a population "brought-in" by others (e.g., police, social agencies, psychiatric emergency team members, and concerned families and friends). The residents spend the majority of their clinical time assessing patients and learning crisis intervention procedures (both pharmacological and psychotherapeutic). With the large full-time faculty, there are many opportunities for discussions of differential diagnostic issues, the initiation of preliminary treatment regimens and familiarization with the types and availability of community resources for the mentally ill. The majority of patients are in crisis and suffer from the major psychiatric disorders. Concerns about suicide, dangerousness, and the capacity to care for self are frequent among the population served. In addition to several staff psychiatrists, the emergency room staff also includes clinical psychologists, medical caseworkers, and nurses. Residents have the opportunity to assist in the teaching of medical students during this rotation.

Consultation Psychiatry

On this rotation the resident receives extensive experience in Consultation & Liaison Psychiatry with adult patients, primarily in the General Hospital and to a lesser extent in Women’s and Children's Hospital. Residents spend the majority of their clinical time learning consultation principles, approaches to patients, interview techniques, diagnostic evaluation, psychiatric symptoms associated with medical and surgical conditions, psychopharmacology in medically ill patients, and crisis intervention. The patients often pose challenging diagnostic questions and come from a variety of cultural, racial, and ethnic backgrounds. Several faculty psychiatrists provide supervision. An active didactic program augments clinical experience. Educational opportunities exist for working with medical students.

Adult Outpatient Psychiatry

An entire training year is spent on the Adult Outpatient Clinic rotation. This year provides intensive training in both long-term and short-term psychotherapeutic treatment of many different psychiatric disorders. Each resident spends several hours weekly in seminars and case conferences covering a variety of topics (e.g., psychodynamic psychotherapy, cognitive therapy, behavioral therapy, group therapy, couples therapy, family therapy, and pharmacological treatment of outpatients). The education in psychotherapy is augmented by the use of a one-way mirror demonstration of a selected case, in which an experienced faculty psychiatrist treats the patient weekly, while a second faculty member on the other side of the mirror reviews the process to observing residents. Each resident evaluates l-2 new patients per week, which are then presented to faculty at a multi-disciplinary evaluation conference. Clinically, each resident receives from four to five hours of supervision per week. Since the clinic is a major community resource, the resident also has the opportunity to learn skills relevant to community psychiatry. After concluding the GY-3 year in the clinic, residents in their GY-4 year are permitted (and encouraged) to return to the clinic l/2 day per week to continue following selected long-term psychotherapy cases.

Child and Adolescent Psychiatry

The major resource utilized for training in Child and Adolescent Psychiatry is the Child-Adolescent Outpatient Clinic, although there is a one-month rotation on the Adolescent Inpatient ward. During the outpatient rotation each resident will have an exposure to both Child and Adolescent outpatients, using a multitude of therapeutic modalities, including family therapy, individual therapy (psychodynamic and behavioral), and pharmacotherapy. An extensive didactic program augments multi-disciplinary individual supervision. Medical students and child psychiatry residents also share in this educational experience.

Geriatric Psychiatry

During this rotation, which is located at the USC University Hospital (a private service), the residents gain familiarity with psychiatric issues among the elderly. This rotation is currently a mix of inpatient and consultation experience. In addition, training in ECT also occurs during this assigned time, and educational opportunities exist for working with medical students.

Addiction Psychiatry

In this one-month outpatient- based rotation, based at the USC-affiliated VA Outpatient clinic in downtown Los Angeles, the psychiatry resident acquires training in the treatment of patients with alcohol and/or drug dependency in an outpatient setting. This rotation introduces residents to the evaluation of patients for inclusion in the programs, and introduces them to the various treatment approaches.

Community Psychiatry

This is a unique educational opportunity for the senior resident to obtain an overview of public sector psychiatry in the County of Los Angeles. The resident is assigned for one month to the headquarters for the County Department of Mental Health, which is responsible for providing mental health services for this county of ten million people. In addition to gaining an appreciation of the organizational tasks associated with the operation and financing of such a system, the resident visits many different types of facilities and speaks with the directors of those programs to gain a familiarity and fuller understanding of their role. Additional goals include increasing the resident's knowledge about the field of Community Psychiatry, including program administration, consultation to community agencies, and leadership of interdisciplinary teams.

Elective Time

Each resident has an elective period that occurs in the GY-4 year. This is an opportunity for the resident to individualize training in psychiatry to suit special interests and needs and to develop special expertise in areas of special interest. Both clinical and research opportunities are available.

Other Educational Opportunities

A Departmental Grand Rounds is held 3-4 times per month and features local and visiting professors from all areas of psychiatry to speak on research and selected topics of interest to the entire department. These activities are intended for all residents and faculty.