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Family Medicine & Psychiatry

CURRICULUM

Drs. Bruce Callister and Tamar Carmel
Drs. Bruce Callister
and Tamar Carmel
The curriculum is combined so that residents spend varying amounts of time per year in each discipline with longitudinal outpatient experiences that extend across all 5 years and represent family medicine primary care, psychiatric specialty care, as well as an integrated family medicine/psychiatry experience in a community health center. Formal teaching is provided in each discipline separately. We have found that the combined program enhances the residency training experience for those residents going through each categorical training program as well. Clinical rotations are generally in 4-week blocks in Primary Care so there are 13 blocks per year. In Psychiatry, with the exception of longitudinal ambulatory psychiatry, the Clinical Rotations are between 4 and 10 weeks and are integrated with the Primary Care experience.

All Family Medicine training will take place in either UPMC McKeesport Hospital, (MCK) or UPMC St. Margaret’s Hospital, (STM) systems.

The descriptions below are an example of our current schedules. As we continuously strive to improve and individualize training, the order and structure of specific rotations may change.

PGY1    PGY2    PGY3    PGY4    PGY5

PGY1

The goal of the PGY1 (internship) year is to learn the basics of family medicine and psychiatry to provide a foundation for subsequent training in both primary care and psychiatry. The first year is weighted towards family medicine, as 4 months of training in general medicine is also required for psychiatry training. A total of eight 4-week blocks and one 2-week block will be spent in family medicine rotations to begin residency training.

PGY1
Family Medicine Psychiatry
McKeesportSt. Margaret’s  
Family
Medicine 101
4 weeksOutpatient
Family
Medicine
2 weeks10th Floor – Inpatient
Dual-Diagnosis
Psychiatry
8 weeks
Inpatient
Family
Medicine
8 weeksInpatient
Family
Medicine and
Geriatrics
8 weeksNeurology -
Presbyterian Hospital
4 weeks
ICU4 weeksICU4 weeksEmergency Psychiatry6 weeks
Obstetrics4 weeksObstetrics4 weeks  
Inpatient
Surgery
4 weeksInpatient
Surgery
4 weeks  
Night Float2 weeksNight Float2 weeks  
Outpatient
Pediatrics
4 weeksOutpatient
Pediatrics
2 weeks  
Outpatient
Gynecology
4 weeksNewborn
Nursery
2 weeks  
  Pediatrics
Emergency
Department
4 weeks  
  Emergency
Department
2 weeks  
Total34 weeksTotal18 weeks
Total as 4 week Blocks8.5 blocksTotal as 4 week Blocks4.5 blocks

½ day FHC (ambulatory) during these rotations
½ day Family Medicine Didactics during these rotations
No ½ day Psychiatry Didactics during first 26 weeks of these rotations
Combined residents would be unable to attend WPIC teaching during "Night Float" or ICU rotations, therefore they should not do these after week 26 of PGY1
**NOTE: rotations on the Family Medicine side are subject to change based on flexibility, availability and personalization of schedule.

½ day Psychiatry Didactics during these rotations

The details of the family Medicine rotations can be found on the websites of the individual family medicine residency sites:

UPMC St. Margaret Family Medicine Residency Program

UPMC McKeesport Family Medicine Residency Program

This initiation into medicine is followed by psychiatric rotations including an eight week block on the Dual Diagnosis Unit (WPIC 10th Floor), a four week block on Neurology Consults (Presbyterian Hospital-PUH), and a six week block in Psychiatric Emergency Services in the Diagnostic and Evaluation Center (DEC) at WPIC to conclude a full first year.

The details of these psychiatric rotations can be found in the general categorical psychiatry residency link.

PGY2

The second year expands on the inpatient experiences in both disciplines and offers the beginning of psychotherapy training.

PGY2
Family Medicine Psychiatry
McKeesportSt. Margaret’s  
Cardiology4 weeksCardiology4 weeksInpatient Adult Mood
Disorders Unit (11th Floor)
10 weeks
Inpatient
Pediatrics
4 weeksInpatient
Pediatrics
4 weeksNeurology - Presbyterian
Hospital and/or
Children’s Hospital
4 weeks
Newborn
Nursery &
NICU
4 weeksGynecology4 weeksInpatient Adult Psychosis
Unit (9th Floor)
10 weeks
Emergency
Medicine
4 weeksObstetrics4 weeksAdult Consult & Liaison
Psychiatry – Presbyterian
Hospital
10 weeks
Night Float2 weeksOutpatient
Family
Medicine
2 weeks  
Total18 weeksTotal34 weeks
Total as 4 week Blocks4.5 blocksTotal as 4 week Blocks8.5 blocks

½ day FHC (ambulatory) during these rotations
½ day Family Medicine Didactics during these rotations
½ day Psychiatry Didactics all year
**Note: rotations on the Family Medicine side are subject to change based on flexibility, availability and personalization of schedule.

½ day FHC (ambulatory) during these rotations. Optional but recommended during the 20 weeks of inpatient psychiatry.
½ day Psychiatry Didactics all year

The PGY2 resident continues to spend ½ day per week in the family health center except during the 34 weeks of psychiatry when FHC attendance is not required but is usually facilitated.

UPMC St. Margaret Family Medicine Curriculum
UPMC McKeesport Family Medicine Curriculum

The details of these psychiatric rotations can be found in the general categorical psychiatry residency link.

PGY3

The PGY3 year expands on knowledge and skills gained in the first 2 years of both disciplines with a focus on Psychiatry. There is an emphasis on longitudinal outpatient experiences working alongside and at the same level of training as the combined residents’ categorical psychiatry colleagues. There are 12 months of psychiatry rotations during PGY3 with one half day per week required in a Family Health Center.

PGY3
Family Medicine Psychiatry
McKeesportSt. Margaret’s  

½ day FHC (ambulatory) weekly for 52 weeks.
Outpatient Psychosis, (CRS
Clinic) ½ day clinic weekly
52 weeks
Outpatient Adult Mood
Disorders, (Bellefield
Clinic) ½ day clinic weekly
52 weeks
Outpatient Geriatric
Psychiatry, (Benedum
Clinic) ½ day clinic weekly
for 6 mos
26 weeks
Outpatient Child and
Adolescent Psychiatry,
 (CCF Clinic) ½ day clinic
weekly for 6 mos
26 weeks
Ambulatory Psychiatry
Elective(s), ½ day clinic
weekly
52 weeks
Psychotherapy Patients,
(Ambulatory) ½ day per
week
52 weeks
ForensicsVariable
Community PsychiatryVariable
Total0 weeksTotal52 weeks
Total as 4 week Blocks0 blocksTotal as 4 week Blocks13 blocks

No Family Medicine Didactics during this year.

½ day Psychiatry Didactics all year
½ day FHC (ambulatory) all year

The details of these psychiatric rotations can be found in the general categorical psychiatry residency link.

PGY4

The PGY4 year will be more concentrated on strengthening residents’ skills in providing outpatient and inpatient medical care with opportunities to integrate Psychiatry and Family Medicine Skills.

PGY4
Family Medicine Psychiatry
McKeesportSt. Margaret’s  
Inpatient
Family
Medicine
4 weeksInpatient
Family
Medicine
4 weeks  
Inpatient
Family
Medicine at
WPIC
4 weeksInpatient
Geriatrics
4 weeks  
Senior ER4 weeksPediatrics
Emergency
Department
2 weeks  
Night Float2 weeksNight Float2 weeks  
Dermatology4 weeksDermatology4 weeks  
Outpatient
Surgery
4 weeksOutpatient
Surgery
4 weeks  
Sports
Medicine
4 weeksSports
Medicine
4 weeks  
Electives8 weeksElective4 weeks  
Outpatient
Orthopedics
4 weeksOutpatient
Medical
Management
4 weeks  
Radiology2 weeksOutpatient
Family
Medicine
4 weeks  
Inpatient
Cardiology
4 weeksICU4 weeks  
Outpatient
Pediatrics
4 weeksOutpatient
Geriatrics
4 weeks  
Obstetrics
(continuity)
4 weeksOutpatient
ENT &
Ophthalmology
4 weeks  
  Teaching
Selective
4 weeks  
Total52 weeksTotal0 weeks
Total as 4 week Blocks13 blocksTotal as 4 week Blocks0 blocks

2 half-days of FHC (ambulatory) during these rotations
½ day Psychiatry Didactics all year
½ day Family Medicine Didactics all year
**Note: rotations on the Family Medicine side are subject to change based on flexibility, availability and personalization of schedule.

½ day Psychiatry Didactics all year

UPMC St. Margaret Family Medicine Curriculum
UPMC McKeesport Family Medicine Curriculum

PGY4 residents will also have 1-2 half-day Family Health Center office hours.

PGY5

The PGY5 year provides an opportunity for residents to further bring together knowledge they have gained in both disciplines and to explore electives designed to integrate the skills they have obtained in family medicine and in psychiatry. Residents also have the opportunity to “round out” their training experience by choosing electives that integrate medical and psychiatric care in a single setting.

PGY5
Family Medicine Psychiatry
McKeesportSt. Margaret’s  
Inpatient
Family
Medicine
4 weeksPediatric
Emergency
Room
2 weeksOutpatient
Psychiatry
Electives
16 weeks
Inpatient
Family
Medicine at
WPIC
4 weeksNight Float2 weeksInpatient
Electives
10 weeks
Sports
Medicine
4 weeksOrthopedics4 weeks  
Outpatient
Surgical
Subspecialties
8 weeksElectives18 weeks  
Electives6 weeks    
Total26 weeksTotal26 weeks
Total as 4 week Blocks6.5 blocksTotal as 4 week Blocks6.5 blocks

3 half-days of FHC (ambulatory) during these rotations
½ day Family Medicine Didactics during these rotations
**Note: rotations on the Family Medicine side are subject to change based on flexibility, availability and personalization of schedule.

No mandatory Psychiatry Didactics all year
3 half-days of FHC (ambulatory) during these rotations

The PGY5 resident will now have three half-days per week in the family health center throughout the year.

The Psychiatry curriculum in the PGY5 year includes required experiences in Community Psychiatry and Forensic Psychiatry. Both of these experiences are ambulatory in nature.

DIDACTICS

The formal didactic curriculum in family medicine during the family medicine components of each residency year will take place at McKeesport or St. Margaret, and consists of organized lectures, seminars, workshops and case conferences specifically focused on topics pertinent to primary care. An evidence-based approach to medical care is strongly emphasized. In all, the family medicine residency program devotes at least 20 hours each month to such sessions with a structured curriculum based on program evaluations. Didactic sessions cover the full scope of family medicine. In general, a resident in the combined program will attend the family medicine didactics when they are on a family medicine rotation.

In psychiatry, it is anticipated that the residents will attend the WPIC Psychiatry Thursday Afternoon Teaching every Thursday afternoon from the mid-point of PGY1 out to the end of PGY4 with the corresponding General Psychiatry Trainees. This formal teaching focuses on a fundamental psychiatric knowledge base upon which subsequent training and education will build. The curriculum includes lectures, seminars, case conferences, grand rounds and workshops.

In addition to formal didactics are the following educational activities at WPIC:

  • Clinical Case Conferences every Wednesday at lunchtime.
  •  Grand Rounds where nationally and internationally recognized experts present a variety of clinically relevant topics.
  • Resident Grand Rounds where senior residents present cases and a multidisciplinary faculty panel discusses the contemporary state of knowledge.
  • Quarterly workshops take place based on resident needs and interests.
  • WPIC Wide Journal Club where residents have the opportunity to be paired with junior and senior faculty, present a recent paper and lead an academic discussion about psychiatry-related topics.

PSYCHOTHERAPY TRAINING

Combined residents follow the same psychotherapy training as the general categorical psychiatry residency.