Message from the Chief Resident
Dr. Lee Bourgeois, MD and Dr. Ryan McQueen, MD
Chief Residents 2013 - 2014
Welcome to the Wake Forest University general psychiatry training program! We are honored to be the co-chief residents for 2013-2014 and would like to provide you with a closer look at our residency training program, especially from a resident perspective.
During the first year of residency training, interns complete five months of adult inpatient psychiatry on the adult inpatient unit at Wake Forest Baptist Medical Center (WFBMC), one month of med-psych inpatient psychiatry at the Salisbury VA, and six months of off-service work. This is to include one month of outpatient neurology at WFBMC, one month of outpatient neurology at the Salisbury VA, two months of outpatient general medicine at the Salisbury VA, one month of outpatient pediatrics at a local hospital-run satellite clinic and one month of emergency medicine at the Salisbury VA.
A real strength of our program is that all overnight call taken by psychiatry residents is psychiatry call at WFBMC. There is no neurology, pediatrics, or general medicine call taken by our psychiatry residents. This allows our interns to develop a solid foundation in emergency psychiatry early in their postgraduate training experience, which serves them well in residency and beyond. Also, all residents rotating through outpatient clerkships are free from clinical responsibilities on Fridays, which is when the department holds all of its various resident seminars, journal clubs, grand rounds, and resident meetings. We feel that this arrangement sets an appropriate balance between clinical work and resident education. The only exception to this is during the first year. Interns round on the inpatient unit on Friday mornings, and then attend an intern-specific lecture series in the afternoon. Also, the program's intern support group, which is run by one or two upper-level residents, provides the interns with a venue to discuss their experiences as new psychiatrists-in-training.
The second year is an important time period in Psychiatry residency training and thus we have made changes to our curriculum to include exposure to subspecialty clinics during this year. Residents will spend 3 months in the Suboxone, ECT, Geriatric, Neurobehavioral, and Child/Adolescent Psychiatry clinics, along with 6 months of consultation-liason psychiatry. We feel that this gives residents early exposure to most subspecialty areas of Psychiatry so that they can begin to prepare their career tract in the area of most interest. Most of these rotations take place at our medical center but there is some exposure to the VA Medical Center as well.
In addition, second-year residents begin working with their own psychotherapy patients. This is often the most exciting (and anxiety-provoking!) part of resident training and to assist with this task, each of our upper-level residents is assigned two psychotherapy supervisors for 1:1 guidance. Residents meet for one hour with each supervisor on a weekly basis to review their psychotherapy cases and discuss important learning issues. This individual attention nicely complements the dedicated psychotherapy didactics provided weekly in our department. In order to give residents a broad education in different psychotherapy modalities, residents change supervisors every year so that they have the opportunity to work with supervisors specializing in the various psychotherapy "schools" (i.e. CBT, psychodynamic psychotherapy, humanistic psychotherapy, brief psychotherapy, etc.). This experience continues until the completion of residency training.
During the third year of training, residents complete 12 consecutive months of adult outpatient psychiatry. A significant portion of this experience is done in our department at WFBMC, but there is also training at the VAMC in Salisbury, NC. Residents also rotate through several off-site psychiatry clinics during their fourth year of training, which exposes the residents to a greater degree of diversity regarding patient background, level/type of care provided and geography.
Adult outpatient off-site locations include an adult outpatient clinic in Mount Airy, the Statesville Assertive Community Treatment Team (ACTT), the Winston Salem VA outpatient clinic, the HOTT project (Samaritan Homeless Shelter) and other rotations that are under development.
In addition to the adult outpatient rotation, PGY-IIIs and PGY-IVs complete three months of psychiatry work at the W. G. Hefner VA Medical Center in Salisbury. The VAMC offers a great deal of flexibility with this rotation, depending upon individual resident interests. This experience can be inpatient, outpatient, medication management, psychotherapy, substance abuse/dual diagnosis, geriatric, young adult, PTSD-oriented, traumatic brain injury-oriented, or some combination thereof. Senior residents also complete one month of child/adolescent inpatient psychiatry at WFBMC. This is especially enjoyable, as it allows residents to work closely with the department's child/adolescent psychiatry fellowship program. During the final two years of their training, residents rotate off-site for additional adult inpatient psychiatry exposure.
Our residency program offers five months of dedicated elective work. Residents are given a great deal of latitude in arranging these electives. Residents frequently arrange electives in forensic psychiatry, sleep medicine, administrative psychiatry and research. Residents are given the opportunity to conduct off-service electives, such as rotations in neurorehabilitation and in neurologic movement disorders.
Throughout the entire training experience, education, research and service are actively encouraged and supported. A few years ago, the resident education curriculum was dramatically improved to provide residents with more instruction in psychotherapy, to go along with the instruction provided in biological psychiatry and psychopharmacology (please see the information regarding didactics for more details). A psychiatry board preparation/test-taking skills seminar, Case Conference Series, and M&M conference were added as well, at the request of the residents. Although research is not a formal requirement for the program, it is strongly recommended that residents gain hands-on experience with psychiatric research, which is certainly not difficult to arrange, given the accessibility of our faculty and their willingness to work with residents on diverse research projects. Recently, several residents have worked on research projects and have authored publications.
From a service standpoint, every year our department works with the hospital and the Mental Health Association of Forsyth County to conduct public anxiety and depression screenings, along with participating in community mental health education activities.
In recent years, our department has played a more proactive role in supporting and improving our training. For instance, the department has been gracious enough to finance membership in the American Psychiatric Association (APA) for every resident in our program, and every year the department provides merit-based scholarships for a handful of selected residents to attend the annual APA and North Carolina Psychiatric Association (NCPA) conventions. Also, the residents are provided representation on the department's Educational Policy Committee and Resident Selection Committee, in order to allow the residents to have a strong voice in departmental matters. The department has also provided for much better educational time protection, so that residents are able to attend seminars.
We hope that this brief introduction to the general psychiatry residency program at Wake Forest School of Medicine has been helpful and informative. Of course, the information provided in this message represents only the tip of the iceberg when it comes to outlining the strengths of our program. If you are interested in our training program, please do not hesitate to contact us, as we would love to hear from you!
Lee Bourgeois, MD and Ryan McQueen, MD
Chief Residents, 2013-2014