Resident Life

Message from the Chief Residents

	Shannon Pitts, MD Chief Resident		Obinna Ikwechegh, MD Chief Resident

Welcome to the Wake Forest University general psychiatry training program! We are honored to be the co-chief residents for 2008-2009 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 six months of adult inpatient psychiatry on the adult inpatient unit at Wake Forest University Baptist Medical Center (WFUBMC), and six months of off-service work (two months of outpatient neurology at WFUBMC, two months of outpatient general medicine at the VA medical center in Salisbury, one month of outpatient pediatrics at a local hospital-run satellite clinic and one month of emergency medicine at WFUBMC).

A real strength of our program is that all overnight call taken by interns (and indeed all psychiatry residents) is psychiatry call; 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 off-service clerkships are free from clinical responsibilities on Fridays, which is when the department holds all of its various resident seminars, journal clubs, grand rounds, resident meetings and departmental lunches. We feel that this arrangement sets a great balance between clinical work and resident education. 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.

During the second year of training, residents complete six months of consultation-liaison (C/L) and emergency psychiatry. The remaining six months are spent completing the electroconvulsive therapy (ECT) rotation and the outpatient child/adolescent psychiatry experience. All of these second-year rotations are done at WFUBMC.

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. Every week, residents meet separately with these two supervisors (for an hour apiece) to go over their psychotherapy cases and discuss important learning issues relevant to psychotherapy. We feel that 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 six months 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 and fourth years of training, residents complete 12 consecutive months of adult outpatient psychiatry. A significant portion of this experience is done in our department at WFUBMC. Specifically, there are general adult clinics, geriatric clinics and neurobehavioral clinics through which residents rotate during this adult outpatient block. Residents also rotate through several off-site psychiatry clinics during these 12 months, which is ideal since it 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 Mount Airy (working in the local mental health center, in addition to making home visits with the local ACT team), Statesville (working in the local mental health center, in addition to working at the local crisis stabilization unit and with the local ACT team), Yadkinville (working in the local hospital, which runs a mental health partial hospital program and a dedicated substance abuse day program), North Wilkesboro (working in the local mental health center) and here in Winston-Salem (working in the VA psychiatry clinic).

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 WFUBMC. 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. Recent options have included Broughton Hospital (the state psychiatric facility covering western North Carolina, located in Morganton) and the Carolinas Medical Center in Charlotte. Typically, residents spend three months on this rotation.

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), not to mention electives at other training institutions.

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 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 University 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!

Cordially,
Shannon Pitts, MD and Obinna Ikwechegh, MD
Co-Chief Residents, 2009-2010

‹‹‹‹ return to Psychiatry News