Psychiatric Nurse

RESIDENTS' TOP TEN REASONS FOR CHOOSING JPS 

  1. JPS is located in the Dallas/Fort Worth Metroplex, which is a great central location with lots of job opportunities for family members.
  2. The state of the art Psychiatric Emergency Room is an excellent medical teaching venue for severe and emergent psychiatric illness. Your experience there really prepares you for even the most demanding jobs in psychiatry.
  3. The team atmosphere offers a supportive and fun environment.
  4. We treat a high volume of complex patients for a well-rounded exposure to anything you may encounter once practicing independently.
  5. Our attending to resident ratio is 1.25:1, meaning you have plenty of supervision in handling complex cases.
  6. Competitive salary.
  7. We have changed the rotations so interns work 2 months in outpatient medicine and 2 months in inpatient medicine instead of 4 months of inpatient medicine. The work load is lighter on outpatient medicine, and the medical complaints are more relevant to what you need to know in clinical practice.
  8. Cost of living in Fort Worth and Tarrant County is very affordable.
  9. Residents serve as expert witnesses in court for commitment hearings. This is an excellent learning experience for understanding how to testify in a court setting.
  10. Lots of free food! The cafeteria allows residents a $10 a day allowance and there are catered lunches at least once a week.

OVERVIEW 

Our general psychiatry residency is a four year medical program which is fully accredited by the Accreditation Council for Graduate Medical Education (ACGME), and more recently by the American Osteopathic Association (AOA) as well. We emphasize developing neuropsychiatric skills including the neurologic examination, neuropsychological evaluation of cognitive disorders and neuroimaging. Residents are exposed to biological, psychological and sociocultural theories of human behavior, methods of prevention, diagnosis, and clinical intervention and research projects. Residents learn to diagnose mental illness, to ascertain individual and family needs, to assess the social context of mental illness, to formulate treatment plans and to make appropriate interventions, including follow-up. Residents also learn somatic therapies, such as psychopharmacology and ECT, psychotherapy and the proper utilization of outside resources, such as vocational rehabilitation, 12-step programs and the legal system.

Resident performance is monitored through written evaluations by clinical service chiefs at the end of each rotation and by psychotherapy supervisors every six months. The residency director meets with each resident semi-annually to discuss all medical evaluations and to help individualize training goals. Clinical records are regularly reviewed to evaluate a resident's ability to record an adequate history, mental status, physical and neurological examination, justification for diagnostic and therapeutic procedures and discharge summary.

Residents take the Psychiatric Residents In Training Examination (PRITE) each year to help assess their progress, identify strengths and weaknesses and assist in the preparation for general psychiatry certification examinations taken after graduation. They also participate in mock oral examinations in which they interview a patient, present the case, and answer questions about the case in the presence of a faculty member and as well as a small group of peers. Faculty members, who have served as examiners for the American Board of Psychiatry and Neurology, critique the interview and its presentation.

Research activities, while not required, are encouraged. Junior and senior medical students rotate in the department and house staff are an intimate part of the teaching of these students. Senior house staff participate in the education of junior residents as well.

SEMINARS & CONFERENCES 

Didactic activities are considered an essential component of the total education program. Seminars are arranged so residents will have an opportunity to attend all programs offered within their four years of training. Specialized lecture programs, which meet on Tuesday, are held for first and second year medical residents. An educational day has been established every Friday to allow third and fourth year residents to focus on both required and optional didactics and meet with fellow residents. Throughout the residency, seminar series are scheduled teaching a broad range of topics such as interviewing and assessment techniques, clinical and descriptive psychiatry, psychopharmacology, child and adolescent psychiatry, consultation/liaison psychiatry, theories and practice of psychotherapy, geriatric psychiatry, community psychiatry, neurobiology, forensic psychiatry and cultural psychiatry. Additional educational meetings include a monthly journal club, case conference and grand rounds. Residents also meet monthly during lunch with the program director and a separate monthly luncheon is held to meet with the chief residents (we have two chief residents -- one for operations and another for academics).

In addition to the scheduled seminars and clinical experiences, each resident participates in an hour of weekly supervision for psychotherapy and an hour for clinical supervision, which is separate from clinical site supervision.

CLINICAL EXPERIENCES 

Each program year of the residency builds upon previous experiences. We expect our residents to become increasingly competent in utilizing clinical and laboratory studies in patients that present a broad range of common medical and surgical disorders, in diagnosing these medical disorders and in formulating initial treatment plans. They will be able to provide limited, but appropriate, continuous care of patients with medical illnesses and to make appropriate referrals. Residents are expected to be familiar with disorders displaying symptoms likely to be regarded as psychiatric, and with psychiatric disorders displaying symptoms likely to be regarded as medical. In addition, they will be able to relate to patients, to the members of patients' social networks, and to other members of the health care team with compassion, respect, and professional integrity.

The resident will be highly skilled in choosing treatments, in formulating a thorough differential diagnosis and treatment plan, and in providing continuous medical care. They will be competent in the major types of therapy, ranging from alcohol detoxification to long-term individual therapy and in the provision of psychiatric consultations in a variety of medical, surgical, and community settings. There is an integrated emphasis upon the development of psychotherapeutic skills for each resident. In addition, they will know the indications for and limitations of the common psychological tests.

ROTATIONS 

The training program is reviewed and revised each year in order to meet the education guidelines provided by the Accreditation Council of Graduate Medical Education. The following schedule provides a basic overview.

First-yearSix months Hospital Inpatient Psychiatry
Two months Neurology
Two months Inpatient Internal Medicine
Two months Outpatient Internal Medicine

Second-year
Three months Psychiatric Emergency Center
Four months Hospital Inpatient Psychiatry
Three months Child & Adolescent Psychiatry
Two months Consultation Liaison
Continuous Outpatient Psychiatry is conducted throughout the second year one afternoon a week

Third-yearTwelve months Continuous Outpatient Psychiatry

Fourth-yearOne month Geriatric Psychiatry
One month Substance Abuse Treatment
One month Neuropsychiatry
One month Psychological Assessment
Eight months Electives
Continuous Outpatient Psychiatry is conducted throughout the fourth year

CALL SCHEDULE 

First and Second Year:

Residents can expect 4 to 5 call nights per month when taking Psychiatry call. The resident will work from 7:30-5:00pm when on Inpatient Psychiatry, Outpatient Internal Medicine or Neurology. They then report to the Psychiatric Emergency Center at 5pm and will work until 8am the following morning. The resident is excused from all duties their post call day, and has a minimum of 24 hours off after a call night. Attending psychiatric staff work alongside the residents 24/7 and provide teaching and close supervision.

Because Psychiatry call is a hospital Emergency Room shift, call may not be taken by phone at the resident's home. When working in Inpatient Internal Medicine, the resident takes call for the Internal Medicine service only, and does not take call in Psychiatry. Residents rotating on Inpatient Internal Medicine take in house call every 5 days and may not exceed 30 consecutive hours working in the hospital.

Third and fourth year residents have no night calls but can expect an average of one to two 12 hour shifts per month in the Psychiatric Emergency Center from 8am to 8pm on weekends.

MOONLIGHTING 

After completion of their first year of training, residents can request approval from the Department's Education Committee to participate in moonlighting on weekends and evenings. Many residents supplement their income by working in local mental health facilities.

For more information about the JPS Health Network residency programs, please contact: nursing@jpshealth.org