PGY4

PGY4 Seminars

The PGY4 year is about 50% consultation-liaison (C/L) psychiatry and 50% electives. This year affords the opportunity to include seminars, in addition to C/L psychiatry, on special topics of interest that are not necessarily aligned with residents’ clinical rotations. All require compulsory attendance. As the residency progresses, elective PGY4 seminars are added, based on residents’ interests and experiences.

Advanced Topics in Consultation-Liaison (C/L) Psychiatry; Seminars and Case Conferences – Joseph Vlaskovits MD, Jason Cooper MD

The purpose of this seminar is to provide an in-depth presentation of the consultative help that psychiatrists can provide to patients hospitalized on non-psychiatric services and referred as outpatients from non-psychiatric clinicians. Psychiatric illnesses in medically ill patients are the prime consideration in C/L psychiatry and will form the core subject of this series. DSM diagnostic categories for major mental illnesses secondary to medical illness and/or treatment are discussed in detail, and those mental illnesses most often associated with particular organ system diseases are considered. Special aspects of C/L psychiatry (e.g. consultation for pain syndromes, organ transplantation, palliative care, and C/L services for hospitalized children and adolescents) are discussed. As with the PGY2 C/L presentations, a major emphasis is the interaction of the psychiatrist with all members of the clinical team – non-psychiatric physicians, ward nurses, medical social workers, etc. – in terms of education about mental issues in general and therapeutic approaches to specific patients. 36 hours (9 sessions).

Administrative/Leadership Psychiatry – Joseph Vlaskovits MD, Robert Rubin MD, PhD, Brian Taylor MD, Jason Cooper MD

In this seminar, the role of the psychiatrist as multidisciplinary mental health team leader is developed in detail. Particular emphasis is placed on the complementary roles of mental health professionals, and how to ensure productive working relationships while minimizing tensions among mental health specialties (e.g. whether psychologists should be privileged to prescribe psychotropic medication). The administrative psychiatrist as arbiter of legal issues of involving patients, psychiatrist practice competencies, etc. is emphasized. The professional satisfactions of being an administrative psychiatrist are discussed. 48 hours (12 sessions).

Extraordinary Psychiatric Disorders – Leslie Horton MD, PhD, Robert Rubin MD, PhD

Rare psychiatric syndromes with which the psychiatrist needs to have some familiarity can occur in all ethnic groups; e.g., Munchausen and Capgras syndromes. These are discussed briefly, as are the more common culturally related syndromes, which can present diagnostic and treatment challenges, e.g., psychiatric symptoms in prisoners of war, possession states/exorcism, and “hystero-psychoses” (latah, windigo, etc.). 12 hours (3 sessions).

Forensic Psychiatry – Joseph Vlaskovits MD

These sessions are a continuation of the Forensic Psychiatry seminars in PGY3 year. The purpose is to provide an overview of the development of laws governing involuntary detention of psychiatric patients, their culpability in criminal proceedings, legal competency of patients with cognitive impairment, the status of California institutions for psychiatric patients convicted of law violations, and the interface of legal and medical authority over these patients. Residents are afforded opportunities for psychiatric evaluation of persons facing legal questions in all the aforementioned areas. 12 hours (3 sessions).

History of Psychiatry – Leslie Horton MD, PhD, Robert Rubin MD, PhD

The development of thought on the nature and treatment of psychiatric illness from pre-Greek and Roman times through the present is briefly surveyed. Emphasis is palced on the events of the 20th and 21st centuries that continue to impact contemporary psychiatric practice. Inter alia, concepts of institutionalization, past somatic treatments, and mind-body dualism and its resolution will be considered. The historical antecedents of key developments in psychiatric practice (e.g., ECT, lithium, psychodynamic psychotherapy, and cognitive behavioral therapyare discussed. 8 hours (2 sessions).

Human Sexuality– Leslie Horton MD, PhD, outside experts

The purpose of this seminar is to provide an in-depth consideration of sexual function and dysfunction, including disorders of sexual desire and gender dysphoria. Societal concerns about gender identity is emphasized;(e.g. consideration of the LBGTQ movement). How individuals identify themselves in contemporary terms (e.g. gender-fluid), and what these identities mean for individuals’ psychology, is discussed. 12 hours (3 sessions).

Hypnosis, Biofeedback, Acupuncture, and Relaxation Treatment Techniques – Outside experts

A survey of these techniques is undertaken in this seminar, along with discussion of which patients and conditions might benefit from their inclusion as diagnostic aids (e.g. hypnosis, and as treatment modalities). 8 hours (2 sessions).
Professional Development / Transition to Practice – All faculty.

The emphasis of this residency program is on training psychiatrists to meet the needs of Ventura County mental health programs. As such, the role of the psychiatrist in these programs will be considered from the standpoint of both practicing clinician and administrator/team leader. This seminar series will be carried through all four postgraduate years, with greater frequency in PGY4 year. In later years, post-residency opportunities in public institutions and clinics will be discussed in detail, including both clinical and administrative positions. Opportunities and challenges in private practice, academic and educational settings, and careers in basic and clinical research will be considered. 40 hours (10 sessions).

PRITE Review Course – All faculty. 16 hours (4 sessions).