The third year of training begins with a four-month block of rotations in internal medicine, after which the residents join their categorical psychiatry counterparts in the outpatient setting for next 12 months. Residents split their time in outpatient psychiatry between the Adult Psychiatry Clinic at the University of Iowa Hospitals and Clinics and the Veterans Affairs Medical Center. Residents also spend one half-day per week at the Community Mental Health Center for Mid-Eastern Iowa.
At University of Iowa Hospitals & Clinics, residents see patients with a variety of illnesses – depression, anxiety, bipolar disorder, schizophrenia, attention deficit hyperactivity disorder, personality disorders, substance use disorders, eating disorders, adjustment disorders, etc. Appointments are generally 90 minutes in length for a diagnostic evaluation, 30 minutes for follow-up medication management, and 60 minutes for post-discharge follow-up. In an appointment, residents interview the patient, staff the case in a conference room with an attending faculty physician, and return to the patient (with the faculty physician) to finalize the treatment plan. Psychotherapy patients are also scheduled during clinic months. Residents are expected to follow three patients per week for the entirety of the 12 months in the Adult Psychiatry Clinic.
At the Veterans Affairs Medical Center, residents are exposed to a wide range of diagnoses, including a large amount of post-traumatic stress disorder cases. Appointments are the same length as those at University of Iowa Hospitals and Clinics, but there is more autonomy in the decision making process. For example, residents are not required to staff each patient and staff do not see the patients unless the resident feels there is a compelling reason. Instead, residents sit down with staff between patients or at the end of the day to discuss cases and get feedback on treatment plans.
In both locations, third year residents provide on-call support, usually once every other week. At University of Iowa Hospitals & Clinics, on-call time is spent on emergent appointments and phone calls. At the Veterans Affairs Medical Center, on-call time is spent on consults and emergency room patients.
Third year residents continue to follow a panel of patients in an outpatient setting one half-day per week through a continuity of care clinic at University of Iowa Hospitals & Clinics or the Veterans Affairs Medical Center. Unlike with the Internal Medicine rotations, Psychiatry rotation are not on a X+Y system, and consequently, there is no week-long Continuity of Care Clinic.
For a more in-depth look at each year of training, explore the following: