The Rush University General Psychiatry Residency Program has been designed to provide residents with comprehensive training in all of the major areas of clinical and scholarly activity pertinent to a general psychiatrist. This training is enhanced by providing residents with multiple other unique training experiences that help distinguish our program. Supported by supervision from experienced, enthusiastic faculty, senior residents, academic conferences and seminars, the residency program aims to develop residents into highly qualified and thoughtful psychiatrists.

First Year Clinical Rotations

• Five rotations on adult inpatient psychiatry.
• Four rotations of primary care medicine—residents choose either three months of internal medicine and one month of adult emergency medicine, three months of pediatrics and one month of emergency pediatric medicine, or two months of internal medicine and one month of pediatrics and one month of pediatric emergency medicine.
• One rotation of adult neurology.
• One rotation of community psychiatry.
• One rotation in our Psychiatric Day Treatment Program.
• One rotation in child inpatient and outpatient and child consult liaison psychiatry.

Adult Inpatient Psychiatry Rotations
During training on the adult inpatient psychiatry units, residents become adept at taking a psychiatric history and performing a complete mental status examination. They develop skills evaluating and treating psychiatric emergencies on the inpatient units and in the emergency rooms. They learn to formulate and to implement comprehensive treatment plans, including the use of psychopharmacological and psychotherapeutic approaches, as well as aftercare planning as part of a multidisciplinary team.

There are two adult psychiatry inpatient units at Rush University Medical Center. There is a 16 bed general adult inpatient unit. This unit cares for patients who suffer from a full range of acute psychiatric disorders that require inpatient treatment. The second adult inpatient unit is a mood disorders unit. This unit has 18 beds and focuses care on adults with mood disorders. There is a strong emphasis on the use of group cognitive behavioral therapy as well as the use of the state of the art psychopharmacological and device based therapies for people who suffer from major depression, bipolar disorder and co-morbid anxiety disorders.

First- and second-year residents are the primary care providers for the patients admitted to the units. Residents present new cases to the senior resident assigned to the inpatient unit during morning rounds for further clinical supervision. Residents discuss cases each day with the attending of record, participate in rounds with the inpatient unit leader three times per week and receive additional supervision from senior faculty members during teaching rounds.

Residents on these rotations also have the opportunity to participate in inpatient clinical research trials. One of our internationally recognized scholars of clinical research and psychopharmacology, Dr. Philip Janicak, is the Director of a team that conducts inpatient research studies. He and his collaborators work closely with the residents to provide clinical care to patients admitted to the studies and to improve the residents’ understanding of psychopathology, psychiatric treatment and research design.

Child Psychiatry Inpatient and part-time Outpatient and Consult Liaison Rotation
This four week rotation exposes residents early in their training to an in-depth experience in child psychiatry. This provides residents who are contemplating a career in child psychiatry with clinical experience to help them make this important career decision. Most of this rotation involves work on an inpatient child psychiatry unit. Additionally, the PGY-1s may accompany the child psychiatry fellows to perform psychiatric consults on the pediatrics units.

Community Psychiatry
Led by Dr. Jay Devulapally, a graduate of the residency program, this important rotation provides residents with community psychiatry experience caring for patients with chronic psychiatric conditions. The clinics where the residents work are run by Thresholds. Thresholds is a large, highly respected, regionally based agency that specializes in providing integrative psychosocial care and rehabilitation to people with chronic mental illness. Many of the patients treated by residents during this rotation may be followed by the residents during inpatient rotations when admission is necessary. The residents are provided with the important experience of observing some patients during both acute and less acute presentations.

Primary Care Rotations
Residents complete four months of training in primary care. They choose between three months of internal medicine and one month of adult emergency medicine, or three months of pediatrics plus one month of pediatric emergency medicine or two months of internal medicine and one month of pediatrics and one month of pediatric emergency medicine. Both the Department of Medicine and the Department of Pediatrics and their training programs have earned Rush national recognition for clinical excellence.

Psychiatry Day Treatment Program
Each PGY-1 rotates for four weeks in our Psychiatric Day Treatment Program. This rotation provides residents with the opportunity to participate in care for patients who do not require inpatient treatment but are in need of the benefits of an intensive therapeutic milieu. Residents help lead psychiatric groups, participate in individual and family sessions. They learn and practice integrating multiple different psychotherapeutic and psychopharmacological interventions in the care of patients with many different psychiatric disorders.

Neurology Rotations
Residents fulfill their neurology requirements by spending one month on the neurology service during their PGY-1 and one month on the neurology service during their PGY-2. The Department of Neurology at Rush has a national reputation for excellence and is consistently a very popular rotation for our psychiatry residents.

Second-Year Clinical Rotations

• Sixteen weeks on consultation-liaison psychiatry
• Eight weeks on adult inpatient psychiatry
• Four weeks of adult inpatient/forensic psychiatry at Cermak Mental Health Services of the Cook County Jail
• Four weeks of chemical dependence at the Resurrection Behavioral Health Impaired Professionals Program
• Eight weeks at the John H. Stroger Jr. Hospital of Cook County, which includes rotations in emergency psychiatry and in an outpatient psychiatry HIV walk-in clinic and a developmental disorders clinic
• Eight weeks of inpatient geriatric psychiatry
• Adult outpatient clinic one afternoon per week for the entire year
• Four weeks of adult neurology

Consultation-Liaison Psychiatry
Residents complete four rotations on the consult service providing consultations to the medical and surgical floors. Residents round with four attending psychiatrists assigned to the consult service. Consults range from the assessment and management of delirium to providing short-term psychotherapy to patients during their hospitalizations.

Adult Inpatient Psychiatry
Residents spend eight weeks providing care to patients with severe mental illness admitted to either of our two adult inpatient psychiatry units. Residents build upon the insights and experience that they developed during their PGY-1 training to provide the primary psychiatric care to the patients assigned to them. The mood disorders unit has 18 beds and focuses care on adults with mood disorders. There is a strong emphasis on the use of group cognitive behavioral therapy as well as the use of the state of the art psychopharmacological and device based therapies for people who suffer from major depression, bipolar disorder and co-morbid anxiety disorders. Residents on this rotation also have the opportunity to participate in inpatient clinical research trials. Dr. Philip Janicak, is the Director of a team that conducts inpatient research studies. He and his collaborators work closely with the residents to provide clinical care to patients admitted to the studies and to improve the residents’ understanding of psychopathology, psychiatric treatment and research design.

Adult Inpatient/Forensic Psychiatry Rotation at the Cermak Health Services of the Cook County Jail
This adult inpatient rotation allows residents to work in a correctional institution providing inpatient adult psychiatric treatment. The patients suffer from a wide variety of psychiatric conditions. The rotation includes three special seminars in forensic psychiatry that enhance the residents overall experience in this psychiatric specialty. The seminars include a weekly civil forensic case review, psychological testing in the forensic setting and a seminar with an attorney who is a scholar in forensic psychiatry.

Chemical Dependence Rotation
Residents rotate at the Resurrection Behavioral Health Impaired Professionals Program. This program is located adjacent to St. Joseph Hospital in the heart of Lincoln Park in Chicago. This is a nationally recognized chemical dependence day treatment program that specializes in the care of health care professionals. This unique rotation allows residents to work as part of a multidisciplinary team providing group and individual chemical dependence treatment for patients from their own professional background. Residents strengthen their understanding of group therapy, the 12-step model, and individual therapies for people with substance abuse.

John H. Stroger, Jr. Hospital of Cook County
During this eight-week rotation, residents spend a majority of their time providing psychiatric consultations in the emergency department of this world famous public hospital. Residents spend the remainder of the rotation working in two different mental health clinics. The remainder of the rotation is split between working with two psychiatrists that specialize in the treatment of patients infected with HIV that suffer from co-morbid psychiatric conditions and in child psychiatry clinic that cares for children with autistic spectrum disorders.

Inpatient Geriatric Psychiatry
During this two-month rotation, which takes place at the Johnston R. Bowman Center for the Elderly, located on the Rush campus, residents gain further experience caring for psychiatric conditions in the older adult population. Residents work closely with the treatment team, including specialist in geriatric psychiatry, internists, psychiatric nurses, social workers and with the patients’ families providing comprehensive care to elderly patients requiring inpatient psychiatric treatment. Residents also accompany faculty to nursing homes in the Chicago area to observe psychiatric care in this vitally important setting.

Outpatient Psychiatry during the Second Year of Training
All second-year residents are assigned to spend one half-day per week treating their own outpatients in the residents’ outpatient psychiatry clinic. Residents receive on-site supervision from an attending psychiatrist assigned to the outpatient clinic and from at least two individual supervisors. Residents treat patients for weekly psychotherapy and for medication management during this year long, part-time rotation.

Third-Year Rotations: Focusing on Adult and Child Outpatient Care

• Outpatient Intake Clinic – Residents evaluate at least one adult patient per week under the direct supervision of one of our outpatient attending psychiatrists. Our outpatient social worker provides additional consultation to the treatment team on most of these evaluations. Patients evaluated in these clinics are either followed up by the resident or referred to other residents or clinicians as clinically indicated.
• Adult Individual, Couples and Family Outpatient Psychotherapy – Residents treat multiple adult patients each week with individual psychotherapy. Residents utilize psychodynamic, cognitive behavioral and other widely accepted psychotherapeutic treatment modalities. All residents are expected to see many patients on a weekly or possibly twice-weekly basis, to help them develop expertise in different psychotherapeutic models. Additionally, all of our faculty members concentrate on teaching residents about the integration of psychotherapy and psychopharmacology. All residents are referred couples therapy cases during their PGY-3 and PGY-4 training and all residents have numerous family therapy intervention experiences throughout their outpatient training.
• Bipolar Clinic – Each PGY-3 residents rotates for twelve months for a half day each week in our Bipolar Disorders Clinic. The residents are supervised directly by one of the Bipolar Clinic Directors. One of the clinic directors is the Department Chair, Dr. William Scheftner and the other clinic director is the Program Director, Dr. Daniel Levin. During this rotation, the residents evaluate and provide follow-up care to patients with bipolar disorder. Bipolar Disorder is frequently an extremely complicated condition to treat. This rotation assures our residents that they will receive a significant amount of exposure treating patients with this condition.
• Outpatient Child Psychiatry - Residents complete a twelve month, part-time outpatient child psychiatry rotation during their third year. Each resident spends a half-day each week running their own child psychiatry outpatient clinic under the direct supervision of Dr. Adrienne Adams. Dr. Adams is the Program Director for our Child and Adolescent Fellowship Program. Residents treat children with both psychotherapy and medication management during this rotation. They also attend the weekly child psychiatry case conference during this rotation. Residents also observe care in the Rush University Child Therapeutic Day School.
• Kreaplin Clinic: This clinic focuses on the treatment of psychotic spectrum disorders. This clinical experience assures that our residents obtain additional outpatient experience caring for patients who suffer from schizophrenic spectrum disorders. Residents learn to utilize the full range of anti-psychotic agents including clozapine, and long term injectable agents in the outpatient setting. This rotation is supervised by one of our Associate Program Directors, Dr. Jeffery Rado. Dr. Rado is board certified in Psychiatry and in Internal Medicine. He utilizes his dual training to train residents on the risks and management of metabolic problems associated with many anti-psychotic agents. Dr. Rado is also very involved in clinical research. This rotation is another gateway for clinical research experience for our residents. Residents spend 1.5 hours each week during their PGY-3 in this clinic.
• Supervision in the Outpatient Clinic: One of our Co-Outpatient Directors, Dr. Amanda Kleinman, assigns each resident rotating in the clinic with a scheduled 30 minute meeting with an onsite attending psychiatrist for each day or half-day they work in the outpatient clinic. Additionally, each resident is scheduled for a half hour of individual supervision with an on-site faculty psychiatrist and social worker to present, see and discuss the treatment plan of all new patients to our clinic.
• The faculty members responsible for providing the supervision described above are Dr. Bezalel Dantz, who is Director of Medical Student Education, Dr. Amanda Kleinman, Co-Director of the Outpatient Clinic, Dr. Daniel Levin, Psychiatry Program Director, Dr. Jeffery Rado, one of the Associate Program Directors, Dr. Daniel Rosenthal, Director of the combined Internal Medicine and Psychiatry Program, Dr. William Scheftner, Chair of the Department of Psychiatry, and Dr. Carl Wahlstrom, a Forensic Psychiatry expert.
• Residents receive direct supervision in our four PGY-3 specialty clinics. These clinics include our half-day, weekly child psychiatry clinic. Supervision for this training is provided by Dr. Adrienne Adams. Dr. Adams is the Program Director of our Child and Adolescent Psychiatry Fellowship Program. Another weekly half-day clinic is our Bipolar Disorder Clinic run by William Scheftner, M.D. and Daniel Levin, M.D. The third specialty clinic is the Kreaplin Clinic. This clinic cares for patients with psychotic disorders and is supervised by Jeffery Rado, M.D. The fourth specialty clinic is an Urgent Intake Clinic. This clinic is run by Dr. Kleinman and supervised by Dr. Kleinman, Dr. Levin and Dr. Rado.
• In addition to all of the daily on-site supervision described above, all of our PGY-3 General Psychiatry Residents have additional weekly, individual 45 minute psychodynamic and 45 minute cognitive behavioral therapy supervision sessions. Our PGY-2 and PGY-4 General Psychiatry Residents all also receive an additional 45 minute psychodynamic supervision session each week. Group cognitive behavioral therapy supervision is available for all PGY-4 General Psychiatry residents. Additionally, there are many faculty members available for either “curb side” or emergency supervision in the outpatient clinic.

Fourth-Year Rotations: More In-depth Experience

The fourth year of training helps solidify residents’ general education in psychiatry and allows them to gain more in-depth experience in rotations that are of special interest to them. Residents spend at least 10 hours per week treating patients in the outpatient psychiatry clinic. Fourth-year residents serve as the senior administrative and teaching resident on the adult inpatient units, for up to 3 months half-time and serve as the senior resident on the consult liaison unit for 4 weeks half-time.

During the fourth year, residents choose from multiple electives. Some of the electives include Forensic Psychiatry, Consult Liaison, Clinical Research Electives, Electroconvulsive Therapy, Chemical Dependence, Partial Hospitalization Program, Psychiatric Care for Patients with Movement Disorders, multiple Geriatric Psychiatry electives, Community Psychiatry, Psychotherapy Evaluation elective at the Institute for Psychoanalysis, Cognitive Behavioral Therapy and outpatient Neurology Specialty Electives.

Clinical Rotation Schedules
There are (13) 28-day rotation blocks per year for PGY-1s and PGY-2s.

PGY-1
Four Rotations	One Rotation	Five Rotations	One Rotation	One Rotation	One Rotation
Internal Medicine or Pediatrics and Emergency Medicine	Neurology inpatient service and neurology consult service	Adult Inpatient Psychiatry	Community Psychiatry	Adult Psychiatry Day Treatment Program	Child Inpatient and Child Consult Liaison psychiatry
PGY-2
Two Rotations	Two Rotations	Four Rotations	One Rotation	One Rotation	Two Rotations	One Rotation
Adult Inpatient Psychiatry	inpatient Geriatric Psychiatry	Consult Liaison service	Adult Inpatient Psychiatry/Forensics at the Cermak Health Services of the Cook County Jail	Chemical Dependence	Emergency Psychiatry, HIV and Psychiatry Walk-in Clinic and Child Developmental Disorders Clinic at the John G. Stroger Hospital of Cook County	Adult Neurology
Half day per week adult outpatient psychiatry at Rush University Medical Center
PGY-3
10.7 months Adult Outpatient		1 Month Child Outpatient		O.3 Adult Emergency Outpatient Service
Adult individual, couples, and family psychotherapy, Adult Intake Clinics, Psychopharmacology Clinic, Bipolar Disorders Clinic		Outpatient Child Psychiatry Evaluations and follow-up for psychotherapy and medication management and observation in Rush Child Therapeutic Day School		Evaluations of patients in our Outpatient Clinic referred from our Emergency Department for urgent care
PGY-4
6 months	1.5 month	3.7 months		0.3 Months	0.5 month
Adult Outpatient	Senior Adult Inpatient	Psychiatry electives		Emergency Outpatient Rotation	Senior Consult Liaison Rotation