Clinical Descriptions

Adult Inpatient Psychiatry

Adult Inpatient Psychiatry at UICOMP offers evaluation and treatment of a broad range of psychiatric disorders. The teaching units have been specifically designed across specialty areas to maximize the educational opportunity for our residents. The UICOMP faculty are dedicated teachers who lead multidisciplinary teams of psychiatrists, psychologists, nurses, therapists, social workers and case managers. Residents benefit from collaboration with residents from other disciplines as they learn to manage a variety of psychiatric problems.

Located at UnityPoint Health facilities, the modern and secure teaching units provide comfortable learning environments for residents as they help patients and families with acute and chronic problems. Each eight bed teaching unit has been built around a system that teaches patient flow, admissions, transfers, discharges, rounding, and overall management in a manner that allows for resident education throughout the entire continuum of inpatient patient care.

Each unit is capped for both residents and faculty to achieve a perfect balance between education, experience, opportunities for scholarly activity, and workload. Residents are supported by electronic medical records, a data entry system, lab and ancillary services, and dedicated resident-oriented learning areas.

Residents will learn the full, comprehensive work-up that includes interview of patient and family, record review, social and functional assessment, physical examination review, laboratories, and when to order neuroimaging, EEG or other studies. Residents will become comfortable with pharmacotherapy, interventional strategies, crisis stabilization, individual and group therapies, and social integration. Supportive and insight-oriented individual psychotherapy, family and marital therapy, art therapy, exercise therapy, cognitive-behavioral therapy and relaxation techniques are also taught. Treatments usually focus on immediate stabilization with initial improvement goals, but will span the entire duration of need when necessary.

Residents can expect daily individual faculty supervision with group interactions on morning rounds. Attendance at group and family therapy sessions is supervised and occurs about twice per week.

The teaching units manage persons with serious mental illness including those with mania, schizophrenia, depression, suicidal and violent thoughts, developmental disabilities, dementia, intellectual disability, and serious personality and anxiety disorders. Because the patient population is diverse and draws from many ethnic backgrounds cultural sensitivity is a component of training on the teaching unit.

Many patients are civilly committed so residents learn about legal matters and gain experience in forensic psychiatry at civil commitment and involuntary medication hearings. The hearings occur weekly on site at the hospital. Residents also enjoy supervised, hands-on experience with the practical aspects of the use of ECT, including patient candidacy, pretreatment evaluation, delivery of stimulus, post-stimulation monitoring, and follow-up. A major systems-based practice learning objective is familiarization of the care of chronically ill patients in a complex system.

Geriatric

Persons afflicted with late life mental illness find solace and services through the UICOMP Geriatric Services. Residents will learn the unique aspects of caring for an elderly population through educational methods that are primarily experiential, supported by oral case presentations and discussions, lectures, individual supervision, role modeling, guided readings, and self-directed learning. Both inpatient and outpatient experiences form the foundation of acute care services and education under the guiding hand of clinical specialists.

During the inpatient Geriatric Teaching Unit experience residents will evaluate various behavioral problems associated with Alzheimer and vascular dementia and other cognitive disorders, depression, sleep disorders, anxiety disorders, chronic pain, psychosis, and personality disorders. Delirium accounts for about 5% of diagnoses. Neurodegenerative diseases are also seen. Residents learn the full, comprehensive work-up of persons presenting in all phases of dementia, including interview of patient and family, record review, social assessment, functional history, physical examination, laboratories, neuroimaging, and EEG. The use of collateral data is emphasized. Management is supervised in the use of evidence-based pharmacology, therapeutic measures including family work, functional improvement, social planning, and disposition. Consultation to other medical specialties is common.

The inpatient caseload is capped for residents and faculty and because of the diversity of patient admissions on the specialized teaching unit, residents benefit from the range of patient encounter types. Residents receive daily individual supervision, interact with the entire treatment team, and attend supervised family meetings.

The geriatric outpatient clinical experience complements the educational inpatient experience. Residents follow geriatric patients with mental disease in a subspecialized outpatient clinic during a portion of their third year. The management of chronic illness, often complicated by medical problems, provides residents ample opportunity, under close supervision, to develop their skills in providing superior care for this special population.

Child and Adolescent

The child and adolescent resident experience offers training in the management of youthful patients, focused on individual needs, but with recognition of the importance of family and social systems integration. The inpatient component involves a five-bed teaching unit that represents one end of the full continuum of care necessary for best practices in the care of this population. Residents appreciate the unique opportunity to actively participate in family sessions, parental counseling and consultation to school systems. They learn via supervision, case management, role-modeling, and through assigned current and classical readings in the field of child and adolescent psychiatry.

The teaching environments follow the common childhood diagnoses: conduct disorder, substance abuse, adjustment disorder, depression, attention deficit hyperactivity disorder, bipolar disorder, oppositional defiant disorder, separation anxiety, anorexia and bulimia nervosa, agoraphobia, and psychosis.

Addiction

The resident training site is at Illinois Institute of Addiction Recovery at Proctor Hospital. The Illinois Institute of Addiction Recovery is a renowned hospital-based, state-of-the art, free-standing facility on the campus of UnityPoint Health – Proctor.

Residents learn to assume the role of physician leader of a multidisciplinary treatment team tasked with the assessment and management of addicted patients. The majority of the resident’s education is provided through patient care, consultation, group therapy, medical record keeping, patient education, and attendance at open Alcoholics Anonymous-Narcotics Anonymous (AA/NA) meetings twice per month and other 12-Step meetings at least twice per month. Formal educational activities include assigned reading from appropriate texts and journals and attendance at scheduled seminars.

In addition to alcohol and drug addiction training, residents will have a one-of-a-kind opportunity to learn management principles for persons suffering from forms of addiction, including gambling, spending money, food, sex, video gaming, and internet addiction.

Consultation Liaison

The UICOMP Consultation Liaison service operates at UnityPoint Health – Methodist as a fully staffed service to other disciplines. Residents on this assignment work alongside their medical and surgical peers to provide input in psychiatric management of hospitalized inpatients. Full-time consultation liaison faculty supervise every case. Residents also learn at a monthly consultation case conference and through scheduled didactics while on service. Observational education occurs when residents see an attending interview and collaborate with consultants.

Outpatient

The outpatient clinical experience for residents at UICOMP is second to none. The carefully crafted progression through the four years of training has been designed to afford an organized and thoughtful approach to learning outpatient psychiatry.

A very limited patient population, and intense supervision with the Program Director, introduces residents to outpatient care in the first year. The second year builds on this foundation through one-on-one supervision, modeling and observation. Third year residents are closely supervised in the advanced techniques of cognitive, behavioral, interpersonal, dialectical, psychodynamic, family, group, couples and other therapies. Specialized diagnostic and management clinics offer residents a concentration of patients with which to learn. Residents maintain long term cases from the first two years and begin to appreciate the success of their management. The third year adds community-based clinics and a forensic clinic. The fourth year introduces residents to the administrative, business, and clinical aspects of a modern private practice outpatient model. Residents also continue in long-term therapy with select patients from prior years, allowing for longitudinal counseling and management experiences with some patients over all four years.

Residents are prepared for all aspects of outpatient management that marks today’s varied practice settings, from individual therapy and combined practices to group settings and rapid turnover medication checks.

Forensic

Throughout the training program, residents have the opportunity to learn basic and advanced forensic psychiatry skills in their interaction with fellowship-trained, forensic board certified faculty. Inpatient and outpatient assignments allow exposure to persons who have legal backgrounds, have been court ordered to treatment, or who face involuntary commitment proceedings. Issues such as informed consent, confidentiality, patient rights, and refusal of treatment represent a sampling of forensic psychiatry concerns that will be faced by residents who will learn to competently manage these sometimes difficult scenarios under the direct tutelage of UICOMP faculty.

UICOMP’s comprehensive, full-service Forensic Psychiatry and Psychology Center provides residents with a unique opportunity to learn about the insanity defense, medical malpractice, child custody, and disability evaluations, among many other types of cases, beyond the lecture-room.

Electives

Part of the fourth year is dedicated to advancing resident knowledge and experience in special interests in psychiatry. Each resident is assisted in the design of a personalized elective schedule to meet individual interests and training needs. Residents are encouraged to enhance their clinical skills, investigate areas of potential practice interest and explore opportunities for research.

• Addiction Medicine
• Administrative Psychiatry
• Positive Health Solutions (HIV Clinic)
• Advanced Cognitive Behavioral Therapy
• Child and Adolescent Psychiatry
• Geriatric Psychiatry
• Jump Simulation Research
• Community Psychiatry
• Advanced Dialectical Behavior Therapy
• Neuropsychiatry
• Forensic Psychiatry
• Headache Clinic
• Palliative and Hospice Care
• Psychosomatic Psychiatry
• Inpatient Psychiatry
• Bradley University Clinic
• TMS Clinic
• Sleep Medicine
• Dementia Clinic
• International and “Away” Electives
• Adolescent Outpatient
• Psychiatry in Medicine Clinic (AIMS)
• Pain Disorders Clinic
• Health Kids University
• Huntington Disease for Psychiatry
• Intake Clinic
• Psychological Testing
• Outpatient Veteran’s Administration Clinic
• Psychodynamic Therapy Clinic
• Advanced Pharmacology Clinic

Neurology

Sixteen full time UICOMP faculty support psychiatry residency training in neurology. A combination of inpatient and outpatient experiences affords residents the opportunity to care for patients with cerebrovascular diseases, nervous system infections, tumors, traumas, neuropathies, dementias, neurocutaneous disorders, movement disorders, myopathies, demyelinating diseases, autonomic disorders, neuromuscular disorders, and ataxias.

Residents learn clinical neuroscience and discover the value of EEG, neuroimaging, EMG, seizure video-monitoring, sleep studies, and neuropsychological testing. Every week residents attend the neurology residency core didactic series, a case conference, a weekly specialty case conference, a neuroradiology conference, grand rounds, and a monthly journal club. The clinical and educational experience is based at the renowned Illinois Neurological Institute, a joint training and clinical collaboration between UICOMP and Saint Francis Medical Center.

Medicine

First year residents are trained at the OSF Saint Francis Medical Center alongside their internal medicine resident colleagues on the University Hospitalist and Teaching (UHAT) service. Because the UHAT services are a major component of the medicine residency program’s inpatient curriculum, psychiatry residents will benefit from a robust learning environment. The UHAT services involve patients with a wide array of medical conditions allowing residents to learn history and physical exam skills, medical decision-making, procedural and communication skills, and to direct and coordinate safe and effective care within the larger context of the healthcare system. Residents present each patient to a faculty member and discuss the proposed plan of care. Residents attend the daily core lecture series, regular noon lectures and grand rounds.

Psychiatry residents are supervised by full-time board-certified faculty in the Department of Internal Medicine. Psychiatry residents work within the strict RRC guidelines for patient case load and duty hours.

Family Medicine

The UnityPoint Health Family Medicine Residency serves as the training venue for psychiatry residents during a one-month family medicine experience. Residents learn alongside their family medicine colleagues (who, in kind, spend time on our consultation liaison service). A large catchment area assures that residents will evaluate a broad spectrum of illnesses and learn the comprehensive methods of managing acute and chronic disease. Residents are supervised by one of eight full-time, board-certified faculty in the Department of Family Medicine. One-on-one teaching, a core didactic curriculum, and small group conferences provide a superb training opportunity for psychiatry residents.