Residency Education Program         
Clinical Rotations     

PGY I Year

The first postgraduate year is structured so that residents are able to tailor rotations to their individual strengths and interests.  Rotation schedules for both MD and DO residents are below.

Core rotations needed for board eligibility include:

        * All residents have at least 4 months of some combination of Medicine, Family Practice, and/or Pediatrics.

Electives may include:  infectious diseases, pulmonary, hematology-oncology, cardiology, critical care, pediatrics, forensic, pathology, and other rotations.

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PGY II Year

The PGY-II year is both in and outpatient based.  Psychiatry is more and more an outpatient-based specialty and very ill patients are now treated as outpatients.  Fewer patients are hospitalized, and hospital stays are focused around acute stabilization.  In order to provide residents with the kinds of skills needed for the future practice of psychiatry, we emphasize short-term inpatient treatment skills and outpatient based treatment for patients with both acute and chronic psychiatric disorders.

Adult Psychiatry Unit

During the PGY-II year, residents finish their inpatient experience with four more months on the Adult Inpatient Psychiatry Unit.  This unit is the primary admitting unit for the local community mental health center.  Many patients presenting with severe and chronic psychiatric disorders are seen.  The average length of stay is approximately 10 days. Residents are part of a multidisciplinary treatment team and assume primary psychiatric care for a number of patients.  Faculty members, who also serve as team leaders, supervise residents.  Evaluation, diagnosis, and treatment in a biopsychosocial framework are emphasized in the supervisory relationship.

Addictions Medicine

Substance use disorders are common in the general population and even more frequent in psychiatric populations.  PGY-II residents rotate for 1 to 2 additional four-week blocks on the inpatient addictions medicine unit at Sparrow Hospital, St. Lawrence Campus. This 12-bed unit sees patients who use alcohol, cocaine, opiates, and other addictive substances. Patients are admitted to detoxify and for short-term treatment before transitioning to intensive outpatient treatment.

Child and Adolescent Psychiatry

During the three-month child and adolescent rotation, residents evaluate and treat children, adolescents, and their families in settings ranging from a university clinic to rural community mental health centers.  Residents will see a wide range of childhood psychiatric disorders.  They will spend one day a week with an MSU attending child and adolescent psychiatrist at the Gratiot County Community Mental Health Center and the Shiawassee Community Mental Health Center where rural poor populations are seen.  Home-based services, traditional therapies, and respite care are also available in these settings.  Residents have primary responsibility for patient care on the child and adolescent rotation and are part of the treatment team when at both community mental health centers.

Geriatric Psychiatry Rotation

The Geriatric Psychiatry rotation is an outpatient-based rotation.  Rotation locations include the MSU Psychiatry Clinics, the Sparrow Hospital Consultation-Liaison Service, and Porter Hills Presbyterian Village in Grand Rapids. PGY II-III residents rotate for a 2-3-month block on a full time basis to the evaluation and management of the frail elderly.  The MSU clinic is a full-day Friday rotation that provides psychiatric consultation to primary care physicians, specialists and concerned family members.  Residents are exposed to common late life psychiatric disorders including dementia, delirium, depression, psychosis and adjustment disorders.  The rotation is also used as a training site for medical students as part of their psychiatry clerkship experience.  Residents spend one day doing consults on medically ill patients with psychiatric conditions at Sparrow Hospital and one day at a nursing home in Grand Rapids Michigan, caring for very ill or dying patients.

Psychiatry Outpatient Rotation

The outpatient clinic experience is a 12 to 16-week block beginning in the latter part of  the PGY-II year.  This long rotation givens residents an opportunity to follow patients over a long time period and to begin to appreciate the natural history of psychiatric disorders.  Residents rotate half of the time in community mental health outpatient clinics and the other half in the University clinic.

Psychiatric Emergency Services

Emergency services at the community mental health center is the psychiatry emergency department for the Lansing Metropolitan Area.  An emergency psychiatry experience is done on a ½ day a week basis at this facility, usually during the outpatient rotation which may be in the PGY-II or III year.

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PGY III Year

The PGY III year continues the outpatient clinic rotation.   Residents continue with 50% time in the Department of Psychiatry Outpatient Clinic and 50% time at the Community Mental Health (CMH) Center.

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PGY IV Year

Consultation-Liaison Psychiatry

Consultation-Liaison psychiatry is a PGY-4 rotation (PGY-2 for residents who will leave for child and adolescent psychiatry) based at Sparrow Hospital main campus in Lansing . The most common consultation questions related to suicidal ideation, depression, dementia and delirium. Residents evaluate patients, provide written consultation and see patients with an attending CL psychiatrist.

Forensic Psychiatry

Forensic psychiatry is a three-part experience that extends from the PGY-II through IV years.  First, residents travel with our child psychologist to an Adolescent Drug Court setting. This special court is designed so that the treating clinicians can meet in chambers with the judge, the probation officer, the family, and juvenile to design the best interventions possible. Residents evaluate and will provide short term treatment in addition to meeting with the court. The second venue for forensics is a traditional rotation to the Ingham County Jail during which residents work with a psychiatrist from the community mental health center providing crisis intervention and very short term treatment to inmates.  Finally, in the PGY-IV year, residents spend Monday mornings interviewing up to 6 patients hospitalized on the inpatient psychiatry unit who are to have commitment hearings. Residents have the opportunity to experience an adversarial judicial proceeding, gaining skills and experience in testifying in the court commitment hearing and being questioned by the judge and the patient’s court appointed attorney.

Hope Network  

Hope Network is a treatment program for patients suffering from closed head injuries.  It includes inpatient residential and outpatient treatment programs. Residents evaluate and treat these patients along with three psychiatrists who have extensive experience working with patients with closed head injuries. This is a rich experience working with some very difficult and complex patients. 

Elective Experiences

Opportunities for elective experiences include an eating disorders clinic, community psychiatry, college mental health, advanced inpatient psychiatry, administrative psychiatry, forensic psychiatry, child/adolescent psychiatry, geriatric psychiatry and rural mental health.  Additionally, many residents interested in long-term psychotherapy work with patients in the outpatient clinic.

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