Psychiatry Residency

During the PGY1 year, residents will complete four blocks of primary care and two blocks of neurology, in addition to their psychiatric training. The primary care blocks are done in a variety of clinical settings including the hospitalist service at the Salem Veteran’s Affairs Medical Center, as well as the emergency department at Carilion Clinic. At the Salem VAMC our residents get to work with medically complex, acutely ill patients and learn how to manage common medical conditions. In the emergency room at Carilion Clinic, our residents get to work with emergency medicine faculty and see and work with a side of medicine where many of our psychiatric patients come through. Additionally, in the PGY1 year our residents will complete two blocks of neurology. Both emergency medicine and neurology both have residency programs at Carilion, and so both are very experienced with teaching residents. Our interns also complete a Research Scholar block in their first year, during which our interns are exposed to the basics of research and scholarship in the medical community, are oriented to the Institutional Review Boards of our institution, and they begin conceptualizing scholarly work they will continue during their training at VTC. The clinical volume during RSC block is purposefully reduced to allow a little breathing room in a very busy year. Interns will also rotate through the inpatient psychiatry services and begin learning about consultation-liaison psychiatry, as well as addiction psychiatry during their first year.

Example PGY 1 Block Schedule

During the second year of training our residents dive into their psychiatric medicine experiences. These include inpatient psychiatry, consultation liaison psychiatry, emergency psychiatry, experiences focused on addiction and substance abuse, geriatric psychiatry, and child and adolescent psychiatry. Night-float is also done during the PGY2 year and is a chance for residents to be much more independent in their clinical work. 

By the end of this year, the resident will have achieved competency in psychiatric assessments, multimodal treatment of the mentally ill across the lifespan and a comprehensive understanding of the biopsychosocial approach to mental illnesses.  

Example PGY 2 Block Schedule

The PGY3 year in our program is where our residents will learn about outpatient psychiatry and the concepts of continuity of care and psychotherapy. We have a variety of outpatient settings with very diverse populations. We have clinics at our local homeless shelter where we provide mental health care access for the homeless indigent population in our city, as well as a “free clinic” that serves the uninsured and working poor, who often struggle to gain access to any kind of mental health care. We also offer residents the opportunity to really dig into psychotherapy skills during this year with our Evidence Based Psychotherapy curriculum. 

Residents have opportunities to work in different specialty clinics, including geriatrics, OB/GYN and addictions. Experience is provided in various treatment modalities, including medication management, case management, short- and long-term psychotherapies and manualized group therapy. Residents are also assigned a psychotherapy supervisor to meet with weekly. 

During this year, residents are given more responsibility and autonomy, but always have faculty supervision. 

Outpatient clinic assignments can be individually tailored to meet the career goals of residents. 

30% At Salem VA Medical Center (MHC and Therapy)

70% CRMH/CNRV (BFC, CHA, Hollins, Radford, Rescue Mission, high-risk OB)

During the final year of training, our senior residents will have the chance to do electives to round out their training before graduating. Popular electives over the years have included sleep medicine, neuropsychiatry, psychopharmacology, and administrative psychiatry. All our senior residents also do sub-attending rotations in both the inpatient setting, and consult liaison psychiatry. 

Senior residents have a diversified experience in fourth year that covers the essential skills that will enable them to transition to independent practice as well as the opportunity to select elective educational experiences to best complete their training. 

Current Elective Options:

• Catawba State Hospital (Adult and Geriatric)
• Administrative Rotation
• Outpatient Geriatric
• Inpatient
• Consultation/Liaison
• Emergency Psychiatry
• Advanced Consultation
• Ambulatory
• Palliative Care
• Child and Adolescent
• Sleep Medicine
• Interventional Psychiatry
• Pain
• Psycho-Oncology Outpatient
• Court Docket with Roanoke City Courts
• Psychology
• TBI Clinic
• Addiction Medicine

CRMH

PGY 1s will have short calls with direct supervision by senior residents the first six months of training. After eight months of training, they will have 2 24-hour calls. 

PGY 2s will do one-to-two-night floats. Monday-Friday from 7:45pm-7:45am. PGY 2s cover all holiday calls.

PGY 2s and 3s will do approximately 6 24-hour calls.

Salem VAMC

PGY 1s-3s will do 2 short calls and 2 long calls (12 hours).

PGY 4s will do 2 short calls at Salem VA Medical Center.

Residents have the opportunity to moonlight both internally and externally. Moonlighting is offered to PGY 3&4s that are in good standings.