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Year Four
The fourth year at Duke provides opportunities for consolidation, specialization and the development of leadership and teaching skills. After any remaining requirements are met in either outpatient child and adolescent psychiatry or community psychiatry, residents are free to choose from a broad range of electives. Alternatively, residents may create a project or elective of their own design in consultation with a faculty sponsor. Often these activities lead to a presentation by senior residents at a Departmental Grand Rounds in the spring of the year.
For those interested in research, there are over 300 departmental clinical research protocols in process in the department at any given time, and as many basic science research projects. Faculty are well accustomed to taking on trainees for extended periods of time as a result of their mentoring role with 3 rd year Duke medical students who do a required year of research.
From the rising PGY-4 class, faculty select an Executive Chief Resident and three other residents to serve as Chief Residents at the VA, John Umstead Hospital , and the Duke Outpatient Psychiatry Clinic. A Med/Psych Chief Resident and a Consultation/Liaison Chief Resident are also chosen from among the combined program residents. These coveted positions offer unique opportunities for residents to hone teaching skills, experience the dilemmas of the "middle manager," learn administrative skills, and serve as a role model for junior residents.
Some popular electives have included:
- Coursework at the Duke/UNC Psychoanalytic Study Center
- International travel for away electives in Europe or Africa
- Virtual reality exposure treatment for anxiety disorders
- Group Psychotherapy including seminar, group leadership and participation in an experiential group
- Duke University student mental health service ( Counseling and Psychological Services or "CAPS")
- Advanced Consultation/Liaison Psychiatry at Duke
- Eating disorders at the Duke Eating Disorders Program
- Dialectical Behavioral Therapy (DBT) for Borderline Personality Disorder including seminar, group leadership and supervision
- Advanced CBT training and research with the Duke Cognitive Behavioral Research and Training Program
- Electroconvulsive Therapy (ECT) with seminar, rounds, ECT consultations and ECT administration
- Geriatric Evaluation Team Clinic and geriatric research with the Duke University Center for the Study of Aging
- Clinical Neuropsychiatry
- Addiction Psychiatry at the VA, Duke Addiction Psychiatry, or John Umstead Hospital ; addictions research with NIDA's Clinical Trials Network
- Pain Evaluation and Treatment
- Complementary and Alternative Medicine at Duke Center for Integrative Medicine
- Mood Disorders Clinic
- Anxiety Disorders Clinic
- Clinical care of patients with obesity at Structure House or Rice Diet Program
- Psychiatry Rehabilitation for severe and persistent mental illness
- Psychopharmacology clinical trials research including PGY-4 entry into the Duke-GlaxoSmithKline Psychopharmacology Fellowship program
- Neuroimaging research elective at the Duke Brain Imaging Center
- Center for Cognitive Neuroscience
- Duke Medical Genomics Training Program
- Laboratory genomics research with the Duke Institute for Genome Sciences and Policy's (IGSP) Center for Models of Human Disease (CMHD)
- Psychiatric consultation to the HIV clinic
- Behavioral Medicine research (e.g. basic and clinical science research in coronary disease, hypertension, diabetes and other disease states)
- Clinical neurophysiology, EEG and ECT research
- Neuroendocrinology research
- Coursework or early entry into mental health services research fellowship
- Development of psychopathology in adults and child/adolescents at the Duke Developmental Epidemiology Program
- Residential addiction treatment at TROSA (Triangle Residential Options for Substance Abusers)
- Advanced child psychiatry electives
- Palliative care and end-of-life issues
- Spiritual aspects of psychiatry at the Duke Center for Spirituality, Theology and Health
- Advanced degree coursework at Duke or local universities
- Women's mental health research (e.g. eating disorders, trauma, mood disorders, chronic pain, infertility, premenstrual dysphoric disorder)
Recent resident research projects have included:
- Depression in patients with congestive heart failure
- Post-CABG mortality in patients on SSRIs
- Effects of glycine agonists on smoking and cognitive psychomotor performance in patients with schizophrenia
- Gender differences in slow wave EEG activity in depressed patients
- Sensory acuities and decision-making strategies of patients with delusional disorder
- History of chlorpromazine
- MRI findings in geriatric depression
- Predictors of treatment response in PTSD
- Creation of a multidisciplinary clinic for the evaluation of patients at risk for Huntington's Disease
- Development of a community screening instrument for PTSD
- Dialectical behavior therapy for geriatric depression
- Munchausen's syndrome
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