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RESIDENCY REVIEW COMMITTEE FOR PSYCHIATRY

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RESIDENCY REVIEW COMMITTEE FOR PSYCHIATRY RESIDENCY REVIEW COMMITTEE FOR PSYCHIATRY Document Transcript

  • RESIDENCY REVIEW COMMITTEE FOR PSYCHIATRY 515 N State, Ste 2000, Chicago, IL 60654 • www.acgme.org GERIATRIC PSYCHIATRY PROGRAM INFORMATION FORM FOR NEW APPLICATIONSGENERAL INSTRUCTIONSThis form is for use by programs making Initial Application Only (for re-accreditation, use the ContinuedAccreditation PIF and the Accreditation Data System). All sections of the form applicable to the program must becompleted in order to be accepted for review. The information provided should describe the proposed program.For items that do not apply indicate N/A in the space provided. If any requested information is not available, anexplanation should be given and it should be so indicated in the appropriate place on the form. Mail the completedapplication to the Residency Review Committee at the above address.The Program Requirements, the Institutional Requirements, and Program Information Form (PIF) may bedownloaded from the ACGME Website (www.acgme.org) and should be reviewed carefully. For questions regarding the completion of the form (content), contact the Accreditation Administrator. For Accreditation Data System questions, contact or email WebADS@acgme.org. For a glossary of terms, use the following link – http://www.acgme.org/acWebsite/GME_info/gme_glossary.aspProgram Letters of Agreement (PLA): Attach at the end of the PIF a letter of agreement (PLA) for eachparticipating site providing an assignment.The program director is responsible for the accuracy of the information supplied in this form and must sign it. Itmust also be signed by the DIO of the sponsoring institution.SPECIFIC INSTRUCTIONSInstructions: Instructions have been provided at the top of each section of the forms. Please read them carefullybefore providing information. Information submitted should be as complete and as concise as possible. Do notattach any unrequested materials such as curriculum vitae, reprints, brochures, annual reports, residenthandbooks, minutes of meetings, etc.For "LENGTH OF ASSIGNMENT," give the total number of months that each Geriatric Psychiatry resident spendsin that site at each level of training. Time spent on each rotation should be expressed as full-time-equivalentmonths. The total amount of time in training should add up to at least 12 months. For "Local Program Director,"list the person who supervises resident training in Geriatric Psychiatry at that site. Also note that "Year 1" refers tothe first year of the Geriatric Psychiatry training program regardless of how many post-graduate years the residenthad before entering the Geriatric Psychiatry program.Attachments: Be sure to include the following attachments:1) An explanation for any participating sites that is not JCAHO-accredited.2) A letter of affiliation as Section 6.0 for all participating sites in which residents receive required training.3) A copy of the written due process policy and procedure.residency-review-committee-for-psychiatry2517.doc i
  • Approval ProcedureResidencies in Geriatric Psychiatry are evaluated by the Residency Review Committee for Psychiatry at each ofits two meetings during the year. These meetings are usually in the spring and fall. The Committee closes itsagenda ten weeks prior to each meeting. Review materials not received by that time may not be considered untilthe subsequent meeting. As a consequence, there may be a delay in excess of six months between the time ofthe site visit and the review of the program by the Committee.residency-review-committee-for-psychiatry2517.doc ii
  • RESIDENCY REVIEW COMMITTEE FOR PSYCHIATRY 515 N State, Ste 2000, Chicago, IL 60654 • www.acgme.org GERIATRIC PSYCHIATRY PROGRAM INFORMATION FORMProgram Name:TABLE OF CONTENTSWhen you have the completed forms, number each page sequentially in the bottom center. Start on Part 1,Section 1 of the PIF. Report this pagination in the Table of Contents and submit this cover page with thecompleted PIF. 1Part 1 Section Page(s)General Program Information 1Participating Institutions 2Fellow Complement 3Faculty / Teaching Staff 4 Part 2 Section Page(s)Background Information 5Rotations 6Scheduled Seminars & Conferences 7Clinical Services 8Affiliations 9Other Professional Staff 10Evaluation Methods 11Due Process Procedures 12Selection & Appointment Process 13Clinical Training & Additional Issues 14residency-review-committee-for-psychiatry2517.doc 1
  • 1RESIDENCY REVIEW COMMITTEE FOR PSYCHIATRY 515 N State, Ste 2000, Chicago, IL 60654 • www.acgme.org PROGRAM INFORMATION FORM (Part 1) FOR NEW APPLICATIONS ONLY – GERATRIC PSYCHIATRYSECTION 1. GENERAL PROGRAM INFORMATIONA. Accreditation InformationDate:Title of Program:10 Digit ACGME Program ID# (for accredited programs):Accreditation Status: Effective Date:Original Accreditation Date: Accredited Length of Training:Program Requires Prior GME: ( ) YES ( ) NO Last Site visit Date: Cycle Length:Core Program InformationTitle of Core Program:Core Program Director:10 Digit ACGME Program ID#:Accreditation Status: Effective Date:Next Review Date: Last Review Date: Cycle Length:The signatures of the director of the program and the Designated Institutional Official attest to thecompleteness and accuracy of the information provided on these forms:Signature of Program (and Date):Signature of Core Program Director (and Date):Signature of Designated Institutional Official (DIO) (and Date):B. Program Director InformationName:Title:Address:City, State, Zip code:Telephone: FAX: Email:Date First Appointed as Program Director In This Program?Date First Appointed as Faculty Member In this Program?Term of PD Appointment: Principal Activity Devoted to Resident Education?Primary Specialty Board Certification: Most Recent Date:Secondary Specialty Board Certification: Most Recent Date:Number of Hours Per Week Director Spends In:Clinical Supervision: Administration: Research: Didactics/Teaching:Is the PD based at the primary teaching Number of years Director has taught GME in this ( ) YES ( ) NOinstitution? specialty:Is Program Director also Department ( ) YES ( ) NO If No, Chair Name:Chair?residency-review-committee-for-psychiatry2517.doc 2
  • SECTION 2. PARTICIPATING SITESSPONSORING INSTITUTION: (The university, hospital, or foundation that has ultimate responsibility for this program.)Name of Sponsor:Address: Single Program Sponsor? ( ) YES ( ) NOCity, State, Zip code:Type of Institution: (e.g., Teaching Hospital, General Hospital, Medical School)Name of Designated Institutional Official:Mailing Address: Phone Number: Email:Name of Chief Executive Officer:Does SPONSOR have an affiliation with a medical school (could be the sponsoring institution)? ( ) YES ( ) NOIf yes, name the medical school below and have an affiliation agreement that describes the effect of these arrangements onthis program available.Name of Medical School #1:Name of Medical School #2:PRIMARY Clinical Site (Site #1)Name:Address:City, State, Zip Code:Type of Relationship with Program: Sponsor ( ) Participating ( ) Clinical ( )Type of Rotation Elective ( ) Required ( ) Both ( ) (select one)Length of Fellow Rotation (in months) Year 1:Joint Commission Approved: ( ) YES ( ) NO ( ) N/AContent of Educational Experience:PARTICIPATING Site (Site #2)Name:Address:City, State, Zip Code:Type of Relationship with Program: Sponsor ( ) Participating ( ) Clinical ( )Does this institution also sponsor its own program in this specialty?Does it participate in any other ACGME accredited programs in this specialty?Distance between 2 & 1: Miles: Minutes:Type of Rotation Elective ( ) Required ( ) Both ( ) (select one)Length of Fellow Rotation (in months) Year 1:Joint Commission Approved: ( ) YES ( ) NO ( ) N/AContent of Educational Experience:residency-review-committee-for-psychiatry2517.doc 3
  • PARTICIPATING Site (Site #3)Name:Address:City, State, Zip Code:Type of Relationship with Program: Sponsor ( ) Participating ( ) Clinical ( )Does this institution also sponsor its own program in this specialty?Does it participate in any other ACGME accredited programs in this specialty?Distance between 3 & 1: Miles: Minutes:Type of Rotation Elective ( ) Required ( ) Both ( ) (select one)Length of Fellow Rotation (in months) Year 1:Joint Commission Approved: ( ) YES ( ) NO ( ) N/AContent of Educational Experience:PARTICIPATING Site (Site #4)Name:Address:City, State, Zip Code:Type of Relationship with Program: Sponsor ( ) Participating ( ) Clinical ( )Does this institution also sponsor its own program in this specialty?Does it participate in any other ACGME accredited programs in this specialty?Distance between 4 & 1: Miles: Minutes:Type of Rotation Elective ( ) Required ( ) Both ( ) (select one)Length of Fellow Rotation (in months) Year 1:Joint Commission Approved: ( ) YES ( ) NO ( ) N/AContent of Educational Experience:PARTICIPATING Site (Site #5)Name:Address:City, State, Zip Code:Type of Relationship with Program: Sponsor ( ) Participating ( ) Clinical ( )Does this institution also sponsor its own program in this specialty?Does it participate in any other ACGME accredited programs in this specialty?Distance between 5 & 1: Miles: Minutes:Type of Rotation Elective ( ) Required ( ) Both ( ) (select one)Length of Fellow Rotation (in months) Year 1:Joint Commission Approved: ( ) YES ( ) NO ( ) N/AContent of Educational Experience:residency-review-committee-for-psychiatry2517.doc 4
  • SECTION 3. FELLOW COMPLEMENTA. Number of Positions (For the current academic year). Positions Total Number of Requested Positions Number of Filled Positions* * Not applicable to new programs with no fellows on duty.B. Actively Enrolled Residents (if applicable) List all residents actively enrolled in this program as of August 31 of current academic year (see Section 3.A). List names alphabetically within Year in Program. Place an (*) asterisk next to the name of each resident accepted as a transfer. Documentation of previous experience for transfer students should be available for review by the site visitor. Program Expected Years of Year of Med Start Completion Year in Prior Specialty of Most School Name Date Date Program GME Recent Prior GME Medical School Graduationresidency-review-committee-for-psychiatry2517.doc 5
  • C. Aggregate Data on Residents Completing or Leaving the Program for the Last Three (3) Years (if applicable) June 30, __ June 30, __ June 30, __ Based in academic year ending: (indicate year) (indicate year) (indicate year) Number of Graduates Who Started in Program Year 1 and Finished this Program* Number of Graduates Regardless of Whether They Began in this Program* Number of Residents That Completed Preliminary Year(s) Number of Residents Who Withdrew from the Program Number of Residents Who Transferred Out of the Program Number of Residents on Leave of Absence from the Program Number of Residents Dismissed from the Program *Excludes residents preliminary complement year(s).D. Residents Completing Program in the Last Three Years (if applicable) List of residents who completed all training for this specialty based on the last academic year ending June 30, ____. Date Took First Stage of Date First Took Second Actual Date of Board Exam - Passed on Stage of Board Exam - Name Start Date Completion First Attempt Passed on First Attempt (Y/N/Unknown) (Y/N/Unknown) List of residents who completed all training for this specialty based on the last academic year ending June 30, ____. Date Took First Stage of Date First Took Second Actual Date of Board Exam - Passed on Stage of Board Exam - Name Start Date Completion First Attempt Passed on First Attempt (Y/N/Unknown) (Y/N/Unknown) List of residents who completed all training for this specialty based on the last academic year ending June 30, ____. Date Took First Stage of Date First Took Second Actual Date of Board Exam - Passed on Stage of Board Exam - Name Start Date Completion First Attempt Passed on First Attempt (Y/N/Unknown) (Y/N/Unknown)residency-review-committee-for-psychiatry2517.doc 6
  • E. Transferred, Withdrawn and Dismissed Residents (if applicable) List of Residents Who transferred to Another Program (From the Current Academic Year and the Previous 5 Years) Name Start Date End Date Transferred to Which Specialty List of Residents Who Withdrew or Were Dismissed (From the Current Academic Year and the Previous 5 Years) Name Start Date End Date Status Reason (up to 50 characters)F. Scholarly Activity (not applicable)G. Duty Hours (if applicable) 1. Excluding call from home, what was the average number of hours on duty per week per resident for the last four week rotation(s)? 2. On average, how many days per week of in-house call (excluding home call and night float) were residents assigned for the last four week rotation(s)? 3. Excluding call from home, what was the longest shift (in hours) worked by any resident during the previous 4 week rotation(s)? 4. On average, do residents have 1 full day out of 7 free from educational and clinical responsibilities? If no, explain: ( ) YES ( ) NO 5. Do residents have a 10 hour period between daily duty periods and after in-house call? ( ) YES ( ) NO If no, explain: 6. Do residents have appropriate duty hours when rotating on other clinical services, in accordance with the ACGME- approved program requirements? ( ) YES ( ) NO If no, explain:residency-review-committee-for-psychiatry2517.doc 7
  • SECTION 4. FACULTY / TEACHING STAFFA. Faculty Roster List alphabetically and by site all physician faculty who devote at least 10 hours a week to resident education. Supply a one page CV for each faculty listed. Primary and Secondary Specialties / Field No. of Average Hours Per Week Spent On Most Years Based Board Recent Teaching Primarily at Certification Certification in This Clinical DidacticName (Position) Degree Site #* Specialty / Field (Y/N)† Date Specialty Supervision Admin Teaching Research(PD)† Certification for the primary specialty refers to ABMS Board Certification. Certification for the secondary specialty refers to sub-Board certification. If the secondary specialty is a core ACGME specialty (e.g., Internal Medicine, Pediatrics, etc.), the certification question refers to ABMS Board Certification.residency-review-committee-for-psychiatry2517.doc 8
  • B. Faculty Curriculum Vitae Provide a one page CV for each faculty member who devotes at least 10 hours to the program.First Name: MI: Last Name:Present Position:Medical School Name:Degree Awarded: Year Completed:Graduate Medical Education (including internships, residencies and fellowships):Program Name Specialty/Field Date From: To: Certification and Re- Certification Information Current Licensure DataSpecialty Certification Year Re-Certification Year State Date of ExpirationAcademic Appointments - List the past ten years, beginning with your current position.Start Date End Date Description of Position(s) PresentConcise Summary of Role in Program:Current Professional Activities / Committees (Limit of 10 in the last 5 years):Selected Bibliography - Most representative Peer Reviewed Publications / Journal Articles from the last 5 years (limit of 10):Selected Review Articles, Chapters and/or Textbooks (Limit of 10 in the last 5 years):Participation in Local, Regional, and National Activities / Presentations/Abstracts/Grants (Limit of 10 in the last 5years):If not board certified, explain equivalent qualifications for RC consideration:residency-review-committee-for-psychiatry2517.doc 9
  • 1RESIDENCY REVIEW COMMITTEE FOR PSYCHIATRY 515 N State, Ste 2000, Chicago, IL 60654 • www.acgme.org PROGRAM INFORMATION FORM (Part 2) FOR NEW APPLICATIONS ONLY – GERATRIC PSYCHIATRYSECTION 5. BACKGROUND INFORMATIONA. Previous Citations or Concerns (if applicable) List the citations from last RRC accreditation if applicable and describe briefly the steps that have been taken to address the citations or suggestions made by the RRC. If documentation is required, provide a specific reference to the information provided in the PIF or append additional support materials. If no citation were listed, inculcate this in the response.B. Changes (if applicable) Briefly describe major changes, other than those included in the response to previous citations and/or concerns (above) that have been implemented since the last survey and review. Include changes in sponsoring organization, participating hospitals, required rotations, resident complement, and facility or facilities.C. Sponsoring Institution/Single or Limited Residency Institution (see ACGME Institutional Requirements) For those institutions which are either a single-program institution (e.g. Psychiatry), or an institution with multiple residencies accredited by the same Residency Review Committee, the institutional review will be conducted in conjunction with the review of the program. Only programs in these two categories are to complete the following institutional questions. Complete only if "single/limited site sponsor" field in Part 1, Section 2 is yes. 1. Provide an institutional statement that commits the necessary financial, educational and human resources to support the GME program(s) and provide documentation that the statement has been approved by the governing body, the administration and the teaching staff (Insert 1). 2. Describe the formal method by which a periodic evaluation of the program’s educational quality and compliance with the program requirements occurs. Explain how residents and faculty in the program are involved in the evaluation process. 3. Describe how the institution complies with the Institutional Requirements regarding “Resident Eligibility and Selection” and the development of appropriate criteria for the selection, evaluation, promotion and dismissal of residents in accordance with the Program and Institutional Requirements.residency-review-committee-for-psychiatry2517.doc 10
  • 4. Summarize how the institution complies with the ACGME Institutional Requirements regarding resident support, benefits and conditions of employment to include the details of the resident contract or agreement as outlined in the ACGME Institutional Requirements. (Do not append the resident contract/agreement to the PIF but state when it is given to the residents and applicants. Have a copy available for verification by the site visitor on the day of the survey with the various items required by the ACGME numbered according to the Institutional Requirements.) 5. Describe in detail the grievance (due process) procedure(s) that is available to residents, including the composition of the grievance committee, and mechanisms for handling complaints and grievances related to actions which could result in dismissal, non-renewal of a resident’s contract, or other actions that could significantly threaten a resident’s intended career development.residency-review-committee-for-psychiatry2517.doc 11
  • SECTION 6: ROTATIONSInstructions: Create a block diagram of the clinical rotations to which residents are assigned in each year of theprogram. Show any percentage of time less than 100 percent for each block of time. If there are alternativepathways, indicate them as shown in the example below, but do not show diagrams for individual residents.Identify the sites in which each rotation occurs. Do not include this example page in the final submission of thedocument.Example:* 4 months 4 months 4 months Geriatric Inpatient Nursing Home Hospice Facility Hospital A 75% 60% 50% Adult Day Health Care Respite Care Outpatient 25% 40% 50% Or 6 months 6 months Geriatric Inpatient Adult Day Health Care Treatment Hospital B 40% 75% Geriatric Nursing Home Outpatient 40% 25% Hospice Facility 20%*The examples in no way imply an ideal program.residency-review-committee-for-psychiatry2517.doc 12
  • SECTION 7: SCHEDULED SEMINARS AND CONFERENCESInstructions: List all scheduled seminars and didactic courses attended by residents using the format below.Provide a full description. Number seminars consecutively so that they may be more easily referenced in laternarratives. Be brief!Format: No.: Title a. Required or elective; b. Principle instructor(s) with professional degree c. Brief description d. Additional attendees e. Length of session, frequency and total number of sessionsExample: 1. Seminar in Psychosocial Aspects of Geriatric Psychiatry a. Required for geriatric residents b. R. Jones, M.D. and W. Green, Ph.D. c. This is a reading seminar in which residents review classical and current literature on developmental and psychological theories of aging. The topics discussed include ageism; retirement; effect of institutionalization; public policy on long-term care; economics; epidemiology of aging populations; changes in family structure; education and care for the caregiver; care settings for the elderly; ethics, quality of life, and brain death; and death and dying. d. Psychology interns and social work students e. 1 hour weekly for 26 weeks 2. Biologic Aspects of Geriatric Psychiatry a. Required for geriatric residents b. R. Black, M.D. c. Dr. Black leads discussions regarding the aging central nervous system including relevant neuropathology, neuroanatomy, neurochemistry, and neurophysiology. Additional readings and discussion include changes in other major organ systems with aging, with special emphasis on sensory receptor changes and psychopharmacology. d. All members of the Geriatric Unit Treatment Team and all trainees assigned to the Unit. e. 1 hour weekly for 26 weeks. 3. Psychiatric Aspects Specific to Geriatrics a. Required for geriatric residents b. T. Smith, M.D. c. Dr. Smith leads a discussion of a residents treatment of geriatric patients focusing on the following issues: bereavement and loss in the aged; psychologic and neuropsychologic testing; clinical psychiatric syndromes in the elderly (e.g. depression and mania and their differing manifestation in old age, paranoid disorders, hypochondriasis, acute and chronic anxiety states, and schizophrenia); transient situational disturbances; sleep disturbances peculiar to old age and the relation of other disorders to normal sleep patterns; grief reactions and issues related to chronic illness, death, and dying; delirium and dementias; syndromes of substance abuse in the elderly; and behavioral and diagnostic skills used in the aging population. d. Attended by geriatric residents only. e. 1 hour every other week throughout the year.residency-review-committee-for-psychiatry2517.doc 13
  • SECTION 8: CLINICAL SERVICESInstructions: Provide a brief narrative description of EACH clinical service indicated in the block diagram toinclude the following information. Do not include this example page in the final submission of the document.Format: Type of Service A. The name of institution(s), whether required or elective, and duration of training, full- or part-time. B. Description of faculty staffing. C. Description of educational activities on this service. D. Breadth of clinical population and experience, including sex, age, ethnic/cultural and socioeconomic mix, diagnoses of patients cared for by this service during a year, and types of treatment provided. E. Average case loads for residents and description of residents clinical activities, including level of responsibility. F. Scheduled supervision: frequency; whether group or individual G. The presence of rotators from other services/programs sharing the same patient population. H. Other (include any other important information relevant to clinical or educational experience).Example:Geriatric Psychiatry Outpatient Clinic A. Required 4 month rotation at Hospital A B. Faculty consists of 2 full-time psychiatrists with added qualification in geriatrics, 1 full-time neurologist, 1 family practitioner with added qualifications in geriatrics, 1 internist with added qualifications in geriatrics, 1 psychologist and 2 half-time social workers; 4 voluntary clinical faculty also spend 1-2 hours weekly at the Clinic. C. Residents spend 2-4 hours weekly in seminars and case conferences; faculty are always available for consultation; Residents are supervised in the medical and neurologic evaluation and management of the geriatric population; and case loads are carefully monitored and controlled for both breadth and variety of experience. D. The Clinic population is about 60% males and 40% females; 60% white, 30% black and 10% Hispanic; all over the age of 65. There are approximately 12 active cases at any time. There were 150 new cases seen during that year. Diagnoses of patients include latent onset schizophrenia, severe depression mood disorders, dementia of the alzheimer type, and other organic brain disorders. The nonpsychotic patients include a variety of conditions such as nonpsychotic depression neurotic conditions and concomitance of other medical diseases. Residents spend their time becoming proficient in the following evaluation and therapeutic modalities: individual psychotherapy, family intervention, group psychotherapy, milieu therapy, behavior modification techniques, psychopharmacology, consultation-liaison, and somatic therapies. E. An average case load for a resident would consist of 10-12 patients in individual psychotherapy, 1 group, 2 families, 2 evaluation cases and 4 long-term management cases. F. All residents have one hour of individual supervision twice weekly, group supervision of group and family work every other week. Additional supervision may be provided on an individual basis. G. Geriatric family practice and internal medicine residents. H. Eclectic faculty experienced in assessment, psychoanalysis, behavior modification and family therapy.residency-review-committee-for-psychiatry2517.doc 14
  • SECTION 9: AFFILIATIONSInstructions: Complete for every affiliation identified on pages 1-3. For any affiliation in which residents receiverequired and selective training, a copy of the letter of affiliation must be attached. Complete, current affiliationagreements that fulfill the Institutional Requirements must be submitted for applications for new programs and forsites that have been added to the program since the last review for existing programs. Affiliation agreements forpreviously approved sites need not be submitted but must be available for inspection by the site visitor. Briefly, innarrative form, describe the facility, distance from primary site of training, the breadth of clinical experience, thefaculty, educational activities, and supervision. Indicate the duration of time the residents spend at the facility,whether full- or part-time, and whether required or optional. Do not include this example page in the finalsubmission of the document.Example: Johnson Hospital (agreement attached) Residents have a required full-time rotation of 4 months duration to this facility. Johnson Hospital is a 600 bed general medical facility with 50 inpatient beds and outpatient services for ages 65 and older, and a 15-bed geriatric psychiatric unit (ages 65 and older) and an outpatient psychiatric clinic. It is located 5 miles from the primary site of training. Fifty percent of inpatients are psychotic with latent onset schizophrenia, severe depressive mood disorders, dementia of the alzheimer type and other organic brain disorders. The nonpsychotic patients include a variety of conditions such as nonpsychotic depression, neurotic conditions and concomitance of other medical diseases. Treatment approaches include individual and group psychotherapy, behavior modification, therapeutic community, psychopharmacology, and family therapy. Residents have primary responsibility for 3-5 inpatients and 3-4 outpatients, and have 3 hours per week of individual supervision. The seminars and conferences and described in Section 4.0. Residents return to the primary clinical site for 1/2 day per week for conferences. The psychiatric faculty consists of 2 full-time geriatric psychiatrists, both certified in general and geriatric psychiatry, 2 psychologists, and 6 psychiatric social workers.residency-review-committee-for-psychiatry2517.doc 15
  • SECTION 10: OTHER PROFESSIONAL TEACHING STAFFInstructions: Other Professional Staff: List psychologists, anthropologists, sociologists, psychiatric nurses, social workers, physiologists, researchpersonnel, etc., who are directly involved in this training program on a regular basis. Do not list occasional lecturers and consultants. Reproduce thispage as necessary. Time devoted to teaching Primarily based at Months per Hours per Scientific or Professional Name, Degree and Title Site 1.2,1.3, 1.4, 1.5 year month Disciplineresidency-review-committee-for-psychiatry2517.doc 16
  • SECTION 11: EVALUATION METHODSInstructions: The following items require a YES (Y) or NO (N) response. Attach a brief description orexplanation where indicated. Be brief! In some cases, written materials, i.e., forms, activity records, patient logs,etc., may be used as documentation. Do not attach these, but have them available on request.A. Evaluations of Residents 1. Does the program director maintain a file that documents the qualifications and progress of each resident? ...........................................................................................................................YES ( ) NO ( ) 2. Does the program provide at least two hours of individual supervision on a weekly basis for each resident, in addition to teaching conferences, rounds or clinical discussions? .................................YES ( ) NO ( ) 3. Are supervisory and other faculty written evaluations of the performance of residents obtained regularly and are they available in a residents file? .........................................................................YES ( ) NO ( ) 4. Are there regularly scheduled evaluative meetings with individual residents to discuss their evaluations and progress in the program? How often? ..............................................YES ( ) NO ( ) How Often ( ) 5. Is a written summary of these meetings entered in the residents training file? .................YES ( ) NO ( ) 6. Does the residents file include copies of all evaluations of performance made in the course of training? ...........................................................................................................................................YES ( ) NO ( ) 7. Do residents receive copies of these evaluations? ............................................................YES ( ) NO ( ) 8. Is the residents entire file accessible to the resident and other authorized personnel? If not, please explain and specifically identify the types of information withheld. ....................................YES ( ) NO ( ) 9. Are there methods by which the residents performance in regard to issues involving clinical responsibilities, ethical behavior, and interpersonal relationships with staff and other trainees evaluated? ...........................................................................................................................................YES ( ) NO ( ) Describe briefly: 10. Is there a final evaluation of the resident upon the conclusion of training that verifies that the resident has successfully completed all required components of the program and is deemed competent to practice independently?...................................................................................................................YES ( ) NO ( )B. Evaluation of Faculty 1. Is there a systematic method for the evaluation of faculty performance by residents?.......YES ( ) NO ( ) Describe briefly, including how this information is made available to the faculty. 2. Is there a systematic method by which the program leadership regularly evaluates the facultys contributions to the educational program? .........................................................................YES ( ) NO ( ) 3. Are the results of this evaluation formally shared with the faculty and used to improve the program? ...........................................................................................................................................YES ( ) NO ( ) Describe brieflyresidency-review-committee-for-psychiatry2517.doc 17
  • C. Evaluation of Program 1. Does the program director meet regularly with residents as a group to discuss the program and to resolve problems? If so, how often? ....................................................................YES ( ) NO ( ) How Often ( ) 2. Are there other systematic methods by which the clinical experiences and didactic programs are evaluated? ........................................................................................................................YES ( ) NO ( ) Describe briefly.D. Goals and Objectives1. Is there a written statement of the goals and objectives of the program that is made available to the residents? ..................................................................................................................................................YES ( ) NO ( ) a. If "Yes", then attach and number as 16a, 16b, 16c, etc. b. If "no", briefly describe how residents are informed about these matters.2. Are the goals and objectives provided to faculty? ....................................................................YES ( ) NO ( )3. Is there a written due process procedure? (Attach a copy.) ....................................................YES ( ) NO ( )4. Do residents receive a copy at the beginning of their training? ................................................YES ( ) NO ( )residency-review-committee-for-psychiatry2517.doc 18
  • SECTION 12: DUE PROCESS PROCEDURESInstructions: Provide a brief narrative description of each incident since the previous accreditation survey inwhich the due process procedures have been formally instituted, including outcome, since the previousaccreditation survey. DO NOT include the residents name, but identify as Resident 1, 2, 3, etc. See the examplebelow. Do not include this example page with the final submission of the document.Example:There has been only one incident. A resident was placed on probation by the Training Committee after the firstsix months of training. Evaluations by supervisors indicated failure to maintain appointments, delays in medicalrecord entries, and lack of attendance at conferences and rounds. The resident requested reconsideration andpresented his rebuttal to the Training Committee. The Committee maintained its original decision. The residentfiled a formal grievance. As specified in the procedures, a Grievance Panel was established. The residentcontended he had been treated unfairly, that he had not been warned and that the expectations were not clear tohim. The grievance was withdrawn, prior to hearing. The resident has continued in the program without furtherdifficulty.residency-review-committee-for-psychiatry2517.doc 19
  • SECTION 13: SELECTION AND APPOINTMENT PROCESS1. Do you accept only applicants whose language facility in English is sufficient to facilitate accurate and unhampered communication with patients and teachers? ........................................................( )YES ( ) NO2. Is there a Selection Committee to assist the Program Director in the appointment of residents? ..................................................................................................................................................( ) YES ( ) NO Briefly describe its composition:3. Is there a procedure for written documentation of the credentials of applicants, including medical school graduation, completion of accredited residency, state licensure, past performance, professional integrity? ...................................................................................................................................................( )YES ( ) NO Briefly describe4. Is this documentation always made a part of the residents permanent training record? .........( ) YES ( ) NO5. Is there a procedure for evaluating and selecting applicants? ................................................( ) YES ( ) NO Describe briefly:6. Prior to entering the program, are all applicants provided with a written description of: a) Clinical rotations and the educational program? .................................................................( ) YES ( ) NO b) Financial compensation and policies regarding vacations and leaves (i.e., sickness, disability, maternity/paternity, etc.)? ...................................................................................................( ) YES ( ) NO c) Liability, medical, and disability coverage, including any important exceptions to coverage? ............................................................................................................................................( ) YES ( ) NO d) Requirements for duty hours and call? ...............................................................................( ) YES ( ) NOresidency-review-committee-for-psychiatry2517.doc 20
  • SECTION 14: ADMINISTRATION AND DIRECTION OF PROGRAMA. Residency Training Committee 1. Is there a Residency Training Committee? .........................................................................( ) YES ( ) NO 2. Is there a resident on the Committee? ................................................................................( ) YES ( ) NO 3. Does the Committee participate in program development? ................................................( ) YES ( ) NO 4. Does the Committee participate in program evaluation? ....................................................( ) YES ( ) NO 5. Does the Committee participate in resident evaluation and/or advancement? ...................( ) YES ( ) NO 6. Is the Committee responsible for teacher and course evaluation and monitoring? .............( ) YES ( ) NO 7. Is there a written description of the Committee and its responsibilities? (Do not attach, but have available upon request.) ....................................................................................................................( ) YES ( ) NO 8. Are formal minutes kept of the Committee’s deliberations? ................................................( ) YES ( ) NOB. Residency Training Records 1. Does the program director maintain files on each resident in training which contain the following: a) Application materials and credentials? .........................................................................( ) YES ( ) NO b) A record of all rotations and clinical assignments? .......................................................( ) YES ( ) NO c) A record of all evaluations? ..........................................................................................( ) YES ( ) NO d) Documentation that all required clinical experiences have been satisfactorily completed? ......................................................................................................................................( ) YES ( ) NO e) A record of all due process actions? ............................................................................( ) YES ( ) NO f) A statement by the program director, upon graduation, that there is no documented evidence of unethical behavior, unprofessional behavior, or serious question of clinical competence? ......................................................................................................................................( ) YES ( ) NOC. Accreditation Responsibilities 1. Since the last accreditation review, has there been a change in program directorship? . ..........................................................................................................................................( ) YES ( ) NO If yes, describe briefly 2. Has this change been reported to the Residency Review Committee? ..............................( ) YES ( ) NOresidency-review-committee-for-psychiatry2517.doc 21
  • SECTION 15: CLINICAL TRAINING AND ADDITIONAL ISSUESInstructions: When a narrative description is requested, include a description of clinical experience, duration,whether required, selective or elective, full or part time, and when the rotation occurs in the training program.Reference the associated seminars from Section 4.0 by number (e.g., Seminars 01, 03). Be brief!A. Clinical Case Conferences 1. Are there clinical case conferences, attended by both faculty and residents, which address both theoretical and practical matters relating to diagnosis, management and treatment?.........( ) YES ( ) NO Briefly describe: 2. Are there interdisciplinary conferences with attendance by nonpsychiatrists and other medical specialists?..........................................................................................................................( ) YES ( ) NO Briefly describe:B. Neurology 1. Is there teaching in neurology specific to geriatrics? ......................................................( ) YES ( ) NO Briefly describe the nature of this training: 2. Is there experience with the handicapped elderly? ............................................................( ) YES ( ) NO Briefly describe:C. Consultation and Liaison Geriatric Psychiatry 1. Is there supervised consultation/liaison psychiatry experience involving patients on geriatric, medical and/ or surgical services? ..........................................................................................................( ) YES ( ) NO Briefly describe:D. Social/Cultural/Community Psychiatry: 1. Is there education regarding culture and the subcultural influences in the patient populations to which residents are exposed? .....................................................................................................( ) YES ( ) NO Briefly describe: 2. Briefly describe any clinical experience offered in social and community work among the aged.residency-review-committee-for-psychiatry2517.doc 22
  • E. Continuous Care Experience: Inpatient 1. Do residents have an opportunity to follow patients after discharge from the hospital? ......( ) YES ( ) NO Briefly describe, including the diagnostic categories, duration of treatment and the minimum numbers of patients, so followed:F. Continuous Care Experience: Outpatient 1. Do residents have an opportunity to treat outpatients longitudinally with supervision? .......( ) YES ( ) NO 2. Do such experiences include patients representing a variety diagnostic categories, utilizing a variety of therapeutic approaches to treatment? ................................................................................( ) YES ( ) NO 3. Do clinical experiences, under supervision, include both psychological and biological approaches to treatment? ..........................................................................................................................( ) YES ( ) NOG. Scholarly Activity 1. Does the training program include opportunities to learn appreciation of research methods and the critical appraisal of professional/scientific literature pertinent to geriatric psychiatry? ....................( ) YES ( ) NO 2. Do residents participate in clinical or basic research?.........................................................( ) YES ( ) NO a) If yes, how many residents have participated the past residency year? b) List projects in which residents have participated in the past five years. 3. Does the program provide residents with opportunities to attend relevant symposia and conferences in geriatric psychiatry? ............................................................................................................( ) YES ( ) NO 4. Do they have other scholarly activities? . ............................................................................( ) YES ( ) NO Please describeH. Administrative Psychiatry 1. Do residents obtain knowledge and experience in the administrative aspects of geriatric psychiatric practice? ............................................................................................................................( ) YES ( ) NO Briefly describe and reference seminar numbers from Section 4.0: I. Collaborative Learning 1. Are there clinical experiences in which residents actively collaborate with other mental health professionals in the treatment of patients? ........................................................................( ) YES ( ) NO Briefly describe: 2. Are there opportunities for the residents to learn leadership and management skills with a team of mental health care professionals? ..................................................................................................( ) YES ( ) NOresidency-review-committee-for-psychiatry2517.doc 23
  • J. Ethics 1. Do residents receive education in ethics relevant to the care of the aged? .......................( ) YES ( ) NO Briefly describe:K. Psychiatric Law 1. Do residents receive training in legal aspects of treating the geriatric patient? .................( ) YES ( ) NO Briefly describe and reference seminar numbers from Section 4.0:L. Teaching 1. Do the residents participate in teaching of other health professionals? .............................( ) YES ( ) NO Briefly describe:M. Clinical Experience with Multiple Treatment Modalities Relevant to the Care of the Aged Briefly describe whether there is BOTH didactic and clinical experience, where it occurs, the extent of the experience, and the nature and amount of supervision. Reference the relevant numbers in Section 4.0 for seminars and conferences related to the training experience. 1. Individual psychotherapy a) Psychodynamic.............................................................................................................( ) YES ( ) NO b) Behavioral ....................................................................................................................( ) YES ( ) NO c) Supportive.....................................................................................................................( ) YES ( ) NO d) Other (describe)............................................................................................................( ) YES ( ) NO 2. Other modalities a) Family intervention .......................................................................................................( ) YES ( ) NO b) Group therapy ..............................................................................................................( ) YES ( ) NOresidency-review-committee-for-psychiatry2517.doc 24
  • c) Crisis intervention/suicide prevention ...........................................................................( ) YES ( ) NO d) Pharmacologic therapies ..............................................................................................( ) YES ( ) NO e) Milieu therapy............................................................................................................... ( ) YES ( ) NO f) Somatic therapy ...........................................................................................................( ) YES ( ) NO g) Other (i.e., hypnosis, biofeedback, etc.)........................................................................( ) YES ( ) NON. Library Facilities 1. Is there a psychiatric library readily available to the residents?...........................................( ) YES ( ) NO 2. Is this library available to the residents after hours and on weekends, if needed?..............( ) YES ( ) NO 3. Location: 4. Number of psychiatry/behavioral science journals regularly received: 5. Number of medical journals regularly received: 6. Are the following available: a) MEDLINE .....................................................................................................................( ) YES ( ) NO b) MEDLAR ......................................................................................................................( ) YES ( ) NO c) INDEX MEDICUS .........................................................................................................( ) YES ( ) NO d) Other ............................................................................................................................( ) YES ( ) NOO. Laboratory and Special Facilities 1. Are the following available: a) Clinical laboratories ......................................................................................................( ) YES ( ) NO b) Sleep laboratories ........................................................................................................( ) YES ( ) NO c) Electroencephalography ...............................................................................................( ) YES ( ) NO d) Imaging.........................................................................................................................( ) YES ( ) NO e) Psychological ...............................................................................................................( ) YES ( ) NO f) Neuropsychological ......................................................................................................( ) YES ( ) NOresidency-review-committee-for-psychiatry2517.doc 25
  • P. Night Call 1. Frequency in year of residency training: Minimum Per Month Maximum Per Month 2. Check in which area(s) call takes place: ( ) Inpatient ( ) Outpatient ( ) ED 3. Is a faculty supervisor always available for consultation and assistance if needed? ...............................................................................................................................................( ) YES ( ) NO a) Inpatient..........................................................................................................................( ) YES ( ) NO b) Outpatient........................................................................................................................( ) YES ( ) NO c) ED...................................................................................................................................( ) YES ( ) NO 4. Is call taken in-house or from home for: a) Inpatient:.............................................................................................................( ) In-house ( ) Home b) Outpatient:............................................................................................................( ) In-house ( ) Home c) ED:.......................................................................................................................( ) In-house ( ) HomeQ. Relationship of Geriatric Psychiatry Residents to General Psychiatry Residents: 1. Are geriatric psychiatry residents involved in the didactic teaching of general psychiatry residents? ...............................................................................................................................................( ) YES ( ) NO If yes, briefly describe 2. Do geriatric psychiatry residents have supervisory and/or bedside teaching responsibilities for general psychiatry residents?.............................................................................................................( ) YES ( ) NO If yes, briefly describeR. Liability Coverage 1. Are residents provided with professional liability coverage related to their clinical activities in the program? ...............................................................................................................................................( ) YES ( ) NO 2. Does this professional liability insurance include "tail" coverage for legal actions filed after the resident has left the program?.............................................................................................................( ) YES ( ) NO 3. Are residents provided with a written statement regarding the nature, extent and limitations of their liability coverage?..............................................................................................................................( ) YES ( ) NOS. Outside Activity 1. How does the program monitor clinical activity outside the residency?residency-review-committee-for-psychiatry2517.doc 26
  • VERIFICATION OF INFORMATION Information Furnished By: Name: Title: Signature: Date: If information is furnished by someone other than the Program Director, the latter must verify the accuracy of the information submitted. Verified By program Director: Name: Title: Signature: Date: If Program Director is not the Chairman of the Department of Psychiatry or Institutional Director, the Chairman or Institutional Director must verify the accuracy of the information submitted. Verified By Chairman of Department of Psychiatry Or Site Director: Name: Title: Signature: Date:residency-review-committee-for-psychiatry2517.doc 27