PGY1 - The first year of the residency training will be spent primarily in inpatient settings, both psychiatric and medical. Each resident will have three months of inpatient psychiatry at Mission Health in Asheville, three months at Haywood Regional Medical Center in Waynesville, and one month at Pardee Hospital in Hendersonville. There will be two months of inpatient medicine at Mission, one month of inpatient neurology at Mission, one month of outpatient pediatrics, and one month of outpatient family medicine in the MAHEC Family Health Center at Biltmore.
PGY2 - In the second year, residents will work in a variety of outpatient settings. They will train one day each week in a general adult psychiatry clinic and one day each week in a primary care clinic where they will serve as a primary care physician for a half-day and a psychiatric consultant for the other half-day in those clinic settings. They will be supervised in this work by both a family medicine faculty member and a psychiatric faculty member. They will spend a half-day treating children and adolescents and a half-day in formal didactics. The other two days will be spent in rotations among a variety of clinical settings including: a community psychiatry clinic; an outpatient ob/gyn clinic; a university student health clinic; hospital emergency departments; outpatient work at a community psychiatry clinic in Sylva; an adolescent wilderness treatment program; an adolescent residential treatment program; a residential eating disorders program; and an ACT team. Residents will receive training for buprenorphine treatment of opiate dependence early in the second year and will be expected to have a small patient population of patients receiving buprenorphine therapy.
PGY3 - Third year residents will return to training on inpatient units, serving as a junior resident supervising first year residents, and further refining inpatient management skills. They will travel to rural teaching hubs to work collaboratively with family medicine residents in providing care for the underserved in rural counties of Western North Carolina. In these rural settings, residents will be providing inpatient consultation liaison services as well as seeing outpatients. They will complete a rotation at the Julian F. Keith Alcohol and Drug Abuse Treatment Center in Black Mountain. They will also continue training in adult, child, and primary care continuity clinics.
PGY4 - The fourth year will allow residents to transition into leadership roles in a variety of settings. Further inpatient work will be an option. There will be elective time to return to sites where they feel a particular interest. The program is also working to develop opportunities for electives at the Charles George Veterans Administration Medical Center in Asheville, Broughton State Hospital in Morganton, and the Eastern Band of Cherokee Indians tribal health system in Cherokee.
Residents will be expected to participate in research projects beginning in their first year, with results of that work to be submitted for publication or presented in poster sessions during the course of their four years. Financial support is available to travel for research related activities. Residents will also participate in quality improvement projects and will study systems of care throughout their training.
The first year didactics will provide an overview of the psychiatric field of knowledge with an emphasis on evidence-based care and the emerging fields of neurobiology and genetics as they pertain to psychiatry. Residents will be taught cognitive behavioral therapy, interpersonal therapy, dialectical behavior therapy, and psychodynamic psychotherapy. There will be ongoing psychopharmacology seminars and a journal club. Residents will also participate in mindfulness based stress management groups for their own benefit as well as to learn to lead those groups.
The outpatient psychiatry clinic will be housed in a building with a school of public health and on the same campus with family medicine and obstetrics/gynecology residencies, which will provide an optimal environment for cross-fertilization of ideas and collaboration.