Department of Psychiatry
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Residency Program in PsychiatryDidacticsPsychopharmacologyCourse DirectorsSanjay Mathew, M.D. Course Goals and ObjectivesResidents will become familiar with the psychopharmacologic treatment of major psychiatric disorders. They will develop fluency in both acute and chronic medication management as well as an understanding of the physiologic underpinnings and psychological factors that drive decision-making in the psychopharmacologic context. The use of medication in a variety of therapeutic milieus, including inpatient, outpatient, and special populations, will be considered. PGY-IAn introduction to psychopharmacology will be presented in tandem with relevant classes in nosology, to facilitate understanding of basic disease classifications and related treatment approaches. The course emphasizes psychopharmacologic drug classes, with a goal of reviewing the basics of mechanism of action, symptom targeting, dosing strategies, and management of side effects. PGY-IIIn the PGY-II year, these principles are revisited with a higher level of sophistication and detail. The course begins with an expanded review of basic principles, including target symptoms and assessment of efficacy. The rest of the year then goes on to examine in more nuanced fashion each major class of psychotropic medication, devoting approximately one month to each. The course uses "Stahl"s Essential Psychopharmacology: Neuroscientific Basis and Practical Application" as a reference. Also included is attention to the "art of psychopharmacology," including discussions of how to work with resistant patients, and complexities of combined treatment (which is also addressed in the psychotherapy curriculum). Goals of the curriculum include mastery of the psychopharmacology related to inpatient psychiatry, including the acute care and management of major psychiatric illnesses and personality disorders. Residents will appreciate the importance of teamwork, continuity of care, and the transition of patients from inpatient settings to alternative levels of care. Residents will learn that psychopharmacology is practiced in the context of a psychotherapeutic relationship with the patient. At the end of this course, residents will be comfortable with the use of psychopharmacological agents in inpatients. PGY-IIIThe third year integrates psychopharmacology with neuroscience and is oraganized around disorder-based modules. Each module begins with an expanded view of the relevant psychopharmacology, and incorporates related neuroscientific principles and findings. Each module concludes with a relevant journal club on the topic, with each resident having the opportunity to present. This organizational framework helps not only integrate neurobiological understandings of illness with psychopharmacology. but also furthers comfort with current evidence-based learning strategies and enhances skill at interpreting current literature. This course thus builds on the evidence-based learning modules from the first and second year course. PGY-IVIn the fourth year, psychopharmacology continues with weekly case-based psychopharmacologic group supervision. There are additionally advanced courses covering psychopharmacologic issues in specific patient populations and specialized topics, including women's mental health, traumatic brain injury, and treatment of sexual dysfunction. Curriculum
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