Psychiatry Residency Electives
Starting in the second post-graduate year (PGY) of the Psychiatry Residency Program, you will have the opportunity to start focusing your training by selecting appropriate electives and/or participating in special programs in psychoanalytic psychotherapy or primary care.
VA Addictions – Methadone Clinic
Residents work with patients with a primary diagnosis of opioid dependence who receive either methadone or buprenorphine maintenance. Residents are expected to learn the administrative aspects of the Methadone Clinic and attain expertise in addiction management.
VA Addictions – Motivational Interviewing/Motivational Enhancement Therapy
Residents will develop skills in motivational interviewing (MI) and motivational enhancement therapy (MET) for a range of commonly encountered treatment concerns (e.g., medication adherence, substance use, diet change, exercise). Training will include didactic teaching on MI theory/principles, live observation of trainer-facilitated MI/MET sessions, and regular review and feedback of audio-recorded, resident-facilitated MI/MET sessions.
VA Addiction Outpatient Clinic
Residents will see a wide variety of patients with a primary diagnosis of addictive disorders and co-occurring psychiatric disorders. Clinic will be followed by didactic teaching on an addiction-related topic.
VA Mental Health Pain Clinic
Residents see and evaluate patients (including some in opioid substitution therapy) with a wide range of pain problems and severity of pain. Residents have the opportunity to learn about various treatment modalities for chronic pain.
Center for Autism Care
The UT Southwestern and Children’s Health℠ Center for Autism Care is a multidisciplinary clinic that integrates research and clinical care for children with autism spectrum disorder. Residents initially focus on assessment, diagnosis and treatment, but may also choose to immerse themselves in the Center’s cutting-edge translational research.
Children’s Medical Center Inpatient Psychiatry
The resident will work within a multidisciplinary treatment team to deliver care to a high-acuity child and adolescent population. The patient population is predominantly mood-based with some medical complexity possible. Residents will be expected to take their own cases proportioned appropriately to PGY level with attending direct supervision.
Children's Medical Center Outpatient Clinic
The CMC Outpatient Clinic provides diagnostic evaluations and treatment to a wide range of children and adolescents, as well as ongoing care of patients who are discharged from the Psychiatric Inpatient and Day Treatment services. The PGY-3/PGY-4 resident will care for child and adolescent outpatients with an emphasis on a developmental, bio-psychosocial, and culturally sensitive approach to outpatient child and adolescent psychiatric practice. New cases and follow-ups are presented, discussed, and staffed by faculty. The cases are carried throughout the rotation, and an appropriate disposition is made at the conclusion of the rotation.
Family Studies Clinic
Residents meet with families in distress and an experienced family psychotherapist as a group. Afterward, videos of sessions are reviewed and discussed. Residents learn the finer points of emotionally focused therapy and other postmodern viewpoints such as narrative therapy. The main responsibilities of residents are to be a co-therapist for a family or couple.
Intensive Treatment of Children with Severe Behavioral and Emotional Problems
Residents work in specialty multidisciplinary programs intended to provide care to children and adolescents with significant social difficulties. Residents complete diagnostic evaluations and treatment plans, and become comfortable managing psychopharmacology in these populations. Moreover, resident physicians learn about other community resources available to this population and participate in weekly staff meetings with probationary staff from the juvenile department.
School Clinic for Children and Adolescents
This Metrocare clinic serves the Garland Independent School District. Residents learn to care for a diverse set of diagnostic challenges in school-age children, including ADHD, ODD, mood disorders, autism spectrum diagnoses, and anxiety disorders. At the end of the rotation, the resident will be adept at creating and modifying a comprehensive treatment plan for children and adolescents in a community mental health outpatient setting as well as interact with school, primary care practices, and counseling support systems in a time-efficient manner.
Community Psychiatry, VA Medical Center
This elective consists of three Dallas Veterans Affairs Medical Center community psychiatry programs: Comprehensive Homeless Center (CHC), Community Support Treatment Program (CSTP), and Community Residential Care (CRC). Unless otherwise pre-arranged, the resident will rotate through each program during the Community Psychiatry rotation.
- Comprehensive Homeless Center: Resident will learn to implement principles of the mental health recovery model and work with multidisciplinary teams in an effort to assist in ending homelessness.
- Community Support Treatment Program: As the seriously mentally ill population frequently requires acute psychiatric hospitalizations, residents will participate in evaluating appropriateness for change in level of care, following veterans as they are hospitalized and as they transition back to community care.
- Community Residential Care Program: Resident will develop psychosocial assessment and intervention skills with chronically mentally ill veterans residing in VA-approved assisted living facilities.
Developmental Disabilities Psychiatric Services
This community clinic at Metrocare serves the following patient populations: children and/or adults with a diagnosis of developmental disabilities, including mental retardation (mild to profound), autism spectrum, complicated by disruptive behaviors, impulsive control disorder, and stereotypical movement disorders. Residents will have exposure to the special diagnostic and treatment problems of children with both developmental disabilities and disruptive behaviors or severe psychiatric symptoms.
Mental Health Access Clinic and Integrated Care, VA Medical Center
This team sees new patients who present for emergency, urgent, walk-in, and non-urgent scheduled evaluations and mental health care. The team also collaborates with Primary Care physicians to care for mental health patients within the primary care setting. The team also provides inpatient consultation-liaison services.
Mental Health Copper Team Outpatient Clinic, VA Medical Center
This outpatient clinic’s patients include combat as well as non-combat veterans. Many suffer from consequences of exposure to war, including Iraq, Afghanistan, Bosnia, Desert Storm, and Vietnam. There will be opportunity to participate in therapeutic interventions, including treatment of patients with serious mental illness needing depot antipsychotic injections or clozapine.
Outpatient Clinic, VA Medical Center
The VA Platinum Clinic is a general psychiatry outpatient clinic which treats veterans with a wide variety of psychiatric disorders including mood, anxiety, psychotic, substance abuse, and personality disorders. Platinum clinic patients include veterans with first onset psychiatric disorders as well as those who are chronically ill, are treatment-resistant, or have complex psychiatric and medical co-morbidities. The purpose of this elective is to help residents expand their knowledge of the diagnosis and evidence-based pharmacotherapies and psychotherapies of outpatients with complex, first-onset, chronic, or treatment-resistant psychiatric conditions.
PGY-4 residents with an interest in Consultation-Liaison Psychiatry explore psychosomatic medicine, including transplant psychiatry at William P. Clements Jr. University Hospital. This elective trains PGY-4 residents in Consultation-Liaison Psychiatry in a private academic hospital setting at Clements University Hospital and at a public hospital setting at Parkland Hospital.
Education Track Teaching Elective on Parkland Consults
The resident will meet with one or more of the third year medical students on the Parkland Consult Service to evaluate a patient. The resident will either demonstrate an interview or supervise a student performing the interview. The resident and student(s) will then discuss the interview process and the patient formulation in depth. There will be the opportunity to participate as a co-facilitator in the Academic Colleges covering topics such as communication skills, mental status exam, child development, culture and medicine, or addictions.
Senior Education Elective at the Parkland Outpatient Psychiatry Clinic
The PGY-4 will take on an educational and clinical role supervising PGY-3s in their evaluation, treatment planning, documentation, and follow-up visits with Parkland Outpatient Psychiatry Clinic (POPC) patients. They also will have direct teaching responsibilities for fourth year medical students who do electives in the Clinic. Further educational responsibilities will include the coordination of case conference, with opportunities to be the “guest” attending, and didactic presentations. Throughout the rotation, there will be direct supervision and education training for the PGY-4 by the POPC attendings (who are experienced in teaching, treatment, and administration).
Teaching Elective at Dallas Veterans Affairs Medical Center
Residents rotate with several mentors during this elective. Mentors serve as role models and assist the residents in improving teaching skills and developing lectures and presentations to medical students and junior residents. Residents are also expected to discuss a selected set of core readings covering teaching-related topics focused on best practices in trainee supervision and formal teaching.
Forensic Examinations
Juvenile Detention Center or Adult Jail
During this elective or selective, residents will have exposure to adult and/or juvenile forensic psychiatry cases. The resident physicians will become knowledgeable in forensic evaluations, Texas mental health law, and competency. Furthermore, residents will provide treatment to patients under the supervision of an attending physician.
Forensic Psychiatry at Terrell State Hospital
Residents have to option to complete a rotation on the Forensic Psychiatry Unit at Terrell State Hospital, where they will have exposure to forensic psychiatry on an inpatient setting. Residents will be a member of a multidisciplinary treatment and evaluation team.
Geriatric Neuropsychiatry Clinic
Dallas Veterans Affairs Medical Center
The Geriatric Neuropsychiatry Clinic at the VA Medical Center is designed to evaluate veteran elders referred for specialized geropsychiatric assessment. Practical, efficient “office” diagnostic skills are emphasized. There are opportunities for in-depth discussion and for residents to observe the attending physician conducting diagnostic interviews. Selected handouts and readings are available to further enhance their elective experience.
Neuropsychology Consult Clinic – VA Medical Center
Psychiatry residents further their understanding of cognitive functioning by being provided with training by two board-certified neuropsychologists. Residents will have the opportunity to observe complete neuropsychological evaluations. Residents can also be trained on the administration and basic interpretation of several cognitive screening measures that they could administer to veterans under the direction of the neuropsychologist.
The practice of psychiatry raises fundamental questions of epistemology and moral theory, which are a focus of Dr. John Sadler's Philosophy of Psychiatry Program. During this elective, the resident will develop skills in recognizing assumptions, defining values, making semantic distinctions, and anticipating practical outcomes of psychiatric practices.
Psychoanalytic psychotherapy training is a particular strength of the Psychiatry Residency Program.
We maintain a close affiliation with the Dallas Psychoanalytic Center (DPC), an independent entity whose offices are housed within our Education Unit. As part of our residents' core training in psychotherapy, each resident will have at least one year of weekly supervision by a DPC psychoanalyst. Members of the Dallas Psychoanalytic Center are also among our most valued and inspiring seminar teachers. Dr. Brenner also serves on the faculty of the DPC.
In addition to these core experiences, our residents are encouraged to take advantage of other optional training opportunities as well:
- Undergoing one’s own psychotherapy can be a powerful learning experience for residents in psychiatry. DPC members provide reduced-fee psychotherapy for residents.
- We sometimes have residents who elect to begin training in the DPC’s Adult Psychoanalysis Program during their third and fourth years.
Dialectical Behavioral Therapy
Residents learn the fundamentals of evidence-based treatment of borderline personality disorder. They will co-lead a psycho-education group for 12 months, participate in weekly group supervision, and conduct individual long-term (12 months) psychotherapy for patients with borderline personality disorder.
Eating Disorder Family Therapy and Research
The resident will join the Adult Eating Disorder Program at Texas Health Resources Presbyterian Hospital of Dallas where PGY-3 residents will follow one to two patients at a time throughout their rotation, and attend therapeutic activities with the patients (meals, art therapy, education, and multifamily group therapy). The resident will lead a case conference for the clinical team during their rotation, focusing on exploring an interest related to their patients.
Evidence-Based Psychotherapy
The goal of this rotation is to provide residents with training in two evidence-based psychotherapies (EBPs) which will be selected by the rotation participants. The following EBPs will be available: cognitive processing therapy, prolonged exposure, acceptance and commitment therapy (ACT), interpersonal therapy (IPT), integrative behavioral couples therapy (IBCT), cognitive behavioral therapy for insomnia (CBT-I), cognitive behavioral therapy for chronic pain (CBT-CP), motivational interviewing (MI), and motivational enhancement therapy for substance use disorders.
Medical Psychotherapy – Parkland Hospital
Residents are trained in inpatient medical psychotherapy on the Consultation-Liaison Psychiatry Service for patients with co-morbid medical/mental health conditions. Interventions are typically brief, problem-focused, and involve behavioral management of staff as well. Potential exists for sharpening short-term CBT skills, as well as learning basics of ACT, if interested.
Family Studies Clinic
Residents meet with families in distress and an experienced family psychotherapist as a group. Afterward, videos of sessions are reviewed and discussed. Residents learn the finer points of emotionally focused therapy and other postmodern viewpoints such as narrative therapy. The main responsibilities of residents are to be a co-therapist for a family or couple.
Psychotherapy at the Faculty Practice
Affective Disorders, Anxiety, and Trauma
The Faculty Practice uses intense psychoanalytic psychotherapy, existential psychotherapy, and mindfulness approaches to help patients with depression, anxiety, personality disorders, and histories of trauma. Residents work under direct supervision of faculty psychiatrists in a setting similar to the private-practice model. There will be opportunities to observe experienced clinicians interacting with patients in both medication management and psychotherapy encounters. Residents also build their own caseload by performing new psychiatric evaluations, providing follow-up visits, and psychotherapy.
Psychotherapy at Parkland Outpatient Clinic
Personality Disorders
This Parkland Outpatient Clinic serves patients with serious co-morbid and often disabling medical problems. Residents are able to carry a year-long caseload of psychotherapy patients. Residents direct psychotherapeutic treatment, utilizing evidence based therapeutic modalities under the supervision of an attending physician.
Psychotherapy at the UT Southwestern Psychiatry Clinic
Medication Management Clinic
The UT Southwestern Psychiatry Clinic has a small percentage of patients, seen by either psychology students or psychiatry residents who do not have their full licenses, who would benefit from psychiatric medications. These patients are seen in a weekly half-day clinic staffed by a resident and the Clinic Director. Residents learn to prescribe medications in close collaboration with a patient’s therapist.
Treatment-Resistant Psychosis, Terrell State Hospital
Terrell State Hospital provides intensive and long-term inpatient treatments for patients from North Texas whose psychotic illnesses cannot be managed in the community. PGY-2 and PGY-4 residents provide psychiatric evaluation and treatment under the supervision of experienced attendings at Terrell State Hospital. There is a strong focus on effective psychopharmacology and on fostering recovery through interdisciplinary teams and family engagement.
This elective – based at UTSW-NC5 or the Dallas Veterans Affairs Medical Center – provides an opportunity for PGY-4 residents to expand their knowledge by dedicating time to read and discuss articles, and prepare for the American Board of Psychiatry and Neurology, Inc. (ABPN) exam.
Residents will craft their own objectives for this reading elective in consultation with an attending. Articles include original research, reviews, or meta-analyses, and cover any psychiatric topics that residents identify as areas of interest. ABPN board review covers neurology and psychiatry topics.
Biomarkers in Psychosis and Biotypes
Working in Dr. Carol Tamminga’s research group, residents will learn how to examine brain activity using biomarkers and to perform and analyze one of the biomarkers in detail. In addition, residents will analyze some aspect of a large data set which includes clinical characterization data, using multiple biomarkers and genetic analyses to adjust categorization in psychotic illness.
Eating Disorder Family Therapy and Research
The resident will join the Adult Eating Disorder Program at Texas Health Resources Presbyterian Hospital of Dallas where PGY-3 residents will follow one to two patients at a time throughout their rotation, and attend therapeutic activities with the patients (meals, art therapy, education, and multi-family group therapy). The resident will lead a case conference for the clinical team during their rotation, focusing on exploring an interest related to their patients.
Community Psychiatry and Psychiatric Epidemiology
Potential projects include work on a variety of data sets already established in Dr. Carol North’s studies of homeless populations, disaster survivors, psychoeducation participants, and other projects. The resident will participate in various aspects of research on these projects, and Dr. North will personally work with him/her on all the necessary skills to analyze and interpret data and write results for publishable manuscripts, with prominent authorship opportunities for the trainee.
Psychoendocrinology Research
Residents have the opportunity to work in Dr. Sherwood Brown’s research group studying dual diagnoses (e.g., depression or bipolar disorders concurrent with medical illness or substance abuse) and the effects of corticosteroids (e.g., prednisone) on mood and memory.
Psychosocial Research and Depression Clinic
Led by Robin Jarrett, Ph.D., the Psychosocial Research and Depression Clinic studies psychosocial causes and interventions for depression. Current emphases include cognitive behavioral therapies, interventions for pregnant women, and prevention of depression. The resident may assist in recruiting, evaluating, and monitoring symptoms of women who are pregnant or attempting to conceive and who are also at risk for major depression due to a previous episode. Participation will result in a related scholarly product (e.g., review of literature or short case report).
Residents have the opportunity to rotate in the University Hospital Sleep & Breathing Disorders Clinic. Additionally, residents will become proficient in understanding the sleep cycle, interpreting polysomnography, and understanding both primary and secondary sleep disorders and treatment.
Objectives for the elective also include learning how medications affect the sleep cycle, how to gather a sleep history, and utilizing a multidisciplinary approach to treatment.
Medical toxicology fellows direct residents on reviewing poison cases that have been called into the Poison Center. Residents will call back hospitals where a toxicology patient has been admitted to obtain more information and will also, under the guidance of a fellow, provide further recommendations.
PGY-3 and PGY-4 residents in the Psychiatry Residency Program work with a university student population at the University of North Texas and at UT Arlington, focusing on typical developmental disruptions of college students, new onset of significant psychiatric disorders, and working with patients with pre-existing illnesses to transition away from home and into greater independence.
Obstetrics Complications Clinic
The Parkland Obstetrics Service is one of the largest in the US and a model for public hospital obstetrical care. As Ob/Gyn residents see patients, those who have co-morbid psychiatric disorders and are in acute need of evaluation or treatment guidance will be seen by the resident and attending. The resident also helps educate the obstetrics medical staff on mental health, treatment options, and community resources.
Postpartum Depression
Parkland Hospital Outpatient Clinic
Residents will evaluate postpartum patients who have recently screened positive for postpartum depression at their Parkland Obstetrics Clinic. Residents work directly with a supervising psychiatrist and interdisciplinary team to decide appropriate treatment for patients and, if indicated, continue to follow up with patents.
Victim Intervention Program, Parkland Hospital
The Victim Intervention Program (VIP)/Rape Crisis Center serves patients who are victims of violent crime, sexual assault, domestic violence, childhood abuse, and political persecution/torture. Residents will learn to thoroughly assess trauma and utilize both medications and psychosocial interventions to provide amelioration of symptoms, social support, and long-term healing.
Women’s Stress Disorders Clinic
Residents work in outpatient clinics that specialize in women's mental health topics at the Dallas Veterans Affairs Medical Center and Parkland Hospital. An optional research experience is available to interested residents.