Consultation-Liaison Psychiatry
Residents complete four months on our Consultation Liaison (CL) service. They provide psychiatric consultations to patients on the medical and surgical floors. Residents round daily with psychiatric attendings with expertise in CL Psychiatry. While in no way an exhaustive list (given RUSH University's prestige as a nationally-ranked academic medical center, patients often seek care from afar for "Zebra" diagnoses), residents can expect to assess and manage delirium, encephalitis, neuroleptic malignant syndrome, catatonia, acute agitation, and decision-making capacity. Residents learn how to establish liaison relationships with other services, to understand the responsibilities and limitations of the consultant role, and to practice therapies relevant to medically ill patients, including bedside short-term psychotherapy, behavioral techniques, and multidisciplinary team approaches. Our CL team is well-regarded throughout the hospital. Several of our CL faculty members are double-boarded faculty in Psychiatry and Internal Medicine, dividing their time between CL and Medicine wards.
Emergency Psychiatry
Residents rotate in the psychiatric unit of our Emergency Department for two months. Collaborating closely with Emergency Medicine attendings and residents, they co-manage patients with psychiatric emergencies. Residents form part of a highly effective, multidisciplinary team consisting of 24/7 social workers, mental health workers, nurses, and security officers. This rotation leads to expertise in triaging psychiatric patients in a timely and efficient manner, and proficiency in evaluating and treating psychiatric emergencies commonly seen in a large urban medical center. Residents receive direct, hands-on supervision by attending psychiatrists with expertise in emergency psychiatry.
Child and Adolescent Psychiatry
The child and adolescent psychiatry rotation is one month long. Residents have the option to either:
- 1) Rotate through RUSH University's Ambulatory Child and Adolescent Psychiatry Clinic and perform psychiatric consultations on the inpatient pediatric units throughout the Medical Center or
- 2) Rotate on the inpatient psychiatric units at nearby Garfield Park Behavioral Hospital under the tutelage of Dr. Sanjay Dharmapuri, Associate Chief Medical Officer of Garfield Park, and an alumnus of our residency program.
The child and adolescent psychiatry rotation becomes an invaluable experience for residents choosing to fast track into child psychiatry as it gives them early exposure to the field before deciding whether to apply for fellowship.
Adult Forensic Psychiatry
Residents spend one month rotating at the Cermak Health Services of the Cook County Jail, one of the largest inpatient psychiatric facilities in the nation. This adult inpatient rotation allows residents to obtain exposure working at a correctional institution by providing inpatient adult psychiatric treatment. The patients suffer from a wide variety of psychiatric conditions. The rotation provides residents with exposure to the forensic psychiatric issues frequently faced in a correctional institution and is also a very rewarding community psychiatry training experience.
Addiction Psychiatry
Residents spend one month rotating with the Substance Use Intervention Team (SUIT) at RUSH. SUIT is a multidisciplinary service that screens every patient admitted to RUSH for problems with alcohol or other drugs. The service provides treatment to identified high risk patients including medication assisted treatment, motivational interviewing, and case management. Residents strengthen their understanding of the assessment and management of patients with substance use disorders utilizing individual psychotherapy, psychopharmacology, and other commonly utilized treatments.
Community Psychiatry
In order to expose our residents to community psychiatry, we partnered with Thresholds, one of the oldest and largest community health clinics in Illinois for people with mental illnesses and substance use disorders. Thresholds offers 30 innovative programs and more than 75 locations throughout Chicago, the adjacent suburbs, and four surrounding counties. Services include assertive outreach, case management, housing, employment, education, psychiatry, primary care, substance use treatment, and research.
Thresholds’ staff meets people where they are—out in the community. Offering services in a community-based setting makes them more accessible and lessens the social exclusion that is often present in the lives of people living with mental illness and substance use disorders. This allows Thresholds’ staff and clients to work on skills, clinical interventions, and recovery that enable them to live independent lives in their own neighborhoods.
Our residents spend a month in their PGY II year working at Thresholds. They are currently participating in the following Thresholds programs:
- ACT (Assertive Community Treatment) team: Together with a Thresholds’ psychiatrist, they spend two days a week visiting patients in their homes to provide psychiatric treatment.
- They work with a Thresholds physician one afternoon a week seeing patients with Substance Use Disorders.
- They spend two evenings a week at a local precinct with a Thresholds social worker as part of the Arrest Deflection Program. They conduct evaluations for the possible presence of mental illness or a substance use disorder in people who have been arrested and, if necessary, facilitate their transfer to an appropriate treatment facility.
- Twice a week, they participate in a street medicine program in conjunction with a Thresholds social worker as a result of Thresholds’ partnership with the Chicago West Side Opioid Task Force.
Road Home Program
Our residents spend two weeks in The Road Home Program: The National Center of Excellence for Veterans and their Families at RUSH. Working directly with a team of nationally recognized experts trained in military culture, our residents treat veterans suffering from post-traumatic stress disorder or military sexual trauma in an intensive outpatient setting. Through this experience, residents gain invaluable experience in group therapy.
Mixed Services Rotation
Residents spend one month on a Mixed Services Rotation where they gain experience with areas of psychiatry that they may not otherwise have an opportunity to see. Residents personalize their rotation by selecting between performing outpatient forensic evaluations, gaining experience in neuromodulatory treatments (Electroconvulsive Therapy, Transcranial Magnetic Stimulation, and Esketamine evaluations and treatments), working with our Collaborative Care Team, performing inpatient and outpatient neuropsychological evaluations, rotating in our Sleep Medicine and Behavioral Sleep Medicine clinics, and evaluating children and adults in our acclaimed Autism Assessment, Research, Treatment & Services (AARTS) Center. Residents typically choose approximately four areas of psychiatry for this rotation. One of the goals of the rotation is to “whet the appetite” of residents so that they may decide to do a more formal elective in that area later in their residency or fellowship training.
Outpatient Resident Continuity Clinic
PGY-2 residents spend half a day per week treating outpatients in the Resident Continuity Clinic. This provides the residents an invaluable experience of being able to work with the same patient for up to three years during residency. There is a diverse range of diagnosis within this clinic – including mood, anxiety, psychosis, and substance use disorders. Residents treat adult patients with a combination of psychotherapy (supportive, psychodynamic, and cognitive behavioral) and medication management to help them develop expertise in different psychotherapeutic models. All of our faculty members concentrate on teaching residents about the integration of psychotherapy and psychopharmacology. Residents are assigned both a psychopharmacology supervisor and a psychotherapy supervisor.
Night Float
PGY-2s begin to work nights during their night float rotation. Night float consists of covering the psychiatric floors, emergency department, and inpatient floors throughout the hospital. Residents typically work six nights in a row from 9 PM to 8 AM. PGY-2s have four weeks of night float spread out throughout the year. Residents receive back-up supervision from the attending on call. Another resident is always available to come into the hospital to provide back-up support if necessary. The amount of night float decreases each year of training.
Call
PGY-2 residents provide supervision to PGY-1 residents on weekdays (i.e., buddy call). PGY-2s average 0-1 buddy calls a month over 5 months out of the year. Additionally, PGY-2s work 12 call shifts on weekends (either Saturday or Sunday) throughout the year. Weekend call shifts are from 8 AM-9 PM. The on call resident covers direct admissions to the inpatient psychiatric units, urgent issues on the inpatient psychiatric units, and all consults to the general medical floors and pediatric units. They may occasionally see consults in the Emergency Department, though ED consults are primarily handled by the paid psychiatry resident moonlighter.
Contact Us
2150 W. Harrison St.
Chicago, IL 60612
Phone: (312) 563-1212
Email: psychiatry_residency@rush.edu