Job Description

Trainee Position Description and Essential Functions

University of Washington Boise Psychiatry Residency Program

Position Identification: Resident

Position Summary:

The UW Boise Psychiatry Residency Program strives to create a supportive, diverse, and inclusive training environment dedicated to the mission of preparing graduates to work as leaders and expert consultants in rural and underserved areas thereby improving mental health care in our state and the surrounding region.

To accomplish this mission we aim to:

  • Train expert psychiatrists who can deliver evidence-based, biological, psychological, and social assessments and treatments
  • Focus on integrated care models, consultation-liaison psychiatry, and telepsychiatry experiences to promote systems-level thinking and improve population health in our state and region
  • Provide robust addiction, geriatric, and child psychiatry experiences to prepare graduates for the full scope of practice required in rural settings
  • Foster leadership opportunities in our medical systems and in local and state medical societies
  • Promote interprofessional collaboration and scholarship
  • Create an educational climate that promotes the professional development of both faculty and trainees as life-long learners

This Job Description is written to help you be familiar with and organize the responsibilities you have in this new work environment. It is to remind you that while you are still in training, this job carries heavy responsibility for patient care.

Each year of training in the UW Boise Psychiatry Residency Program has been thoughtfully planned to provide the resident experiences in the practice of psychiatry in rural and underserved systems, tailored to the resident’s level of training. The UW Boise Psychiatry Residency Program focuses on experiences in multiple systems of care using a variety of treatment modalities to reach broad populations.

For the purpose of this document, the term “Resident” includes medical and dental residents and fellows, including those in ACGME, CODA and non-ACGME accredited programs.

General Overview of the Resident Role

A resident’s responsibilities include patient care responsibilities within the scope of their clinical privileges commensurate with level of training and other responsibilities required of all members of the medical staff. Under the supervision of attendings, general responsibilities of the resident may include:

  • Initial and ongoing assessment of patients’ medical, physical and psychosocial status
  • Performing history and physical examination
  • Developing assessment and treatment plan
  • Performing rounds
  • Recording documentation, including progress notes, admission notes, procedure notes and discharge summaries
  • Ordering tests, examinations, medications and therapies
  • Arranging for discharge, referral and after care.
  • Providing patient education and counseling about health status, test results, disease processes and transition of care planning
  • Performing procedures, including psychotherapy and neuromodulation
  • Teaching and evaluating junior learners, such as medical students

Criteria for Graduation

To graduate from the program, and to be eligible to sit for the American Board of Psychiatry and Neurology examinations in Psychiatry, residents must complete 48 months of approved training, including a PGY-1 year. To graduate, each resident must also:

  • Complete, in a satisfactory manner, all required clinical rotations, as well as sufficient elective rotations to total 48 months of training.
  • Pass an oral examination (“Mock Boards”) that includes interviewing a psychiatric patient and answering examiners’ questions regarding diagnostic formulation, assessment methods, and treatment approaches.
  • Complete at least 6 months of their own personal psychotherapy or 6 months of countertransference-focused psychotherapy supervision during their 4 years of training.

Be approved for graduation by the department’s Clinical Competency Committee (CCC). In considering residents for graduation, the CCC considers clinical competence, interpersonal skills, ethical standards, and professional conduct.

UW GME Expectations for Professional Behavior

Essential Functions

Essential functions are the fundamental job duties of the position that cannot be eliminated or substantially modified without changing the nature of the position.

A job function may be considered essential for the following reasons:

  • The reason the position exists is to perform that function
    • Resident educational requirements and patient care responsibilities
  • A limited number of available residents can perform that function
  • Varies by program, rotation, year, risk pools, etc.
  • The function may be highly specialized so that the trainee in the position is hired for their expertise or ability to perform the particular function
    • Cannot easily hire more trainees, especially of a specific R level
  • The percentage of time spent on a function does not determine whether or not it is essential.

Essential functions for GME residents must include consideration of:

  • ACGME program requirements
  • Specialty board requirements
  • UW program requirements
    • Unique to each UW training program and must consider:
      • Complexity of rotations/service requirements
      • Size of program
      • Structure and depth of risk pools
      • Please refer to the program’s Clinical Coverage Policy
    • Inclusive of the hospital system requirements:
      • Rotations dependent on residents’ service for patient care
      • Coverage options available

A resident must perform the position’s essential job functions with or without an approved reasonable accommodation. Reasonable accommodation means modifying or adjusting practices, procedures, policies, job duties, or the work or application environment so that a qualified individual with a disability can still perform a position’s essential functions. Approved reasonable accommodations are determined via an interactive process involving the resident, DSO/HR/GME and the program.

Essential functions ensure the safe and smooth delivery of education and patient care and are identified in alignment with program aims to facilitate trainee readiness for independent practice across an appropriate range of clinical settings for that specialty. Transparent documentation of a program’s essential functions is also an important resource for applicants evaluating the training program during recruitment.

Essential Program Administrative Functions

Onboarding

The Resident must:

  • comply with all program and institutional tasks required for credentialing and onboarding by the requested deadlines
  • obtain and maintain an active medical license in the state of Idaho at all times

Program Tasks and Documentation

The Resident must:

  • participate in all requests for schedule preferences, requests for absence or schedule changes of requests for clinical coverage on the requested timelines or deadlines.
  • complete in a timely manner all evaluations requested for medical students, peer residents, faculty or other members of the team
  • complete MedHub clinical and educational hour logs
  • complete the annual ACGME Resident Survey
  • complete the program’s annual confidential internal survey
  • complete required examination preparation and/or testing requirements, to include USMLE or COMLEX Step 3, in-training examinations and program-specific guidelines for national board certification
  • attend all required program meetings, including semiannual meetings, mentorship meetings, program retreats, etc.
  • meet competency requirements for knowledge, patient care, problem-based learning, professionalism, interpersonal communication, systems-based practice, and specific psychotherapies in a manner appropriate for their level of training and consistent with the department’s standards.

Essential Program Core Educational Functions

Didactics

The Resident must:

  • comply with all standards for attendance at didactics or other core educational activities
  • attend all didactics and educational activities in-person, unless special accommodations must be made with Program Director pre-approval.
  • other functions/details specific to the program:
  • Didactics and core educational activities are held on Thursdays. The schedule is as follows:
    • 1st – Resident Business Meeting (VA).
    • 2nd – Case Conference (VA). Trainee & Caseload Supervisor, Chief Resident coordinates
    • 3rd – Grand Rounds (virtual)
    • 4th – Journal Club (VA). Read an article and be prepared to discuss
    • 5th – M&M Conference (VA).
  • Group Sessions:
    • PGY1-2 Residents must either attend weekly Group sessions or elect to attend the American Group Psychotherapy Conference (AGPA) and participate in the 2-day experiential process group, or propose an alternate activity devoted to experiential learning of group process.
    • PGY3-4 Residents are required to attend the weekly Cohort Group for the first three months of PGY3 year. After three months, residents can choose to participate in the ongoing cohort group. If a resident opts out after the 3 months of required attendance OR if a resident initially chooses to participate in the ongoing cohort group but later decides to opt out, the resident must participate in an exit process and attend the American Group Psychotherapy Conference (AGPA) and participate in the 2-day experiential process group, or propose an alternate activity devoted to experiential learning of group process. Residents will be required to attend a Program Steering Committee Meeting to present this idea for approval.
  • Journal Club & Case Conference
    • Psychiatry residents will conduct their own monthly journal club. Psychiatry residents, psychology trainees, and social work interns share the responsibility for monthly case conference. Journal club is led by the Research Director.

Scholarship

The Resident must:

  • comply with all program or specialty requirements for research or scholarship, quality improvement, national or regional conference presentation, publication or scholarly writing or teaching and presentations internal to the program (e.g. journal club, didactics, case conference, M&M, etc.)
  • each resident in the UW Boise Psychiatry Residency program must complete a scholarly project and a QI project prior to graduation. Generally, residents complete their QI project in their PGY3 year. If another project is preferred, a resident may request prior approval for the preferred project.
  • submit their scholarly project idea to the Program Director during the spring of their PGY3 year and then follow the timeline to complete their project and present Psychiatry Grand Rounds during their fourth year.

Essential Patient Care Functions

Presence and preparedness

The Resident must:

  • present to work as physically, mentally and emotionally fit for duty
  • follow the program and site-specific policies and procedures for any leave, holiday, inclement weather, or site supervisor absence.
  • arrive at the patient care setting on schedule
  • arrive at work in attire appropriate for the professional and safe delivery of patient care
  • meet expectations for chart review or pre-rounding
  • satisfy expectations that precede sign-out and/or departure from the clinical setting, including an appropriate handoff and follow up on all patient assessments/data/studies that will alter care in the near term.
  • be available to be contacted via any electronic messaging system used by assigned site and/or have provided another mean of immediate contact.

Administrative

The Resident must:

  • complete patient health record documentation on the same day of the patient visit at all sites unless otherwise specified by the site. (Examples include but are not limited to progress notes/visit summaries, discharge summaries) Residents are required to attend to chart flags, refills, etc. in a timely manner.
  • comply with expectations for EHR inbox management, including timely responses to messages from patients, medical staff and tracking and patient follow up of expected results
  • check flags and alerts at least twice per week via onsite or remote access and complete them in a timely and thorough manner.
  • check and respond to emails and instant messaging daily for each site the resident is currently assigned, as well as program related emails from leadership and administrative staff.
  • if transcription is available, must comply with site specific policies on the use of transcription. Ambient dictation tools are not permitted for note generation unless approved by the Program Director.

Patient Care Communication

The Resident must:

  • respond in a timely manner to pages, phone calls, and instant messages via Teams, Epic Secure Chat, Skype, or similar messaging software.
  • remain within the program-prescribed geographic range while on call or eligible for coverage
  • complete sign out when resident changes services with the completion of interim SBAR notes (Situation, Background, Assessment and Recommendation) on inpatient units and verbal sign out with the incoming resident. Chief Resident and Attendings at each site can provide site specific information. On-call roster will provide after-hours coverage updates.

Patient Care Volumes

The Resident must:

  • work toward (with supervision) or meet benchmarks for patient care volumes in all clinical settings
  • review all program supervision policies and protocols for guidance on clinical supervision
  • appropriately request and utilize supervision
  • attend at least 14 hours of psychotherapy supervision per 6 months’ time with each supervisor.
  • work toward or ultimately meet psychotherapy certification standards
  • be available for clinical matters from 8am – 5pm regardless of the timing of patient appointments.
  • follow program policy on the maximum allowed time for therapy and medication management appointments per clinic day.
  • follow all site specific no show policies appropriate to the acuity level of the patient.

Consultation

The Resident must:

  • appropriately respond to, triage, and staff consultations in a timely manner
  • document findings and recommendations in a timely manner
  • communicate with the requesting service directly (e.g. in-person, phone) in advance of and following the assessment
  • ensure that consultations are staffed and finalized with a faculty member in a timely manner

Essential Shift and Schedule Functions

Settings

  • complete assigned shifts in settings deemed essential by the program, such as inpatient units, emergency department, outpatient specialty and primary care clinics
  • complete assigned away rotations deemed essential by the program

Shift length and timing

The Resident must:

  • comply with all ACGME work hours requirements. Work hours are defined as all clinical and academic activities related to the residency program, i.e. patient care, administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call, and scheduled academic activities such as didactics and conferences. Work hours do not include reading and preparation time spent away from the work site.
  • record all work hours in MedHub weekly
  • complete shifts of all lengths deemed essential by the program, which may include daytime, swing, nights, weekends, and holidays
    • Shifts must not exceed ACGME limits of up to 28 hours per shift, and up to 80 hours per week averaged over a 4 week period, inclusive of all in-house call activities and all moonlighting.
  • where appropriate, comply with designated break lengths (to meet personal needs and not impact patient care)
  • Residents must have one day in seven free from all educational and clinical responsibilities, including call, averaged over a four-week period. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative activities.
  • Adequate time for rest and personal activities must be provided. This should consist of an 8-hour time period provided between all daily work periods and after in-house call.
  • Residents must have at least 14 hours free of clinical work and education after 24 hours of in-house call.
  • Clinical and educational work periods must not exceed 24 hours of continuous scheduled assignments (up to 4 hours of additional time may be used for activities such as providing effective transitions of care and or resident education, but additional patient care responsibilities must not be assigned to a resident during this time).
  • In rare circumstances, after handing off all other responsibilities, a resident, on their own initiative, may elect to remain or return to the clinical site to continue to provide care to a single severely ill or unstable patient; humanistic attention to the needs of a patient or family; or to attend to unique educational activities. These additional hours of care or education will be counted toward the 80-hour weekly limit.

Call Responsibilities

The Resident must:

  • complete assigned shifts of overnight call, as deemed essential by the program
  • complete assigned shifts of home call, as deemed essential by the program. At-home (pager) call is defined as call taken from outside the assigned institution.
  • be available for in-house call when assigned. In-house call is defined as those work hours beyond the normal workday when residents are required to be immediately available at the assigned institution.
  • remain within the prescribed geographic range while on call or eligible for coverage
  • Complete the required number of On-Call and Night Float rotations for each PGY year:
    • PGY1: Ten Saturday daytime call shifts while on psychiatry inpatient rotation with attending supervision on site each day.
    • PGY2: Six weeks night float, 8 weekend calls per year.
    • PGY3: Four weeks night float, 10 weekend calls per year.
    • PGY4: Three weeks night float, 8 weekend calls per year.
  • make up all required call shifts that were missed for any reason.
  • follow program protocol for call trades due to illness or emergency.
  • individually work out call trades and owed call shifts with the other residents in the program and update the chief resident, call schedule coordinator, and program leadership of the changes.
  • be available for all assigned call shifts for the full duration
    • Night float home call= 4:00 pm – 8:00am Sunday through Friday
    • Friday night home call = 4:00pm – 8:00am Friday and Saturday
    • 24-hour Saturday/Sunday Call = 4:30 pm Saturday to 4:30pm Sunday. Of note, for the 24-hour Saturday/Sunday call, Saturday 4:30 pm – Sunday 7:30 am will be home call, and Sunday 7:30 am to 4:30 pm will hybrid home and in-house call
  • In-house or at-home call must occur no more frequently than every third night, averaged over a four-week period. Night float rotations are not subject to this constraint.
  • Continuous work, including in-house or at-home call, must not exceed 24 consecutive hours for all PGYs.
  • When residents are called into the hospital from home during night float, the hours residents spend in-house are counted towards the 80-hour limit.
  • If interested in moonlighting, must be PGY2 or higher in good standing and follow all moonlighting policies and procedures, including ADGME work hour rules. Moonlighting must not interfere with the ability of the resident/fellow to achieve the goals and objectives of the educational program.

Statement Of Nondiscrimination

The University of Washington prohibits discrimination, harassment and sexual misconduct in any education program or activity that it operates. Individuals may report concerns, make complaints, or direct inquiries to the Civil Rights Compliance Office.

This document reflects requirements, established practices, policies, procedures, and resources as of the date of publication; however, parts of this document may be updated from time to time in accordance with changes in the law and applicable requirements, established practices, policies, procedures, and resources. Continued participation by a resident in the program will demonstrate agreement by the resident to adhere to the updates. The program will communicate such change via timely email communication to all residents.