Sentara Norfolk General Hospital is a 640-bed Level I Trauma Center where residents rotate for inpatient psychiatry and consultation/liaison psychiatry training. First- and second-year residents work on the 34-bed inpatient mental health unit under the supervision of Christine Steinhagen, M.D. (Site Educational Director) and Paul Sayegh, M.D.

Sentara Norfolk General Hospital

Residents have primary patient care responsibility and function as a major part of a multi-disciplinary team which includes nurses, mental health technicians, social workers, case workers, and discharge planners. Working with the managed care system is an essential part of this training experience. There is also the opportunity to work with the legal system; temporary detention orders are sought at times, and there are often involuntarily committed patients on the service.

Residents cover the emergency department during the day and also directly supervise medical students on the ward. Residents also make decisions about accepting patients from the community, and work closely with the Psychiatric Emergency Response Services nurses who do initial assessments on emergency room patients. The second-year resident attends to patient care, but also gains experience in the provision of electroconvulsive therapy and is more involved with groups therapy treatments and administrative concerns.

The patient population is quite varied. Residents gain extensive experience working with patients with psychotic and mood disorders, substance abuse disorders, and personality disorders, as well as the rest of the spectrum of mental illness, including mental retardation.

Sentara Norfolk General Hospital is committed to providing care to chronically mentally ill patients, who make up approximately half of the psychiatric inpatient population and bring their own special challenges to both inpatient care and discharge planning. Patient care experience is liberally supervised by the attendings. Teaching rounds and academic discussions occur daily, and include psychopharmacology, ethics, medical aspects of psychiatric patients, current literature, psychodynamic issues and other pertinent topics. The inpatient psychiatry service at Sentara Norfolk General Hospital is an intensive and rewarding training experience.

Second-year residents also rotate on the Consultation/Liaison Psychiatry service. The resident on the service supervises one or two medical students. This busy service consults on patients in General/ Neurovascular/Surgical/Cardiac Intensive Care units and the Burn/Trauma unit, as well as step-down units, the OB/Gyn service, surgical and internal medicine floors, and the Rehabilitation unit.

The resident has primary responsibility for the day-to-day running of the service, and regularly consults with physicians from other services, working closely with them in making recommendations for care and helping to implement those recommendations. Supervision is provided by David Spiegel, M.D., and William McDaniel, M.D.