EVMS Training Facility - Hampton VA
Training Facility - Hampton Veterans Administration Medical Center
First-year residents have two separate two-month internal medicine rotations at the VAMC. Working alongside internal medicine residents, they care for patients in the ICU and on the wards. We have the opportunity to work with specialists, particularly those in the HIV, renal, oncology and infectious diseases fields. There is a unique opportunity to become familiar with caring for patients with spinal cord injuries and those who are on ventilators.
The first-year neurology rotation is also at the VAMC. Residents work directly with an attending to care for both inpatients on the consult service and outpatients. The Epilepsy Clinic is a wonderful opportunity to learn about seizure disorders and their care. First-year residents also rotate on the inpatient psychiatry wards. The wide variety of patients make this an excellent rotation. Working with an attending and a senior resident, the first-year resident cares for patients with PTSD, schizophrenia, substance abuse, mood disorders, and the full gamut of psychiatric illnesses. We learn a great deal about psychopharmacology as well as the management of different illnesses. There is the opportunity to lead therapy groups as well as provide a small amount of supportive psychotherapy. Experience with ECT is also a part of this rotation.
In the second year of psychiatry residency, residents spend three months working in the emergency department, seeing patients who come in seeking psychiatric care. Working closely with an experienced psychiatric nurse and an attending, we evaluate patients and make the decision whether to hospitalize them, start medications, refer them or send them home. This rotation is quite challenging but rewarding!
In third year, residents work in the outpatient Mental Hygiene Clinic, providing medication management, evaluations and therapy to a wide variety of patients. These residents work closely with clinic staff and are supervised by staff psychiatrists. This position offers a great deal of autonomy and is a wonderful opportunity for residents to solidify the knowledge they have gained in the first two years of residency.
In fourth year, there is a geriatric psychiatry rotation. During this month, we work with an attending to care for older psychiatric patients in the nursing home, on the medical wards, and evaluate them in the emergency department. This rotation underscores the many concepts of geriatric care that are taught in didactics throughout the years.
The fourth year of residency includes a two-month substance abuse rotation at the VA hospital. Residents work within well-established substance abuse recovery programs and are an integral part of the team. The programs are directed by two attendings who are board-certified in substance abuse. Residents have a unique opportunity to become familiar with many of the elements of treating those in recovery and to broaden their awareness of substance abuse issues.
Also in fourth year, there is a 3-month Senior Resident rotation on the inpatient psychiatry wards. This resident directly supervises a first-year resident and a medical student, and works alongside an attending. This very responsible position is invaluable in solidifying our knowledge of psychopharmacology, psychodynamics and management of all major psychiatric disorders.