Postgraduate Year 4

In the fourth year it is expected that residents will refine their basic skills as well as acquire new knowledge in particular areas of interest of psychiatry. All residents are expected to continue outpatient psychotherapy and medication management clinics. There is significant time available for additional elective experiences based on resident preferences. Residents may elect to have an administrative experience on one of the inpatient units or outpatient clinics, provide community consultation, and/or conduct research.

About 50 percent of a fourth-year resident’s time is devoted to an assigned clinical experience, such as serving as a junior attending on an inpatient unit or junior attending in one of the specialty clinics. The remaining 50 percent is devoted to elective activities which include clinical, teaching, and/or research options.

Alternatively, fourth-year residents may elect to enter one of the fellowships offered by the Department of Psychiatry at the PGY-4 level: Child and Adolescent or Women's Mental Health. These fellowships have specific clinical research programs and allow the resident to develop an area of expertise before beginning a private, public, or academic career.

Elective rotations in the fourth year vary with resident preference and may include an in-depth clinical experience in any one of the department’s programs - Neurobehavioral, Psychotic Disorders, Women's Mental Health Services, Mood & Anxiety Disorders, or Child and Adolescent Psychiatry.


  • Further development and consolidation of an identity as a psychiatrist through administrative assignments as chief resident or senior resident in a variety of clinical settings.
  • Integration of clinical skills through participation in a variety of selective and elective rotations.
  • Further development of intellectual curiosity through participation in ongoing research or development of new projects.

Grand Rounds Presentation. As part of the ACGME requirement for academic activity, our senior residents are required to present at the department grand rounds. They can select the topic and form of the presentation. Clinically-based residents often opt for the presentation of a clinical case or series of cases that served as the basis for educational development. For those residents who conducted research or completed a specific research project, they will often present the process and results.


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