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Job Description:

Maintain a satisfactory record of assigned patients for whom he/she has primary care. Copies of these records shall be filed monthly with the program director and shall be available for inspection. Maintain medical records as defined by the program director. Submit an annual report to the American College of Osteopathic Neurologists and Psychiatrists. Write one (1) professional research project pertinent to psychiatry which is suitable for publication. The paper shall be submitted to the American College of Osteopathic Neurologists and Psychiatrists during the last year of training prior to completion of the residency training. Participate in all professional staff activities involving patient care and evaluation as assigned. Attend at a minimum of 85% of didactics, all in a timely fashion, only with prior approval for dismissal.

A. Internal Medicine

Ability to take a complete medical/radiologic history and perform a complete review of all previous studies from an internal medicine perspective. Perform both general and problem-focused physical examinations on patients. Ability to formulate comprehensive and accurate problem lists, differential diagnoses and plan of management from an internal medicine perspective. Develop specific motor skills necessary to perform procedures on patients (i.e. Lumbar puncture, thoracentesis, central venous pressure line insertion, and venipuncture). Ability to apply knowledge of anatomy, diagnosis, and treatment of disorders of the musculoskeletal system commonly seen in internal medicine patients. Analyze pathophysiological principles to understand the reason that patients develop signs and symptoms from various diseases. Apply basic pharmacological principles and prescribing practices to the treatment of common internal medicine diseases. Communicate with sensitivity when dealing with patients and family members who are upset, fearful or confused. Develop communication skills that facilitate the dissemination of information to patients and family members from diverse cultural and socioeconomic backgrounds. Demonstrate clearly and accurate gathering of broad information from clients through effective listening skills. Exemplify the behaviors of service quality, professional & ethical conduct in all inter-actions with patients, families and colleagues. Demonstrate respect for patients, their families, peers, other medical and mental health professionals and ancillary staff. Maintain the highest standards of ethical and professional behavior. Identify and utilize resources for dissemination of new information and research regarding the practice of internal medicine through professional scholarship. Identify evidence-based medicine guidelines in the field of internal medicine though critically perusing highly revered sources. Demonstrate the practical use of such learning by using the information in the internal medicine practice and communicating with colleagues. Develop knowledge of when to consult, seek advice or assistance in an internal medicine case in a manner that maximizes patient care and minimizes miscommunications. Employ a team oriented approach to problem solving in internal medicine. Advocate for the needs of the patient, particularly in light of the limitations of the healthcare delivery system.

Neurology Ability to take a complete medical/neurologic history and perform a complete review of all previous studies from a neurology perspective. Ability to perform and document a comprehensive history and physical exam. Ability to formulate comprehensive and accurate problem lists, differential diagnoses and plan of management from a neurology perspective. Develop specific motor skills necessary to perform procedures on patients Build and demonstrate a solid foundation of neuroanatomical knowledge to become familiar with indications for prominent neurological conditions. Demonstrate knowledge of the pathophysiology relevant to system-wide issues involving respiratory, cardiac, endocrine and other systems. Begin to develop an understanding of how medical care is delivered in an integrated manner between psychiatry and neurology. Develop skills for effective, compassionate communications with patients and families, particularly with regard to neurological functioning and prognosis. Demonstrate effective and appropriate interpersonal and communication skills within the neurology team, and with nurses, consulting physicians & ancillary services. Interact professionally toward patients, families, colleagues, and all members of the health care team. Demonstrate ethical and honest behavior in all professional interactions. Develop competence in quickly documenting treatment and prescribing practices in the medical record to facilitate effective care across disciplines. Develop an evidence based approach to patient management by a critical perusal of the available neurology literature as it applies to evidence-based medicine. Demonstrate facility with targeted literature search and data integration designed to improve patient care practice. Develop knowledge of when to consult, seek advice or assistance in a neurology case. Prepare and present neurology case example at grand rounds. Complete all required trainings on confidentiality, practice expectations and core clinical orientation materials. Dedicate to life-long learning and to practice habits in osteopathic philosophy and manipulative medicine if applicable.

Inpatient Geriatric Psychiatry Have competency in conducting a thorough geriatric psychiatric interview and in generating a DSM-V/ICD-10 diagnosis. Assess client’s functioning on an on-going basis while in the inpatient setting, particularly with regards to neurocognitive functioning, adaptive/functional living ability, medication side effects and potential for self-harm/other-harm/self-neglect. Become competent in planning for the treatment of both the acute psychiatric disorder, using the best practices available, and any chronic neurocognitive challenges that the client presents with. Efficiently document psychiatric evaluations, treatment planning, discharge planning and prescription generation using the electronic medical record. Show clients concern and professional interest in an age-appropriate manner at all times. Augment one’s knowledge of psychiatry, neurology, dementia processes, psychopharmacology as it relates to an acute geriatric population. Develop knowledge of patient evaluation and treatment selection, including neurocognitive diagnostic tools and studies related to effective therapeutics. Develop awareness of how psychiatric health care is delivered in a population with multiple health issues, neurocognitive impairments and limited resources. Enhance ability to access both broad scientific/medical research (journals, etc.) and specific client-specific information (medical record). Begin to develop awareness of geriatric psychiatry as a specialty area and begin to assess competence in treatment of such populations. Expand knowledge of other disciplines (social work, nursing), particularly neuropsychological screening/assessment by the psychology staff. Become exposed to a wide range of disorders commonly found in a geriatric population (delirium, dementia, Korsacoff’s psychosis etc.) and develop competence in evaluating and treating such disorders. Develop competency in establishing and maintaining therapeutic rapport with geriatric clients and their families through effective listening strategies and respectful interactions. Clearly, concisely and in an age-appropriate manner, communicate with geriatric clients, particularly taking into account hearing deficits, comprehension challenges and other barriers to communication. Communicate and collaborate effectively with colleagues from other disciplines (particularly the discharge care managers) in arranging safe post-discharge placements for the geriatric clients. Develop effectiveness in participating in a multidisciplinary treatment team. Develop increased self-awareness of the personal biases and issues that might impact effective care with geriatric clients; develop strategies to mitigate the impact of these biases. Become competent to explain to geriatric clients, family members, and professionals about scientifically-valid medical, psychosocial and behavioral issues with regard to geriatric psychiatry in a manner consistent with their cognitive abilities. Become competent in initiating a consultation referral and in providing a consultation to a referral. Enhance ability to tailor treatment while respecting the cultural, ethnic, religious, economic, and sexual orientation diversity of clients and their families. Maintain caring responsibility for the geriatric client’s treatment by being respectful, timely, clear and direct in communications with the client and others interested in his/her care. Develop effectiveness in identifying the appropriate level of care for geriatric clients, including making referrals to assisted living facilities, outpatient and residential settings. Become effective in coordinating care for clients through consultations, referrals, and direct care while maintaining appropriate continuity of services. Develop practice patterns that provide for effective care for geriatric clients, particularly with a focus on identifying undiagnosed medical issues and cognitive challenges to medication/ treatment compliance. Identify areas of the scientific literature dealing with geriatric psychiatry and become familiar with the best sources to regularly obtain useful information. Assess the scientific literature critically and with particular focus on evidence-based practices that will help your geriatric clients. Become competent in effectively providing care within an inpatient geriatric treatment setting, following all hospital guidelines. Develop awareness of broader community resources that may aid treatment effectiveness; work effectively with geriatric case managers to access such services. Have effective teamwork strategies in working with colleagues and broader healthcare delivery systems in providing high levels of care to geriatric clients. Use appropriate consultation and referral systems when dealing with the medical complications of aging in the geriatric clients. Become facile in dealing with Medicare, state-funded grant programs, managed health systems, and other entities that fund care for the geriatric population. Develop an awareness of practice issues that can result in adverse risk to the company or legal issues that can impact clients, avoiding negative results to both. Maintain behavior at all times that is consistent with Centerstone and ACGME as applicable. Enhance ability to provide compassionate care to geriatric clients and their families, recognizing the competencies and limitations of each. Develop a thorough understanding of the role of aging as it applies to the musculoskeletal system in psychiatric disorders and other somatic issues.

Population(s) Served:

Residents will treat adults suffering from acute psychiatric illness, with a high percentage of clients aged 55 and older on the Centerstone Hospital campus. Residents will treat patients with the diagnosis of Alzheimer’s disease and related disorders, mild cognitive impairment, and cognitive dysfunction secondary to brain damage or disease. Residents will treat patients with general medical conditions and other diagnoses relating to diabetes, cardiac, emergency, orthopedic, surgical, and neurological conditions at Manatee Memorial Hospital.

Schedule:

The trainee shall not be assigned to work physically on duty in excess of 80 hours per week averaged over a four-week period, inclusive of in-house night call; moonlighting is not permitted during PGY-1 and PGY-2. No exceptions to this policy shall be permitted.

The trainee shall not work in excess of 24 consecutive hours.

Allowances for already initiated clinical care, transfer of care, educational debriefing and formal didactic activities may occur, but shall not exceed four additional hours and will be reported by the resident/fellow in writing with rationale to the Program Director and reviewed by the GMEC for monitoring individual residents and program. These allowances are not permitted for PGY-1 trainees. Trainees shall not assume responsibility for a new patient or any new clinical activity after working 24 hours.

The trainee shall have 48-hour periods off on alternate weeks, or at least one 24-hour period off each week and shall have no call responsibility during that time.

Upon conclusion of a 20-24 hour duty shift, trainees shall have a minimum of 12 hours off before being required to be on duty or on call again.

For all rotations, it is up to the resident to monitor work time and report to the Program Director any infractions prior to working over allotted periods as referenced above.

Time Type:

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Centerstone is an equal opportunity employer. Employment at Centerstone is based solely on a person's merit and qualifications directly related to professional competence. Centerstone does not discriminate against any employee or applicant because of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), or any other basis protected by law.

At Centerstone, we use our values as a guide for what we do. Respect, Expertise, Integrity and Empowerment are at the heart of every interaction at Centerstone, and particularly rooted in our beliefs toward diversity and inclusion.

Our approach to diversity is simple—it’s about embracing everyone. Together, we continue to develop an inclusive culture that encourages, supports and celebrates the diverse voices and experiences of our employees. It powers our innovation and connects us closer to each other, to our clients and the communities we serve. We strive to create a workplace that reflects the growing world around us, and where everyone feels empowered, safe and welcomed.