Clinical Experiences and Education

Clinical Sites

LAC+USC Medical Center

LAC+USC Medical Center is a vast complex of county medical facilities located immediately across the street from the USC Health Sciences Campus. The iconic art deco General Hospital that was once the cornerstone of clinical care and graduate medical education was replaced in November of 2008 with a state-of-the-art 600-bed hospital. LAC+USC Medical Center serves a vital training mission, providing residency education for over 900 physicians annually, including over 60 physicians in psychiatry training programs. The medical center’s size, abundance of rich clinical experiences, and expertise in medical education have established the LAC+USC Medical Center as a dominant medical influence in Southern California for decades and the largest provider of healthcare in Los Angeles. As one of the busiest public hospitals in the United States, we are proud to serve diverse, underserved, and historically marginalized patient populations across Los Angeles County.

Augustus Hawkins Mental Health Center

Inpatient psychiatric services are based at the 62-bed facility at the Augustus Hawkins Mental Health Center, which is located approximately 18 miles south of the LAC+USC Medical Center. The inpatient hospital contains three adult teaching wards (33 beds) and the only adolescent ward in the county (10 beds). Admissions are primarily involuntary. Patients are predominately underserved patients with a high level of psychiatric acuity, often facing complex psychosocial stressors including poverty, substance abuse, housing instability, trauma, and legal concerns.

The USC Health Sciences Campus

The University of Southern California is a large private university with two campuses located seven miles apart. The University Park Campus is southwest of downtown Los Angeles; the Health Sciences Campus is two miles northeast of downtown. The Health Sciences Campus is home to the Keck School of Medicine, which has more than 700 students, and to the School of Pharmacy. The campus includes three modern private hospitals: Keck Hospital of USC, the Norris Comprehensive Cancer Center, and the Roski Eye Institute.

Veterans Affairs

Rotations at USC-affiliated VA facilities in downtown and West Los Angeles allow for specialized training in addiction and geriatric psychiatry.

Core Rotations & Rotation Schedule

Emergency Psychiatry

  • Location: LAC+USC Medical Center
  • Our 20-bed psychiatric emergency department is one of the busiest in the country
  • Residents provide psychiatric & forensic assessments of patient’s risk of suicide or dangerous behavior and capacity for self-care, providing emergency care for patients in crisis
  • Learning experience highlights:
    • Building expertise in the use of emergent psychotropic medications
    • Managing psychiatric emergencies with verbal de-escalation in combination with medication, gaining confidence with patients in crisis in a secure & supported setting
    • Provide consultations for high acuity patients in the medical emergency department
  • Call: No call

Inpatient Psychiatry

  • Location: Augustus Hawkins Mental Health Center
  • Rotation provides an intensive experience in diagnostic evaluation and treatment as well as introductions to major psychopathologies and the legal regulation of inpatient psychiatric practice (e.g., hospital- and court-based legal hearings)
  • Residents carry a typical caseload of five to eight patients under the supervision of faculty psychiatrists
  • Learning experience highlights:
    • Caring for complex patients facing numerous psychosocial stressors and severe mental illness, gaining confidence in a high-acuity setting
    • Testifying in patient legal proceedings based in the hospital and in one of the largest mental health courts in the county
    • Managing common medical comorbidities in an inpatient psychiatric setting in combination with a full-time, in-house, internal medicine attending
  • Call: Typically two weeks of night float (7PM-7AM), two weeks of day float (7am-7pm), two weekends of long call (7am-7pm), and two weekends of short call (7am-12pm) per academic year for first- and second-year residents

Outpatient Psychiatry

  • Location: LAC+USC Medical Center
  • PGY-2 residents have one afternoon per week embedded in their Emergency Psychiatry rotation to introduce them to the practice of outpatient psychiatry
  • PGY-3 residents spend the majority of their outpatient year at the Adult Outpatient Psychiatric Clinic (AOPC) at LAC+USC Medical Center, a clinical setting focused on resident training
  • Resident schedules incorporate half-day experiences in various integrated care settings, including adult primary care, geriatrics, OB/GYN, and pediatrics, in addition to one half-day per week working with patients in a private hospital setting via Keck Medicine of USC
  • Learning experience highlights:
    • Building a sense of commitment & connection to a personal caseload of approximately 80 patients with a longitudinal connection over 1-2 years
    • Gaining expertise in psychodynamic and cognitive behavior therapy with a therapy caseload of 4-6 patients per week, with individual weekly faculty supervision in each therapeutic modality
    • Collaborating with co-residents to conduct weekly group therapy sessions
  • Call: No call

Consultation Psychiatry

  • Location: LAC+USC Medical Center and Keck Hospital
  • The Psychiatry Consultation-Liaison Service serves a high volume of patients throughout LAC+USC Medical Center, including a jail ward for currently incarcerated patients with acute medical concerns and a 24‐bed behavioral medicine ward
  • The Consultation-Liaison service at Keck Hospital presents opportunities to evaluate and treat patients on specialized medical/surgical services, including transplant, bariatric, and oncology services, with additional opportunities for clinical exposure to electroconvulsive therapy
  • Learning experience highlights:
    • Developing confidence and an independent clinical style by leading a consult team consisting of one PGY-2 resident, one attending physician, and medical students, with close one-on-one attending mentorship
    • Performing psychiatric transplant evaluations for donors and recipients
    • Exploring the interface between complex medical conditions and psychiatric treatment, closely collaborating with residents in other specialties throughout the hospital
  • Call: No call

Education

All residents have protected time to attend a half-day of core lectures weekly. The didactic curriculum for each year is designed to augment training and teaching provided on individual clinical services and to ensure comprehensive instruction in all ACGME milestone areas in psychiatry.

PGY1 Curriculum

The first year curriculum serves to introduce residents to core skills in psychiatric practice including psychiatric interviewing, violence risk assessment, mood and psychotic disorders, and neurological and medical knowledge related to psychiatry. Examples of included lectures include Psychosis: Diagnosis and Differential, Movement Disorders in Neurology, and Psychiatry in Film.

PGY2 Curriculum

The second year curriculum continues to develop resident knowledge of anxiety disorders, trauma, and personality pathology, and introduces core concepts related to Consultation & Liaison psychiatry including capacity assessments, psycho-oncology, HIV psychiatry, and women’s mental health. Residents also begin to deepen their psychotherapy and start their CBT curriculum midway through their second year.

PGY3 Curriculum

The third year highly emphasizes different psychotherapeutic techniques in addition to continuing to strength resident’s knowledge of medications commonly utilized in the outpatient practice. Topics for lectures including psychodynamic formulation, couple’s therapy, sexuality, and Intensive Short-Term Dynamic Psychotherapy.

PGY4 Curriculum

The fourth year curriculum continues to develop past topics in addition to focusing on specific subspecialty topics such as palliative care and sleep medicine. This year also has a large focus on career development, with series on career exploration and on recent publications to help transition our graduates into their career.

Service-Specific Curricula

Each major clinical service including inpatient, emergency, consultation-liaison, and ambulatory services sponsors a separative curriculum including content specific to each service, including case conferences, ethics discussions, and journal club meetings.