How We Learn
Scholarly Concentration, Didactics, Therapy Training, Pathways, Research Track, and Diversity
At Stanford, we put a lot of emphasis on self-directed and independent learning, coupled with strong mentorship to allow you to get to your goals. One of the ways in which we implement this philosophy is through our well-received scholarly concentration (elective) time in our curriculum. PGY-2 residents receive 8 weeks of full-time to explore their interests, whether clinical, educational, or research-related; PGY-3 residents receive 200 hours spread out throughout the year, and PGY-4 residents receive 500 hours spread out over 6-12 months (or 6 months of 50% time). This is 100% protected time to pursue our interests (and residents often expand their projects to more than just the time allotted to them). Here are some of the ways in which residents are currently (or in the recent past) using their concentration time:
Specialized Clinical Experience:
- Women’s Wellness (i.e. pregnant and lactating women)
- La Clinica
- Sports Psychiatry (student and professional athletes)
- Psych-Oncology Clinic
- HIV Psychiatry (Positive Care Clinic)
- Child & Adolescent Psychiatry (additional/early clinical rotations)
Additional Training in Psychotherapy:
- Cognitive Behavioral Therapy for Insomnia
- Couples & Family Therapy
- Advanced Topics in CBT
- DBT for Adult Eating Disorders
- Same-Sex Couples Therapy
- Black CAPS (African and African-American Stanford students)
- Advanced Topics in Psychodynamic Psychotherapy
- Mindfulness-based substance use reduction therapy
- Time-Limited Dynamic Psychotherapy
- TMS and DBS
- Consultations on the inpatient units for patients with Functional Neurological Disorder
- Home visits
- Screening for Eating Disorders
Exploratory & QI Examples
- Writing columns on mental health in popular media outlets (i.e. Washington Post, Scientific American)
- Literature of Psychosis - studying psychosis through artistic expressions and literary works
- Studying cultural influences on body image perceptions
- Understanding health technology
- Interviewing teens at juvenile hall to better understand risk and protective factors
- Development of a Spiritual Psychiatric Integrative Residential Intensive Treatment Program (SPIRIT)
- Effective interventions for the prevention of PTSD in post-disaster settings
- Designing ICUs to reduce delirium potential (in collaboration with the Stanford Design School)
- Archetypal and Existential Psychotherapy
- Creating medical documentation orientation for interns
- Development of lunchtime talks on mental health portrayals in the public media
- Resident-led medical student reflection groups
- Gender & Sexuality, Culture & Spirituality curriculum development
- Guiding Asian parents towards more effective communication with their teens (www.stanfordchipao.com)
- Creating educational materials for early psychosis patients
- Inpatient curriculum development for residents to teach medical students
- Completing an MPH or MBA
- Minority Stress and Outreach Workshops
- Psychoanalytic and Psychodynamic Psychotherapy Fellowship
- Development of a Stanford University course: Leadership in Mental Health
- Assisting psychiatry faculty in the teaching of Stanford undergraduate humanities courses: Culture & Madness, and Psych & Art & Literature
- Co-leading underclassmen in Psychodynamic Psychotherapy supervision
Global Mental Health Examples
- Jujuy, Argentina
- Chennai, India
- Santiago Atitlan, Guatemala
- Petra, Jordan
- Kathmandu, Nepal (post-earthquake)
- Houston, TX (post-hurricane)
- Influential factors in high-functioning psychosis
- Development of interdisciplinary simulation modules
- Metabolic Disorder in patients with schizophrenia in Argentina
- Biomarkers using EEG for the Amelioration of Mood disorders (BEAM) study
- Benzodiazepine Review manuscript
- Factors driving educational inequality
- Geriatric psychiatry inpatient interventions for reducing readmission
- Studying effects of various therapy models for functional neurological disorder
- Neuroimaging in children with autism
- Understanding the impact of the environment on health-behaviors (nutrition, healthy eating, community food systems, food security)
- Needs assessment in access to mental health care in underserved community of East San Jose
- Functional connectivity of adolescents at risk for depression
- Eating disorder assessments and treatments
- Reviewing literature on stigma and mental health utilization by Korean immigrants and Korean-Americans
- Outcomes for ECT non-remitters
- Imaging studies in substance use disorders and PTSD
- Cultural factors in caretaking of chronically mentally ill patients in the Chinese community
- Refugee Mental Health, Human Rights, and Gender-Based Violence
- Obesity and Weight Management Disorders
- Qualitative research regarding attitudes of athletes and cultural aspects of athletics that influence participation in mental health interventions
Our didactics run 12-5pm each Thursday for all residents and the coursework is split into four quarters of the year.
Grand Rounds is held 12-1pm from October through June, followed by a resident lunch. During the summer quarter, lunch is scheduled 12-1pm. During lunch, residents lead talks on topics ranging from implicit bias to global mental health to psychiatry in the media. Lunch is followed by an afternoon of classes. PGY1s and 2s have process group during this time. Courses vary by quarter as noted below.
The PGY1 Essentials of Psychiatry is an integrated course that runs the whole year and covers important topics pertinent to intern year, including emergency psychiatry, inpatient psychopharmacology and psychosocial treatments applicable to treating a psychiatric inpatient.
PGY2s spend 9-months learning the basics of psychodynamic psychotherapy paralleling the start of their first outpatient, dynamic therapy case early in the year. They also cover more in-depth psychopharmacologic treatments though a flipped classroom/team-based learning approach. The program directors teach the Leadership, Scholarship, & Career Development, QI and Clinical Teaching courses early in the year, preparing residents for upcoming scholarly concentration time, the development of QI projects and medical student ward teaching. The 6-month clinically-focused neuroscience course begins at the end of PGY2 year.
As PGY3s enter their outpatient training, didactics focus on outpatient treatments including psychopharmacology and more advanced psychodynamic concepts, as well as an introduction to CBT and Couples and Family Therapy. Residents explore more systems issues through their forensics and public and global psychiatry courses. Issues of culture & spirituality are explored through an innovative, process-oriented approach. As PGY3s complete the year, they continue to develop their leadership skills as they prepare for careers post-residency.
During the PGY4 year, course content strives to deepen residents’ understanding of themselves, humanity, and the field in general. The didactics also seek to prepare residents in a very practical manner for their future jobs.
Individual Psychotherapy Training
Supportive Psychotherapy: Evaluation clinic
- ½ day per week for 2 months
- Supervision with one way mirror
Thursday Didactics: Introduction to Biopsychosocial Formulation, How to Interview, Motivational Interviewing, CBT for Psychosis, Behavioral Activation, DBT for Inpatient
Psychodynamic Psychotherapy: Individual Psychotherapy Clinic (IPC)
- 1 Patient (long-term)
- 1 hour of individual supervision with videotape feedback
- 1 hour of group supervision with 2 co-facilitators (faculty and PGY 4 resident)
Thursday Didactics: Introduction to Psychodynamic Psychotherapy; General Psychiatric Management for Borderline Patients
Psychodynamic Psychotherapy: Individual Psychotherapy Clinic (IPC)
- 2-3 Patients (1 may continue from PGY2 year)
- 1-2 hours of individual supervision (may have multiple supervisors) with videotape feedback
- 1 hour of group supervision with co-residents and 2 faculty facilitators
Cognitive Behavioral Therapy: Psychosocial Treatment Clinic
- 3 Patients
- 1 hour weekly clinic didactics
- 1.5 hours group supervision
- Elective experience
- 1 Patient for 6 months
- Weekly supervision
Thursday Didactics: CBT bootcamp and Advanced CBT didactics, Couples and Family Therapy, Evolution of Psychodynamic Psychotherapy: Theory and Practice, Dynamic Case Formulation, Working with Trauma
Psychodynamic Psychotherapy: Individual Psychotherapy Clinic (IPC)
- 2-3 Patients
- Option to do “IPC plus” rotation with 4-5 patients;
- 1-3 hours of individual supervision (may have multiple supervisors)
- Optional Group Supervision
- Option to co-facilitate PGY 2 IPC Group Supervision
- Cognitive Behavioral Therapy: Psychosocial Treatment Clinic
- CBT for Psychosis: INSPIRE clinic
- Time Limited Dynamic Psychotherapy (TLDP): Evaluation Clinic or IPC “Plus”
- Interpersonal Therapy: Women’s Wellness Clinic
- Dialectical Behavioral Therapy: DBT Clinic
Didactics: Time-Limited Dynamic Psychotherapy, advanced psychodynamic topics, Dialectical Behavioral Therapy, How to Supervise, Existential Therapy, , Countertransference Seminar, Psychodynamics of Sexuality, Dreams in Psychodynamic Psychotherapy
- Resident Support/Process groups: Led by two experienced group leaders per year. Developmentally-designed process groups starting with support group in PGY 1 & semi-structured process group in PGY 2. Optional dynamic-based process groups in PGY 3 & 4 year. Groups are an essential part of the educational experience supporting residents through the transition from medical school, facilitating bonding among residents, and helping residents develop identities as psychiatrists. Ideally, they contribute to residents’ increased breadth and depth of awareness of individual, relational and group interpersonal processes. Weekly, 1-hour sessions throughout year
- Inpatient groups: Co-facilitate with psychologist as part of VA and Stanford inpatient rotations including inpatient group didactics at Stanford.
- Outpatient therapy groups: Opportunities to co-lead groups in Stanford and VA outpatient settings include Dynamic Psychotherapy Group for Functional Neurologic Deficit Disorder patients, Dialectic Behavioral Therapy, Addictions and Bipolar Disorder groups
- Medical Student Support Groups: Opportunity to co-facilitate med student support groups and attend group training sessions and supervision
- Women in Science and Engineering Support Group: Opportunity to facilitate WISE group with supervision
Academically oriented psychotherapy opportunities
- Psychotherapy Pathway
- Psychotherapy Related Scholarly Projects
Additional therapeutic training resources in the area
Our Pathways Program provides residents with cohesive academic pathways starting in the PGY2 or PGY3 year that encompass specialized clinical care, scholarship, teaching, and leadership with the goal of preparing residents for a career in a specified area of psychiatry. Residents have the option of “specializing” in one of the following areas: Clinical Educator, Psychotherapy, Neuropsychiatry, Addiction, Community Psychiatry, Global Mental Health, Diversity and Health Equity, Psychosomatic Medicine, Geriatric Psychiatry, Women’s Mental Health, Child Psychiatry, Eating Disorders & Weight Management, Interventional Psychiatry, Trauma or Humanities and Psychiatry. Residents will be assigned a mentor within each pathway.
The following is an example of a pathway requirement for Community Psychiatry. The pathway resident must engage in an activity in each focus area (2 for clinical):
- Bill Wilson Center
- School-based child rotation
- La Clinica de la Raza
- Advanced rotation at PACE or Center for Survivors of Torture
- Uplift Family Services
- Asian Health Services
- Participate in case conferences
- Community speaking opportunities
- Stanford CAPS Student Health Outreach
- Community Psychiatry Workgroup
- Immigration Issues Workgroup
Stanford Medical School
- Office of Community Health
- Jeanne Spurlock Congressional Fellowship
- APA/APAF SAMHSA Minority Fellowship Program
- APA/APAF SAMHSA Diversity Leadership Program
- Group for the Advancement of Psychiatry (GAP) Fellowship
- APA Fellowship in Public Psychiatry
- John P. Spiegel Memorial Fellowship
- American Association of Community Psychiatrists
- Directed Reading
- Institute for Psychiatric Services conference
The Stanford Psychiatry Residency Research Track program offers a unique opportunity for residents interested in developing independent research careers in academic psychiatry. The research track is designed for residents with extensive research background to continue to engage in basic science, translational, and clinical research throughout residency. Stanford Psychiatry has a long-standing history of research excellence, cultivating generations of leaders in the field of neuroscience and psychiatry. We pride ourselves on interdisciplinary scholarship, dedicated mentorship and a culture of innovation and interdisciplinary collaboration. With easy access to world-class faculty and research laboratories, research track residents are encouraged to engage across disciplines and work with program directors to customize their training.
Residents are admitted to the research track under a separate ERAS NRMP number. Residents interested in applying to the research track should indicate this in their ERAS application. Interviews for the research track include the interview process for the categorical track as well as additional interviews with research faculty. Research track candidates will be asked to complete a supplementary application form, wherein they may request to interview with potential research mentors. Research track applicants may be asked to give brief presentations about their research plans.
Protected Research Time
- 100% time over 3 four-week blocks
- Every effort is made to honor research goals in determining time of year and contiguous vs nonadjacent block scheduling.
- 25% longitudinal time over the year
- Residents apply for T-32 fellowship during this time
80% research time, 20% clinical time under requirements of T-32 fellowship
Research fellows will be mentored on writing grant proposals to obtain independent sources of funding and will be encouraged to apply for academic faculty positions upon completion of their fellowship.
As an alternative, residents may also apply into the child and adolescent psychiatry integrated research/clinical fellowship.
Stanford’s internationally-renowned research faculty welcome residents in their labs. There are world-class neuroimaging and basic science labs, an array of clinical research labs both at Stanford and at the Palo Alto VA Hospital, as well as opportunities to participate in translational research in engineering, epidemiology and population health, and the interface between psychiatry and other fields including the humanities.
Mentorship and Funding
The Stanford Department of Psychiatry has a strong history of research training and we take pride in mentoring our research track residents. Research track residents have the opportunity to identify prospective mentors during the application process as well as during the first couple of years in residency. Research track residents are also provided with start-up funds by the department and are eligible to apply for internal departmental research grants as well as other federal and private research funding opportunities.
Research for Non-Research Track Residents
Residents interested in research but not wanting to have research as a primary career goal are also encouraged to engage in research under our scholarly concentration program. There are also opportunities to obtain advanced degrees during residency training including doctoral training as well as master’s level training.
Residents are heavily involved in both existing program-specific and Stanford-wide diversity initiatives, and are also encouraged to pursue new endeavors. Below are ongoing opportunities and areas of interest.
Building a Diverse Community
- Diversity and Inclusion Advisory Council: resident-led group focusing on recruitment of underrepresented minorities and individuals from other groups underrepresented in medicine into the Stanford Psychiatry Residency program; additional emphases include curricular development, mentoring and wellness.
- Stanford GME Diversity committee: hospital-wide committee with a mission to address systems of privilege within medicine, including those based on race, ethnicity, gender, sexual orientation and physical ability.
- Stanford LGBTQ Housestaff and Allies: promotes community among LGBTQ-identified housestaff, collaborates with LGBTQ Meds (medical student group)
- Stanford Clinical Opportunity for Residency Experience (SCORE) program: The Stanford Psychiatry Residency program is proud to participate in the SCORE program, which supports Stanford Medicine’s mission to diversify its workforce by bringing fourth-year medical students from diverse backgrounds, including those individuals who are underrepresented in medicine, and/or socially, economically, or educationally disadvantaged, to Stanford for a four-week residential clinical training rotation.
- Stanford Leading through Education, Activism and Diversity (LEAD) program: the Stanford Psychiatry Residency program has had strong representation in LEAD, a 10-month, interdepartmental longitudinal program that provides leadership training and mentorship in creating scholarly works around diversity and inclusion topics.
- Ongoing exploration of pathways towards academic careers in mental health for individuals from underserved communities, including “pipeline” development.
Diversity-Inclusive Clinical Experiences
During core rotations, residents care for diverse patient populations in a broad array of settings.
- Inpatient and emergency psychiatry rotations:
- Palo Alto Veterans Hospital
- Stanford Hospital
- Crisis Stabilization Program at Santa Cruz County Psychiatric Emergency Services
- Outpatient electives:
- Santa Clara County Partners in AIDS Care and Education (PACE) clinic
- Center for Survivors of Torture (through Asian Americans for Community Involvement)
- La Clinica (community health center in Oakland)
- San Jose Community Based Outpatient Center (integrated care clinic at San Jose VA)
- Momentum for Mental Health ( nonprofit mental health center in Santa Clara County):
- Sanford Positive Care Clinic
- Residents may request training experiences in psychotherapy that emphasize multi-culturalism, LGBTQ-focused care and other issues of diversity/identity
- Stanford Specialty Clinics including Addiction Medicine Dual Diagnosis, Women’s Wellness, Depression, Obsessive Compulsive Disorder, Bipolar Disorder, Psychosomatic Medicine, Geriatric, Neuropsychiatry, Asian Mental Health, Pediatric Gender Clinic
Curricular and Didactic Educational Experiences
- Curriculum Development
- Education around issues related to Diversity & Inclusion is embedded into the core didactic curriculum in PGY years 1-4. Topics include: dedicated culture and spirituality in psychiatry course in PGY3 year, LGBTQ language and usage, structural racism, minority and majority identity development, microaggressions, intersectionality, trauma, social determinants of health, military culture and more.
- Resident-led workgroup to review and update curricular topics and objectives
- Speaker Series
- Residents brainstorm, develop and coordinate sponsored seminars on topics such as implicit bias, tools for communicating with vulnerable populations, issues in LGBTQ mental health, race/racism and mental health, allyship, disaster psychiatry, etc.
- Both the GME and the Psychiatry and Behavioral Sciences department sponsor Grand Rounds focused on issues related to Diversity and Health Equity
- Stanford Counseling & Psychological Services Outreach seminar: an elective course to increase clinicians' understanding of social justice and to help develop skills in delivering outreach services
Fellowships and Awards
In recent years, residents have been awardees of a number of diversity-related fellowship/awards including:
- APA Diversity Leadership Fellowship
- APA SAMHSA Minority Fellowship
- Jeanne Spurlock, MD Minority Fellowship Achievement Award
- Association of Women Psychiatrists Fellowship
- AADPRT Nyapati Rao & Francis Lu International Medical Graduate (IMG) Fellowship
- Indo-American Psychiatric Association Outstanding Resident Award
- California Medical Association Cultural and Linguistic Competency Award
Scholarly Activity and Advocacy
Resident scholarly work and areas of advocacy include:
- Survey of students, residents, and faculty that assesses knowledge-base and comfort-level in caring for LGBTQ patients, as well as level-of-interest in joining an LGBTQ clinic
- Interdisciplinary work with committees throughout the medical school and hospital to improve LGBTQ patient care (e.g., training staff, updating policies, refining hospital EMR)
- Development of workshop series on allyship
- Development of Asian Mental Health Clinic
- Development of partnership with La Clinica de la Raza, an FQHC with a focus on culturally appropriate, high quality, accessible care
- Development of a therapy group for international graduate students
- Study of cultural factors in caretaking of chronically mentally ill patients in the Chinese community
- Qualitative research exploring the educational experiences of underserved youth in East Palo Alto
- Community partnership to address suicide in Silicon Valley middle and high schools
- Refugee mental health, human rights and gender-based violence
Department Small Grants
Belinda Bandstra, M.D., M.A. (PI), Mario Mercurio, Yasmin Owusu, M.D., and Ripal Shah, M.D., M.P.H.
Recruitment and Retainment of Underrepresented Minority Faculty and Residents
Lawrence McGlynn, M.D. (PI), Ripal Shah, M.D., M.P.H., and Neir Eshel, M.D., Ph.D.
LGBTQ Mental Health: Opportunities for Research and Practice