Residency Rotation Schedule

PGY-2

Inpatient Eating Disorders (5 half days per week for 2 months): Second year residents rotate on the eating disorder unit at Sanford Medical Center Broadway. Sanford Health specializes in the treatment of eating disorders and patients come to seek care in the intensive outpatient program, partial hospitalization program and inpatient program from throughout the country. During the rotation, residents work with faculty with special interest in eating disorders treating both adolescent and adult patients participating in these three different levels of care.

Adult Partial Hospitalization Program (5 half days for 3 months): Second year residents rotate in the adult partial hospitalization program at Sanford 1711 Medical Building. During this rotation, residents work closely with dedicated faculty to treat patients who require a level of care between outpatient and inpatient.

Child and Adolescent Partial Hospitalization Program at either Sanford Health or Prairie St. John’s (5 half days per week for 1 month): Residents rotate at the partial hospitalization program at Sanford Health or Prairie St. John's, caring for young patients who require a level of care between inpatient and outpatient. 

Consultation Liaison (5 half days per week for 2 months): Second year residents rotate on the consult liaison (CL) service at Sanford Medical Center Fargo and Sanford Medical Center Broadway. The consult service has many difficult and interesting cases and is regarded as an excellent learning opportunity by many residents.

Emergency Psychiatry (5 half days per week for 2 months): Second year residents rotate in the emergency department at Sanford Medical Center Fargo. In the emergency department, there is a four-bed behavioral health pod with designated nursing and security staff. Residents are consulted to see patients receiving care in the pod and outside of the pod. During this rotation, residents work closely with a psychiatric nurse practitioner who shares the patient load.

Substance Abuse and Treatment Program (5 half days per week for 2 months): Second year residents rotate in substance abuse programs at Prairie St. Johns, a large private psychiatric hospital which provides a significant amount of substance abuse treatment to the area. Residents are involved in patient treatment in the residential program, partial hospitalization program and inpatient units. Residents also participate in group therapy and chemical dependency evaluations.

Yearlong rotations:

Psychotherapy Clinic (1 half day per week for the entire year): During the first 3 months of second year, residents have one half day per week devoted to psychotherapy training with their co-residents and psychotherapy rotation director. This is in addition to psychotherapy training during regular Wednesday afternoon didactics. Through multiple courses residents are given instruction in evidence-based therapy modalities including supportive therapy, motivational interviewing, brief psychodynamic therapy, cognitive behavioral therapy, behavioral activation and the unified protocol. In October of second year residents start their psychotherapy clinics at multiple sites including Essentia Health, North Dakota State University, Benson Psychological Services and Sanford Health. Residents see patients individually and later engage in supervision with their psychotherapy supervisor (a psychologist practicing in the community) weekly at a mutually available time.

Outpatient Psychiatry at Sanford Health (2 half days per week for the entire year): Second year residents begin their continuity clinic at Sanford Health. This is a longitudinal clinic that lasts until the end of residency (3 years total). During second year, two half days per week are spent in clinic to establish the resident’s patient panel. In this clinic residents treat adults with a wide variety of psychiatric illnesses. Residents staff during clinic with one of 4 dedicated attendings who briefly see the patient with the resident. Residents are also responsible for responding to patient’s messages outside of clinic.

Scholarly Activity (1 half day per week for the entire year): Second year residents have designated time for research and scholarly activity, which can include studying and reading materials of the resident’s choice. Research opportunities for publications are available for residents who conduct research; however, this is not required. Residents may also use this designated time to prepare their grand rounds. During residency, residents present a total of two grand rounds on a topic of their choice, which are attended and viewed by behavioral health providers from multiple facilities across the state of North Dakota.

PGY-3

Community Psychiatry at Southeast Human Service Center (5 half days per week for 3 months): Third year residents rotate at Southeast Human Service Center, which is one of eight human service centers within the North Dakota Department of Human Services and provides a wide range of human services including psychiatric care. This rotation focuses on treating severe serious mental illness and co-morbid chemical dependency through a team-based approach and understanding of community resources. Residents see patients in the outpatient crisis clinic, where patients are typically experiencing a decline in their mental health symptoms requiring prompt outpatient care. Residents also experience assertive community treatment by spending time with the ACT (assertive community treatment) and IDDT (integrated dual diagnosis treatment) teams.  Residents also see patients in the Cass County jail.

Child & Adolescent Psychiatry: During third and fourth year, residents complete two out of three of the following rotations in child and adolescent psychiatry. If a resident is interested in Child and Adolescent Psychiatry fellowship, more rotations can be completed with available elective time.  

1. Inpatient child psychiatry at Prairie St. John’s (5 half days per week for 1 month): Residents rotate on Prairie St. John’s, which is a private free-standing psychiatric hospital which provides inpatient psychiatric care to the local area, as well as to patients throughout the state. 
2. Child and Adolescent Partial Hospitalization Program at Sanford Health (5 half days per week for 1 month): Residents rotate at the partial hospitalization program at Sanford Health, caring for young patients who require a level of care between inpatient and outpatient. 
3. Outpatient Child and Adolescent psychiatry at Sanford Health (1 half day per week for 1 year): Residents rotate one-on-one with a child and adolescent psychiatrist treating children and adolescents in their outpatient clinic at Sanford Health Professional Building. 

Consultation Liaison Psychiatry at Sanford Health (5 half days per week for 2 months): Third year residents rotate on the consult liaison (CL) service at Sanford Medical Center Fargo and Sanford Medical Center Broadway. The consult service is typically busy with many difficult and interesting cases and is regarded as an excellent learning opportunity by many residents. Third year residents also have ample opportunity to teach medical students during this rotation.

Elective time (5 half days per week for 2 months): Third year residents have two months of elective time in which they can devote five half days per week to an elective of their choosing. Please see the Elective section for more details on unique elective opportunities.

Yearlong rotation:

Telemedicine/Rural Outreach (1 half day each week except for a designated week each month where residents travel and spend 1 full day at the site for the entire year): Third year residents start their two-year long telemedicine rotation at a rural site in North Dakota or Minnesota. One half day per week residents treat patients through telemedicine, except for one designated week per month where residents travel to the site to spend the entire day treating patients in person. Current sites include Northwest Human Service Center in Williston, ND, North Central Human Service Center in Minot, ND, Badlands Human Service Center in Dickinson, ND, Lake Region Human Service Center in Devils Lake ND, South Central Human Service Center in Jamestown, ND, Sanford Health in Thief River Falls, MN, Sanford Health in Perham, MN, Sanford Health in Bismarck, ND and Rural Psychiatry Associates in Grand Forks, ND. Residents that travel long distances receive an additional day off during the week as a comp day for travel. Residents are reimbursed for travel related expenses.  

Psychotherapy Clinic (1 half day per week for the entire year): Third year residents continue their psychotherapy clinic, often switching to a different psychotherapy supervisor in order to improve the diversity of psychotherapy training.

Outpatient Psychiatry at Sanford Health (1 half day per week for the entire year): Third year residents continue their continuity clinic at Sanford Health Broadway Clinic..

Outpatient psychiatry at an additional location (1 half day per week for the entire year): Third year residents see patients in the outpatient setting at one of several different clinics in order to improve the diversity of outpatient psychiatry training. Current sites include Southeast Human Service Center, Child and Adolescent Clinic at Sanford Health and Integrated Clinic at Sanford Health.

PGY-4

Clozapine Clinic at Southeast Human Service Center (1 half day per week for 4 months): Fourth year residents rotate at Southeast Human Service Center in an outpatient clinic devoted to treating patients experiencing severe mental illness with clozapine. This includes initiating clozapine, monitoring the treatment and managing side effects. Residents collaborate with a PharmD to have literature review and discuss treatment plans for each patient.

Elective time (5 half days per week for various months): Fourth year residents have generous time for elective opportunities. During most months, residents have at least four to five half days per week for elective time. This is slightly less for the chief residents as some of their elective time is dedicated for chief resident responsibilities.  Please see the Elective section for more details on unique elective opportunities.

Child & Adolescent Psychiatry: During third and fourth year, residents complete two out of three of the following rotations in child and adolescent psychiatry. If a resident is interested in Child and Adolescent Psychiatry fellowship, more rotations can be completed with available elective time.

1. Inpatient child psychiatry at Prairie St. John’s (5 half days per week for 1 month): Residents rotate on Prairie St. John’s, which is a private hospital which provides inpatient psychiatric care to the local area, as well as to patients throughout the state. 
2. Child and Adolescent Partial Hospitalization Program at Sanford Health (5 half days per week for 1 month): Residents rotate at the partial hospitalization program at Sanford Health, caring for young patients who require a level of care between inpatient and outpatient. 
3. Outpatient Child and Adolescent psychiatry at Sanford Health (1 half day per week for 1 year): Residents rotate one-on-one with a child and adolescent psychiatrist treating children and adolescents in their outpatient clinic at Sanford Health Professional Building. 

Chief Resident and Senior Resident: All fourth year residents have time set aside in their schedule for mentoring PGY-1 residents and medical students. Chief residents have additional dedicated time for chief resident duties.

Yearlong rotations:

Geriatric Psychiatry (1 half day per week for the entire year): Fourth year residents spend time at a nursing home facility in the community, providing psychiatric consultation and treating elderly individuals with mental health problems. Residents work with faculty who have special clinical interest and years of experience serving this population.

Telemedicine/Rural Outreach (1 half day each week except for a designated week each month where residents travel and spend 1 full day at the site for the entire year): Fourth year residents continue their telemedicine rotation at a rural site in North Dakota or Minnesota. One half day per week residents treat patients through telemedicine, except for one designated week per month where residents travel to the site to spend the entire day treating patients in person. Current sites include Northwest Human Service Center in Williston, ND, North Central Human Service Center in Minot, ND, Badlands Human Service Center in Dickinson, ND, Lake Region Human Service Center in Devils Lake ND, South Central Human Service Center in Jamestown, ND, Sanford Health in Thief River Falls, MN, Sanford Health in Perham, MN, Sanford Health in Bismarck, ND and Rural Psychiatry Associates in Grand Forks, ND. Residents that travel long distances receive an additional day off during the week as a comp day for travel and are provided housing for the trip. Residents are reimbursed for travel-related expenses.

Outpatient Psychiatry at Sanford Health (1 half day per week for the entire year): Fourth year residents continue their continuity clinic at Sanford Health Broadway Clinic.

Electives

Endless elective opportunities exist for psychiatry residents in the area, with some common electives among residents described below. Residents can also create their own elective opportunities. One resident is using elective time to become a certified yoga instructor! Residents can also spend some time outside of the community on an away elective.

Collaborative Care at Sanford Health: Through a collaborative care approach, residents can rotate in either the family medicine residency clinic or the internal medicine residency clinic to answer questions regarding the psychiatric management of patients in the primary care setting. Both busy clinics have a high volume of patients with mental health issues and greatly appreciate the help of psychiatry residents. This is a very popular elective among residents. 

ECT at Sanford Health: Residents can work with attendings performing ECT and many residents can meet the eligibility requirements to become privileged in ECT at Sanford Health and become comfortable independently performing ECT evaluations and procedures following residency. 

Advanced Psychopharmacology through the University of North Dakota: During this elective, residents meet weekly with one another and a PharmD faculty and choose various psychopharmacology topics they wish to discuss in depth.

Psychology Consult Service at Sanford Health: Residents can rotate with the psychologist who works with hospitalized patients at Sanford Health. 

Palliative Care at Sanford Health: Residents can rotate with the palliative care nursing and medical staff to learn more about helping patients identify their goals of care and compassionately care for those facing serious medical issues or at the end of their lives. 

Inpatient Psychiatry: Residents can use elective time to rotate in inpatient psychiatry units at multiple sites including Sanford Health, Prairie St. Johns and North Dakota State Hospital. As these sites frequently have first year residents and medical students, this gives residents the opportunity to mentor and teach.

Advanced Psychotherapy: Residents can use elective time to gain more skills in a specific psychotherapy technique or continue their psychotherapy clinic as a fourth year.

Board Review: Residents can use limited elective time for board review.

Homeless Clinic at Family Healthcare: Residents can use elective time to treat patients with behavioral health problems at Family Healthcare, a primary care clinic dedicated to treating homeless and financially disadvantaged individuals in the community.

Geriatrics (Stability/Falls Clinic) at Sanford Health: Residents can rotate in this specialized geriatric medicine clinic to gain more experience treating this unique population.

Methadone Clinic at Community Medical Services: Residents can rotate at a methadone clinic in the community to gain experience in medication assisted treatment of opioid use disorder.

Neuropsychology at Neuropsychology Associates: Residents can rotate with a neuropsychologist to gain more knowledge and experience with neuropsychological testing.

Neuroradiology at Sanford Health: Residents can rotate in neuroradiology at Sanford Health to gain more knowledge of interpreting CT, MRI and other neuroimaging.

Pain Medicine at Sanford Health: Residents can rotate in the pain clinic to gain more experience treating patients with chronic pain.

Sleep Medicine at Sanford Health: Residents can rotate in sleep medicine to gain more experience diagnosing and treating sleep disorders. 

Weight Management at Sanford Health: Residents can rotate in the weight management clinic with a psychiatry faculty with a special interest in weight management to gain more experience treating patients with obesity and other weight issues.

Chemical Dependency Consult Service at Sanford Health/First Step Recovery: Residents can rotate with the chemical dependency consult service to gain experience completing chemical dependency evaluations.

Movement Disorder Clinic at Sanford Health: Residents can work in an interdisciplinary team to evaluate and treat psychiatric disorders associated with Huntington’s Disease and Parkinson’s Disease.

Research: Residents can use elective time to conduct research. Eating Disorders is an active area of Research at Sanford Research with many ongoing projects.

Roger Maris Cancer Center at Sanford Health: Residents can work with psychology faculty at the cancer center to evaluate and treat patients with mental health issues in the setting of cancer.

Women’s Health: Residents can work with an internal medicine physician to learn and treat various women’s health related diagnoses.

Call Obligations

PGY-1: Residents will have call orientation at Sanford Medical Center Fargo for ER/CL and 3B/Broadway.

Residents will have one weekend of call total while rotating at North Dakota State Hospital.

PGY 2 and PGY-3: During second and third year, residents complete between 52-55 total call shifts. Residents are only on call during the weekend. Residents will have two call shifts per weekend on call. Day call is 8am to 8pm on Saturday and Sunday at Sanford Medical Center 3B/Broadway (covering follow ups on the medical floor, new consults on the medical floor and direct admissions to the inpatient psychiatric unit) or Sanford Medical Center Fargo ER/CL (covering follow ups on the medical floor, new consults on the medical floor and consults in the emergency department).

PGY-4 : No call!