Overall goal and general programmatic features

The overall goal of the Johns Hopkins psychiatric residency is to produce a well-educated broadly experienced psychiatrist who can prosper in any subsequent career. This goal is approached systematically by combining closely supervised intensive clinical experiences in multiple settings with a comprehensive didactic programme. These experiences broaden in comprehensiveness over the 4years of the residency. The experiences are also aligned with the health-care reform demands of the contemporary era in giving residents clinical responsibilities within an integrated continuum of care system across service settings. Each year of the residency combines a clinical experience of progressive complexity on the wards and in the clinics with a didactic lecture series (1h/week) specific to that year. In addition, an ongoing across-the-years department-wide educational programme runs concurrently and consists of weekly meetings of Departmental Grand Rounds (1.5 h), Research Seminar and Visiting Lecture Programme (1 h), Basic Science Seminar (0.5 h), Journal Club (1 h), Psychoanalytic Continuing Case Conference (1 h), and Chairman's Service Round (2 h).

All residents, juniors and seniors, participate in considering general principles of psychiatry, with an emphasis on the perspectival concepts described above, during these weekly didactic meetings. The Departmental Grand Rounds is organized as a lecture by one of the faculty. It is devoted to the consideration of a patient who exemplifies a particular psychiatric condition, what is known of its causes, and its treatment. The Journal Club is a tutorial led by a faculty member concentrating on some article from the scientific literature chosen by a resident as worthy of being carefully studied. The Research Seminar and Visiting Lecture series is a lecture directed at recent advances in psychiatry and customarily led by a visitor to the department. The Basic Science Seminar is a series organized annually around some scientific topic appropriate for detailed study by psychiatrists and led by members of the department who are expert in the topic. A year's study in this seminar has been devoted in each of the last 4years to genetics, epidemiology, psychopharmacology, and brain imaging. The Psychoanalytic Seminar is a tutorial/seminar concentrating on a case followed over time by a resident in which the life-story perspective is closely studied in its particular exemplification. The Chairman's Service Round is a recitation based on the presentation of a patient to the residents and is led by the Chairman who directs the discussion that follows in a question-and-answer fashion.

The integration of these several didactic elements with the daily tutorial experience of ward rounds and outpatient meetings is accomplished through the more informal interactions of residents and faculty that these sessions make possible. The discourse of the departmental 'community' is a vital, but harder to delineate, element of the educational experience of everyone—student and faculty alike. Its place in student education, though, can be identified in the specific goals and objectives of each residency year that we now describe.

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