Year IV of residencyspecific goals and objectives

The goals of this year are those of completion and depth. The resident will add child psychiatry skills and enhance mastery of providing a continuum of care by rotating in a psychiatric day hospital. The resident, through a freely chosen elective, develops advanced experience in a psychiatric subspecialty—a 'field of concentration' with one or more faculty members to demonstrate how advancing knowledge accrues through research and close study. Finally, an appreciation of psychiatric administration is provided to residents through a weekly meeting with the Chairman of the Department where discussions review the rationales behind past and present responses of the department to the demands of health care reform, managed care, and hospital/medical school needs.

We expect that by the end of this year the resident will:

• acquire the skills of child and family assessment and gain an initiatory appreciation of the specialty of child and adolescent psychiatry;

• have an understanding of the changing health-care environment and of the competencies necessary for success in clinical practice and in other professional leadership roles;

• acquire confidence in office psychiatric practice and long-term psychotherapy given an experience with some patients extending out for years;

• have an advanced understanding of a subspecialty of psychiatry through close mentoring from a faculty member in an elective;

• have an appreciation of the rational approaches to administrative decisions within a system of psychiatric services in the contemporary challenging era for health care.

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