A medical school graduate often completes an internship in her general area of specialty during the first year after graduation. For this reason, an intern is often referred to as a PGY-1 by hospital insiders, referring to someone in her first postgraduate year of training. An intern seeking a residency in psychiatry and eventual board certification as a psychiatrist will first undergo a psychiatry internship as a PGY-1, followed by three additional years known as a residency — PGY-2, 3 and 4 — before she sits for her psychiatry board examinations. The participation requirements for a psychiatry internship vary according to the specific institution that admits the intern to its program. Requirements common to most programs, however, include clinical rotations in internal medicine and inpatient psychiatry, in addition to coursework and seminars.
The courses of study and clinical exposure during a psychiatry internship are divided into blocks of four weeks to six months, depending upon the program and the emphasis placed upon experience in certain areas. All psychiatry interns must successfully complete clinical rotations — specifically, in both inpatient and outpatient internal medicine and neurology. Internal medicine involves the study of the treatment of adult diseases and includes the subspecialties of endocrinology, gastroenterology and hematology, for example. Physical disease and disorders of the nervous system, including the brain, are addressed during the neurology rotation. These rotations are included in a psychiatry internship because many internal medicine and neurological diseases can mimic psychiatric disorders and psychiatric medications naturally have systemic effects in addition to their primary uses.
A psychiatry internship also includes one or more clinical rotations through inpatient psychiatric units. Interns admit patients, evaluate conditions, prescribe medications and laboratory tests, and discharge patients under the supervision of more experienced residents and a supervising attending physician. Inpatient hospitalizations include acute admissions, emergency admissions and long term or chronic treatment units. Learning about the pharmacology of psychotropic medications is also a priority. Some programs emphasize emergency psychiatry services, adolescent psychiatry, psychotherapy or research projects, which then become an additional responsibility for the intern.
On-call duties of varying duration and hours are also required of a PGY-1 during a psychiatry internship. This extent of this responsibility depends upon the specific rotation and the participating hospital's requirements. As a general rule, however, the hours of a psychiatry internship are less rigorous than other medical specialty internships. Psychiatry residents are also entitled to four weeks of vacation during their first year of internship.