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Sub-Internship

Sub-Internships are an excellent way to further advance your knowledge and skills in psychiatry, to expand your exposure to different treatment styles, and to explore programs that you are considering applying to for residency. They provide a great opportunity for you to get to know your potential future teachers, and a great opportunity to demonstrate your skills and abilities to programs you are interested in. Generally, around half of our incoming class at the Psychiatry Residency Spokane is composed of people who previously did sub-internships with us, so we strongly encourage those people who are interested in our program to consider applying for one of the following experiences.

Current options include:

4 weeks Consult/Liaison or 4 weeks Outpatient/Child

Hospital Experience

Consult Psychiatry: The Adult Psychiatry Consultation Teaching Service provides psychiatric services for a broad range of patients with psychiatric and neuropsychiatric disorders in the context of medical, surgical, obstetric, and other inpatient settings at Providence Sacred Heart Medical Center. Our service offers an opportunity to see the intersection of psychiatric conditions with medical illness. Commonly treated conditions include delirium, dementia, depression, anxiety, suicide attempts, substance withdrawal, conversion disorder, somatic symptom disorder, and factitious disorder. Due to the high acuity and underserved population treated at Sacred Heart, less common conditions such as catatonia, NMDA receptor encephalitis, rapidly progressive dementias, etc. are not uncommon in this hospital. We also help with agitation management and capacity evaluations. The sub-intern will work alongside a psychiatry resident and become an integral part of the team with direct supervision by a faculty psychiatrist.

Outpatient/Clinic Experiences

Child/Adolescent and Outpatient Sub-I: A blended sub-I experience working with children/adolescents in two different care settings with a few days of work in the adult outpatient clinic is available. The child experience is divided between our RISE program, which is a partial-hospitalization program serving patients aged 12-18 and our BEST program, a partial-hospitalization program serving patients aged 6-12. Both programs work with patients with diverse presentations, often of high acuity and coming from underserved backgrounds.

An additional outpatient experience at the Spokane Teaching Health Clinic is part of this rotation, with time spent in the addictions and general outpatient clinics. This outpatient experience serves a vulnerable and otherwise significantly underserved population. Because of this, the severity of psychiatric illness in this population is often quite high. There are frequently situations in which access to psychiatric care is both critical to overall health and significantly limited.

Integrated (or Collaborative) Care

The Spokane Teaching Health Clinic is a major site for integrated care, with multiple care coordinators and multiple psychiatrists practicing this form of mental health care. This is an unusual and exciting opportunity to learn about a health care delivery system that will likely become quite prominent over the upcoming years. Although we cannot offer a full rotation in integrated care, opportunities to work integrated care time into a consult or outpatient/child sub-I are available if you are interested.

Underserved Populations

On both inpatient and consult psychiatry at Sacred Heart Medical Center, we serve an underserved and vulnerable population. As with the outpatient setting, this fact results in a fairly high level of psychiatric morbidity among this population. Frequently, our teams are deeply involved in addressing social determinants of illnesses (both medical and psychiatric), and as such these rotations provide an excellent opportunity to develop this skill.

Monday

AM: Outpatient or Consult work
PM: Outpatient or Consult work

Tuesday

AM: Outpatient or Consult work, Didactics with Dr. Cliff Green from 11.30-12.30.
PM: 1-5: Medical Student Didactics with clerkship director and independent study time.

Wednesday

AM: Outpatient or Consult work; 12-12.45: Journal Club
PM: Outpatient or Consult work; 1-2 Didactics with chief resident.

Thursday

AM: Outpatient or Consult work
PM: Didactics with Residents

Friday

AM: Outpatient or Consult work
PM: Outpatient or Consult work

Requirements to Apply

  • In the process to apply for a sub-internship with our program, we ask that all applicants have the following:
  • A letter of good standing from your medical school
  • Any STEP or COMLEX scores (you must have taken one of these examinations to participate in a sub-I here)
  • Intention to apply to psychiatry residency through our program (unfortunately, we have too few sub-intern spots available to assign them to people not interested in our residency)
  • Existing ties to the West, preferably the Pacific Northwest
  • At least three dates during which you could work here
  • Your preferences about what clinical experience you would prefer; we currently offer:
    • 4 weeks Consult/Liaison or
    • 4 weeks of Child and Adolescent/Outpatient
    • Any interest in integrative care opportunities

How to Apply and What to Expect

The application process is handled by our program assistant, Chantel Blanchard. Please email her at Chantel.Blanchard@Providence.org as soon as you know that you are interested. She’ll coordinate with you to ensure all your documentation is in order (the documents noted above as well as more mundane things like background checks, immunization records, etc.), and send you a brief application to fill out.

Because we often have many more requests for sub-internship opportunities than available positions, sub-internships opportunities are determined competitively. Your application will be reviewed by the administration and multiple attendings. Generally, we respond to all Sub-I applicants on Feb 14th, or, for those who apply after that date, within two weeks after your application is submitted.

Housing: There are many rental properties and sublets available in the Spokane area, which we encourage you to explore. If these are not a good fit, we also offer free dormitory-style housing near the Sacred Heart Hospital to visiting students. Please contact Chantel Blanchard for details.