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Fourth Year

The fourth year of psychiatry residency is the culmination of multiple years of rigorous inpatient and outpatient training and helps transition residents into their future roles as attending psychiatrists, or prepare them for further fellowship training. PGY4 residents spend 2 months each on inpatient and consult/liaison services and 1 month on the VA emergency psychiatry service. In each of these rotations, the residents operate in a semi-autonomous “junior faculty” role, supervising and mentoring PGY1 and PGY2 residents under the guidance of faculty.

The rest of the fourth year provides extensive flexibility for residents to tailor their experience to fit their needs and career interests. They complete a 1 month forensic selective rotation at a site they select from multiple unique options. One month is spent on another selective rotation of their choosing. The remaining 5 months are dedicated to clinical or research electives. A further break-down of selective rotations are as follows:

Forensic Selective

  • San Antonio State Hospital OR
  • Bexar County Jail AND Adult Protective Services

Clinical Selective

  • VA Intensive Outpatient Program OR
  • Addition psychiatry at Brooke Army Medical Center OR
  • Emergency psychiatry at University Hospital


Timeline of Fourth Year

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