Clinical Sites During Resident Rotations

Delaware Psychiatric Center

Provides required Inpatient, Geriatric, and Forensic Psychiatry rotations

The Delaware Psychiatric Center (DPC) was originally founded in 1889. It is the only state-operated inpatient psychiatric facility in the State of Delaware. DPC is a part of Delaware Health and Social Services and is located on the Herman M. Holloway, Sr. Campus. This campus, encompassing more than 100 acres, functions as the administrative headquarters for the Delaware Office of the Secretary of Health and Social Services and many of the Department's Divisions. Currently, DPC's operational capacity constitutes over 160 beds with an average daily census of 162 in fiscal year 2011.

DPC provides an acute inpatient and extended care treatment for clients in specialized units with a variety of psychiatric diagnosis including psychotic disorders, mood disorders, substance related disorders, and personality disorders. DPC also has a 42-bed forensic psychiatry unit for male and female inmates in the Delaware criminal justice system. This modern, state of the art forensic unit houses a fully appointed Mental Health Court. Upon admission, nurses, psychiatrists and psychologists use a team approach for crisis stabilization. Then they work with each patient to create an individualized recovery program with ultimate goal of community integration

Elsmere VA Medical Center

Provides required Neurology rotation

The Elsmere VA Medical Center combines a 60-bed hospital and 60-bed NHCU, both accredited by the Joint Commission with a VBA Regional Office and 2 Vet Centers (one on campus), offering veterans the unique opportunity to obtain health care, benefits services, and Readjustment Counseling at one location. The Center provides a wide spectrum of primary and tertiary acute and extended care inpatient and outpatient activities in an academic setting. The Elsmere VAMC is also a certified community Cancer Center. Major specialties include medicine, neurology, and surgery. Subspecialties are present in most clinical areas. Elsmere serves veterans from the state of Delaware, southern New Jersey, southeastern Pennsylvania, and the eastern shores of Maryland. A licensed child care center is on site. Active affiliations are maintained with Thomas Jefferson University, the University of Maryland, and Temple University.

In 2003, the number of scheduled patient exams for neurology was 4,800. Of that number, 1,200 were in-patients. Elsmere VAMROC also operates clinics that provide primary care in Millsboro, Delaware, and Vineland and Ventnor, New Jersey.

Coatesville VA Medical Center

Provides required Internal Medicine rotation

Coatesville VAMC is a specialty referral facility. The medical center primarily serves veterans from southeastern Pennsylvania, Delaware, and southern New Jersey. Emphasis is placed upon veterans' clinical and social needs via such treatment programs as substance abuse, post-traumatic stress disorder (PTSD), chronic mental illness, homelessness, women's health, and dementia. A continuum of health care services is provided through Patient Care Services, which includes Primary Care, Mental Health, and Geriatrics and Extended Care. Inpatient hospital care is provided for medical and psychiatric conditions. New Hospice, Gero-Psych, Home Based Primary Care (HBPC), and Geriatric Evaluation Management (GEM) Programs were established and implemented during FY-2004. Residential/domiciliary programs are operated for the treatment of substance abuse, post-traumatic stress disorder (PTSD) and homelessness. Transitional care is offered in a nursing home care program, as well as a brief stay nursing home care program. Two non-VA organizations operate residential/transitional programs for discharged veterans (male and female) on three former bed units. A full range of outpatient services is provided. For greater access to care, Community Based Outpatient Clinics (CBOCs) offer both mental health and primary care services. Coatesville VAMC operates 472 beds.

The center provided care to 21,865 patients in 2003. The average age of patients is 64 years. This hospital, located in the Delaware Valley, has a state of the art information system that includes a paperless electronic medical record.

A primary care team is assigned to oversee a patient's general medical care needs upon entry into the facility, where a physical examination, an overview of the medical history, nursing and other screening assessments are completed within 24 hours. Other assessments, such as, behavioral, functional, medication, nutritional, dental, pain, podiatric, psychosocial, recreational, rehabilitative, risk (fall), social work and spiritual are completed based on pre-established standards. The primary care physician is responsible for coordinating all aspects of the veteran's interdisciplinary treatment. Patients presenting for outpatient care are assigned a primary care physician and undergo the initial assessment and identification of problems within a designated time frame. A newly organized women's health clinic provides our residents with a more varied experience.

Terry Children's Psychiatric Center

Provides required Child & Adolescent rotation

The Terry Children's Psychiatric Center is a publicly funded psychiatric facility providing a continuum of care for children under the age of 13 through the Delaware Department of Services for Children, Youth and Their Families. The Terry Center houses approximately 18 residential beds, 6 short-term crisis beds and provides intensive day treatment services to 35 children.

The Terry Center serves as a formal teaching site for child and adolescent psychiatry fellows from Jefferson Medical College and Hospital and for general psychiatry residents from the Delaware Psychiatric Center. Family Practice residents from local hospitals and trainees in Psychology, Psychiatric Social Work, and Creative Arts also spend part of their rotation, internship, or practicum placement at the Terry Center.

Silver Lake Treatment Consortium

Provides required Child & Adolescent rotation

Silver Lake Treatment Consortium (SLTC) is a consortium of treatment programs that provide residential and day treatment services to youth who have displayed significant behavioral, emotional, and/or psychiatric difficulties in the past and are currently unable to live at home and/or be educated in the public school system. PGY-II residents travel to SLTC on a part-time basis during their full-time, two-month Child and Adolescent rotation, and PGY-IV residents also have the option of rotating with SLTC as an elective. SLTC is comprised of two residential treatment centers (RTCs), Brenford Place RTC, and Middletown RTC, as well as a day treatment center, Silver Lake Treatment Center. All three are State programs providing services to youth, aged 12 to 17, along with their families. SLTC is operated under the jurisdiction of the Division of Child Mental Health Services.

The programs within the Silver Lake Treatment Consortium are clinically supervised by a Licensed Clinical Psychologist with contract support from a Board-certified Child and Adolescent Psychiatrist. Offered within the three programs are group therapy sessions, individual therapy sessions, parent training and support group, and most importantly, family therapy sessions. The behavior modification program utilized across all three programs is a teaching model that replaces negative behavior with pro-social skills.

Family support and participation is imperative to effect behavior change within the adolescent. The educational department within the Silver Lake Treatment Center provides regular and special education services and offers Math, Science, Social Studies, English, and Career Studies within its curriculum. Discharge planning begins at admission where presenting problems are identified as goals to work on for the student and the team.

Wilmington Hospital - Christiana Care Health System

Provides required Emergency Psychiatry (CAPES and Night Float), and Family Medicine rotations, as well as an elective ECT rotation during the PGY-IV

A Wilmington landmark since 1890, fully modernized Wilmington Hospital remains a reliable source of high quality health care, near the center of town in the City of Wilmington, where it shouldered so much of the health-care burden for the Wilmington community throughout the last century. Wilmington Hospital provides emergency care services, outpatient primary care services, joint replacement and sleep disorders centers and diagnostic imaging and medical laboratory services. The hospital offers 250 licensed beds, plus 41 licensed inpatient-beds in their on-site Center for Rehabilitation.

Residents on rotation at Wilmington Hospital become part of the Psychiatric Crisis Team that offers 24-hour intervention for those in crisis due to psychiatric illness. All patients in need of psychiatric treatment who come to the Emergency Department are evaluated by the Crisis team. Patients who do not require admission to the hospital receive relevant information and referrals.

Christiana Hospital - Christiana Care Health System

Provides required Consultation & Liaison rotation

The Emergency and Trauma Center at Christiana Hospital is a 110,000+ square foot, state-of-the-art facility, providing round-the-clock, Level-I trauma and emergency care for Delaware and the surrounding region.

Christiana Hospital's 80-bed department (expansion in progress) serves over 90,000 patients yearly and includes: twenty exam/treatment rooms to expedite treatment of major illnesses and injury, six cardiac/critical care rooms, two trauma resuscitation areas equipped to care for 2-4 patients and capability for emergent, life-saving procedures within the trauma bays, as well as ceiling mounted emergency imaging equipment, Christiana Care LifeNet helicopter transport with two adjacent helipads for airborne arrivals, as well as helicopter transports from surrounding states, and twenty-five bed Heart Center adjacent to the Emergency Department, to name a few.

The Emergency Department at Christiana Hospital is supported by a 625-square foot, fully equipped surgical shock trauma operating room with a dedicated elevator designed for life-threatening emergencies, and a 22 bed surgical critical care complex for neurosurgical, surgical, trauma and pediatric intensive care.

Based in Wilmington, Delaware, Christiana Care Health System is one of the largest health care providers in the mid-Atlantic region, serving all of Delaware and portions of seven counties bordering the state in Pennsylvania, Maryland and New Jersey.

Residents on rotation at Christiana Hospital become part of the Consultation & Liaison team that offers 24-hour psychiatric consultation for those in crisis due to a medical illness.

Community Mental Health Clinics-Wilmington and Dover

Provides required Outpatient rotation

The state of Delaware has three outpatient community mental health clinics located in each of the State's three counties: Kent, Sussex, and New Castle. PGY-III residents spend 12 consecutive months working in the Wilmington CMHC in New Castle County.

The community mental health center services include screening and assessment, crisis counseling, short-term counseling, long-term therapy, medication and medication management and healthcare coordination. The average age of the clinic population is between 35 to 54 years of age, and approximately 30% are 18 to 34 years of age. The clinic self-reports the patient population's ethnicity/race as about 40% White/Caucasian and 60% Black/African American. There are about 52% female and 48% males. Representative primary diagnoses include Major Depressive Disorder, Bipolar Disorders, Schizophrenia, Paranoid type, Schizoaffective Disorder, Dysthymic Disorder, Schizophrenia, Undifferentiated Type, Mood Disorder NOS, Posttraumatic Stress Disorder, and Major Depressive Disorder, Single Episode, Unspecified. In SFY-2006, the Wilmington CMHC saw 698 unduplicated patients, while the Wilmington front door saw 742 unduplicated patients.

Thomas Jefferson University-Jefferson Medical College

Provides psychiatric grand rounds and didactics

Thomas Jefferson University, an academic health center, was founded as Jefferson Medical College in 1824. Jefferson Medical College has awarded more than 26,000 medical degrees and has more living graduates than any other medical school in the nation.

An infirmary to treat the poor was opened in 1825, and by 1844, Jefferson was providing patient beds over a shop at 10th and Sansom Streets. A 125-bed hospital, one of the first in the nation affiliated with a medical school, opened in 1877, and a school for nurses began in 1891.

On July 1, 1969 the institution became Thomas Jefferson University, composed of Jefferson Medical College, Thomas Jefferson University Hospital, the College of Graduate Studies, and the College of Allied Health Sciences. Today, this academic health center tests and treats 25,000 inpatients and more than 300,000 outpatients every year, and enrolls 2,600 future health care professionals. Public and private funding of Jefferson research exceeds $64 million annually.