Higher Graduate Diploma Program in Clinical Medical Sciences (Psychiatry)

The mission of the program is to produce psychiatric specialists possessing both broad and in-depth knowledge in alignment with the rapid advancements in the field. Graduates are expected to demonstrate professionalism, deliver comprehensive, high-efficiency care tailored to psychiatric contexts, and practice with compassion and a strong commitment to patient safety, upholding a holistic, patient-centered approach.

Graduates shall be capable of practicing independently without supervision, demonstrating social responsibility, and adhering strictly to professional ethics, standards, and the psychiatrist’s code of conduct. They must embody a mindset of lifelong learning, possess research capabilities to generate new knowledge, display academic leadership, and demonstrate effective management skills. Furthermore, they are expected to work efficiently within multidisciplinary teams, maintain professional behavior toward colleagues, healthcare professionals, patients, and families, and understand national health systems, quality improvement processes, appropriate resource allocation, and health promotion.

The training institution must explicitly document its program mission in writing and disseminate it to all relevant stakeholders. The training program must be founded on the national demand for psychiatrists, address competency requirements that support the country’s healthcare system, respond to the health needs of the community and society, and reflect appropriate social accountability. Stakeholders and representative trainees must participate actively in defining the program’s mission.

Graduates specializing in Psychiatry from the Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, must demonstrate the intended learning outcomes and milestones during their training, encompassing essential qualifications and competencies across the following six domains:

1. Patient Care

Providing holistic, patient-centered care with an emphasis on efficiency and safety, while being capable of practicing psychiatry independently without supervision. Competencies include:

1. Psychiatric interviewing, physical examination, mental status examination, and the utilization of key assessment tools for screening, evaluation, diagnosis, treatment, and rehabilitation of psychiatric patients or medical patients with psychiatric comorbidities, adhering to professional standards and evidence-based practice.
2. Disease prevention and mental health promotion.
3. Holistic, patient-centered care with a commitment to rational, efficient, and safe medication use.

2. Medical/Psychiatric Knowledge and Procedural Skills

Demonstrating comprehensive psychiatric practice appropriate to the training context:

• Possessing basic knowledge of mental health, psychology, medical sciences, and social sciences essential for psychiatric practice.
• Demonstrating up-to-date, evidence-based psychiatric knowledge across various contexts.
• Possessing standard psychiatric skills suited to clinical operational contexts.
• Maintaining complete, accurate, and consistent medical records and reports.

3. Interpersonal and Communication Skills

• Effectively presenting patient data and discussing clinical cases.
• Imparting knowledge and skills, as well as providing consultation and guidance to medical students, physicians, and multidisciplinary teams.
• Communicating accurately and effectively with patients and their families, with compassion and respect for patient autonomy and human dignity.
• Demonstrating strong interpersonal skills and collaborating effectively with multidisciplinary teams and colleagues at all levels.

4. Practice-Based Learning and Improvement

• Critically appraising literature and conducting psychiatric research.
• Demonstrating critical thinking skills in medical decision-making and evidence-based medicine.
• Engaging in self-directed learning to continuously enhance skills and professional experience through independent clinical practice.

5. Professionalism

Demonstrating lifelong learning attributes (Continuing Medical Education / Continuous Professional Development), along with professional conduct, attitudes, morals, and ethics:

• Conducting oneself with strong moral principles, ethics, and a positive attitude toward patients, families, colleagues, fellow professionals, and the community.
• Demonstrating self-reflection, personal development, and effective management of challenging clinical and personal situations.
• Demonstrating active curiosity and commitment to continuous professional development to maintain and enhance standard knowledge, skills, attitudes, and behaviors that meet the evolving needs of patients and society.
• Demonstrating accountability for assigned tasks and prioritizing the public interest.

6. Systems-Based Practice

Demonstrating an understanding of the national health system, clinical quality improvement systems, and appropriate health resource allocation, adhering to principles that:

• Align with national health systems, clinical quality improvement systems, the justice system, and the country’s socio-cultural context.
• Prioritize patient safety and rights.
• Demonstrate awareness of cost-conscious medicine and adapt patient care to the context of public health services according to professional standards.

Case Conference

• Schedule: Every Tuesday, 1:00 PM – 4:00 PM
• Responsible Personnel: 1st – 3rd Year Psychiatric Residents (as presenters and moderators)
• Case Selection Criteria: Inpatients (IPD), Outpatients (OPD), or Consultation cases under the resident’s care. Selected cases should present diagnostic dilemmas, treatment planning challenges, or rare/educational clinical presentations. Patients must be clinically stable and cooperative for interviewing during the conference.

Preparation and Workflow

1. Patient Assessment & Preparation: Collect comprehensive clinical data, including medical history, physical and neurological examinations, Mental Status Examination (MSE), laboratory investigation results, and psychological test reports. Explain the conference’s purpose, assess patient willingness, and obtain informed consent prior to the conference.
2. Coordination:
   • Notify the attending faculty member at least 1 week in advance.
   • Submit the patient history protocol to the supervising faculty at least 3 days prior to the conference.
   • Announce the time and venue to fellow residents in advance.
   • Bring the patient to the conference on Tuesday, 1:00 PM – 4:00 PM, with the attending resident serving as the case presenter.
   • Prepare evaluation forms and CME forms for the supervising faculty for every session.
3. Conference Sequence:
   • Present patient history.
   • Open the floor for medical students, residents, and faculty to ask additional history questions.
   • Bring the patient into the conference room for history taking and Mental Status Examination (MSE), conducted by a 3rd-year resident.
   • Escort the patient back to the ward via nursing staff after the interview.
   • Psychologists and psychiatric social workers present psychological test results and family evaluations.
   • Case Discussion: Conduct a comprehensive discussion covering clinical problems, diagnosis, psychodynamic formulation, treatment plan, clinical course, and prognosis. (Discussion order: Medical Students R1 R2 R3)
   • Invite faculty members to discuss, provide comments, and give feedback.
4. Post-Conference: Supervising faculty evaluates and grades the performance. Designated resident representatives from each year write the final discussion summary. Submit completed evaluation forms from faculty to the administrative office after the session.

Psychotherapy Conference

• Schedule: Every 4th Friday of the month, 1:00 PM – 4:00 PM
• Responsible Personnel: 2nd and 3rd Year Psychiatric Residents
• Content: Presentation of psychotherapy cases currently managed by the resident.

Preparation and Workflow

1. Data Collection: Gather patient history, physical/neurological exams, MSE, lab/psychological test results, and detailed process notes from each psychotherapy session.
2. Coordination: Notify the supervising faculty 1 week in advance. Distribute patient data to faculty and fellow residents prior to the conference date. Announce the time and venue, and prepare evaluation forms.
3. Conference Sequence:
   • Present patient history and psychotherapy session notes Q&A session.
   • Resident leads the discussion on psychodynamic formulation and the therapeutic process of each session.
   • Supervising faculty provides discussion, constructive feedback, evaluation, and scoring.

Journal Club

• Schedule: Tuesdays or Wednesdays, 1:00 PM – 4:00 PM (as scheduled)
• Responsible Personnel: 1st – 3rd Year Psychiatric Residents
• Content: Critical appraisal of a relevant psychiatric research article (presentation time: maximum 30 minutes).

Preparation and Workflow

1. Preparation: Select a research article in consultation with the supervising faculty. Provide the article to the faculty at least 2 days in advance. Announce time/venue, distribute materials to residents, and prepare evaluation/CME forms.
2. Presentation Structure:
   • Rationale
   • Research questions / Objectives
   • Hypothesis
   • Methods / Study design:
     • Population: sample size, sampling technique, inclusion & exclusion criteria 
     • Measurements: dependent & independent variables, instrument, criteria for measuring outcome variables 
     • Data collection: method, double-blind? 
     • Data analysis: computer software, statistics used 
   • Results: descriptive (demographic) data & major findings
   • Discussion & Concluded findings:
     • Consistent vs. inconsistent findings with other literature, and reasons why
     • Limitations of the study
     • Implications for practice
3. Discussion & Evaluation: Residents discuss and express opinions regarding the methodology and content Faculty provides additional insights Supervising faculty completes evaluation and scoring.

Seminar and Topic Review

• Schedule: Fridays, 1:00 PM – 4:00 PM (as scheduled)
• Responsible Personnel: 1st – 3rd Year Psychiatric Residents
• Content: Academic paper presentation on assigned topics compiled from textbooks, literature reviews, and recent scholarly publications.

Preparation and Workflow

1. Consult and notify the supervising faculty 1 week in advance.
2. Distribute copies of the paper to faculty and residents prior to the presentation date.
3. Prepare evaluation and CME forms.
4. Present content using engaging multimedia tools Resident discussion Faculty commentary Faculty evaluation and scoring.

05 Specific Curriculum & Clinical Requirements

Case Psychotherapy (Psychotherapy Case Reports)

Residents are required to complete supervised psychotherapy cases according to the following requirements:

Procedure:

1. Select a case and psychotherapy modality under the guidance of an assigned faculty supervisor.
2. Conduct 45–50 minute weekly sessions.
3. Obtain patient permission to audio-record and transcribe sessions for supervision. Attend supervision for every session (minimum of 8 sessions per case).
4. Log supervision dates and times in the Psychotherapy Supervision Tracking Form after each session.
5. Format the report according to the guidelines set by the Royal College.

Submission Deadlines:

• Case 1: Submit within 2 months prior to completing the 2nd residency year (R2).
• Case 2: Submit by January of the board examination year (R3).

Research Requirements

Each psychiatric resident must conduct at least one original psychiatric research project. Submission of the final research report or an accepted manuscript to the Residency Training Committee is required by March 31st of the board examination year. The completed report is a mandatory prerequisite for board examination application.

Research Criteria & Timeline

• Research Standard: Must be a systematic original article adhering to proper research methodology (Case reports, case series, or review articles are not acceptable).
• Topic Selection (8th Month): Submit at least 2 proposed research topics to the Committee by the 8th month of training for mentor assignment.
• Proposal Defense (End of R1): Complete the proposal defense before the end of R1. Submit the revised protocol to the Institutional Review Board (IRB), Faculty of Medicine, Chulalongkorn University, within 1 month post-defense. (Note: R1 residents who fail to submit their finalized proposal to the IRB will not be promoted to R2.)

Research Workflow

1. Conduct literature review and write the proposal following the graduate research standards of Chulalongkorn University.
2. Submit the proposal to the Residency Training Committee to assign a mentor and schedule the proposal defense within the specified timeframe.
3. Revise and submit the finalized proposal to the Institutional Review Board (IRB).
4. Perform data collection according to the approved proposal.
5. Analyze data and write the complete research report or manuscript. Submit to the Committee for review and schedule the final defense examination.
6. After passing the defense, make final revisions and submit the report/manuscript for final Committee verification. Obtain approval signatures from the Mentor, Examination Committee, Training Committee, and Department Head on the Approval Form prior to submitting to the Royal College Subcommittee.
7. Submit 1 hard copy and the digital file of the final research report to the department administrative office.