Rhode Island Hospital

Joshua Nathan, MD
Rhode Island Site Director
phone: 444-3534
pager: 350-9248

Overview. Rhode Island Hospital has three main areas for students to choose to work in:

  1. The inpatient unit (Jane Brown 5-South and 4-South) population covers the spectrum of psychiatric illnesses, and you will be exposed to pharmacotherapy, family meetings, and group psychotherapy. Students working on the inpatient floor stay mainly on the unit, and typically work directly with an attending psychiatrist and resident.
  2. The consult service with Dr. Harrington treats the various medical patients throughout RIH that have psychiatric issues (delirium, psychosis, etc.). Students evaluate and chart patients individually during the morning hours and then round with the team during the afternoon. Dr. Harrington is a great teacher (he was awarded the Senior Citation Award in 2003), but be aware that the service often runs late hours. Also be aware this rotation is a popular elective for fourth year medical students. As such, typically only one student may choose the consult service.
  3. The Partial Program with Drs. Villalba and Elliot is an intensive day program. The focus is on group therapy, and students participate in both individual assessments as well as group therapy. There is less resident contact than on the other services, and at times (depending on the partial population) less cross-sectional exposure to a wide variety of psychiatric illness. Due to the size of the program, typically only one student may choose the partial program. 4 th year students are better suited for this experience.

Orientation Information.

Welcome to your Psychiatry Rotation at Rhode Island Hospital! I'm Dr. Nathan, the site coordinator. We'll go over these items in greater detail in person. For now, or at any point in the future, if you have any questions, you should contact me:

Joshua Nathan MD
Pager -- 350-9248
E-mail -- [email protected]


Starting at Rhode Island Hospital

Orientation begins in my office on the 5th Floor of the Jane Brown Building around 9:30 (depending on the drive from Butler). As you exit the elevators from Jane Brown, you'll notice a locked psychiatric unit door. If you turn and walk the opposite direction, you'll immediately see to your right a waiting room -- my office is attached to the waiting room. If for some reason I'm not there yet, page me from the phone in the waiting room.

Parking is usually a problem for everyone around here, but you can do some things before you start the rotation to minimize your hassles.

For those who already have (or had) badge access to one of the parking lots on campus, call Kimberly (parking lady) at 444-6157. She will make sure that your badge is active, verify your car and license plates, and discuss what lots you can park in.

For those who have never parked at RIH campus before -- park in one of the pay (visitor) lots your first day. You need to see Kimberly in person at the parking office (across from the APC in the Physician's Office Building, Basement, room 032 -- phone 444-6157). You will need your Rhode Island Hospital ID badge with you. Once you get processed and assigned a parking lot, you should be fine for the next day. You will be given a voucher for parking in the paid lot your first day --go to the HR desk on the first floor of Potter Building to pick up your voucher.

Computer Access -- RIH is completely computer order entry. For those of you who have it, you'll continue to use your access codes to access both the computers and the intranet (for labs, orders, etc…) If you do not have access to the Lifespan computer system, you will need to contact the IS Help Desk at http://intra/is/helpdesk/ (onsite access only) or at 444-6381. They will assist you in getting the forms you need for access. Once you have the forms complete, I provide a signature, and you should have computer access within 48 hours of starting this process. Call me with any problems.

Badge access for JB5S and JB4 will be arranged with Alfredo, the clinical manager of the units, once you've arrived for the rotation. Until then ring the doorbell on the unit to gain access.

Basics of the Psychiatric Rotation

Students will have their choice of three services: Inpatient, Consults, or Partial

Here at RIH, the Inpatient service consists of working directly with an attending, and usually a resident, on a medical psychiatric unit. All major psychiatric illnesses are treated. Co-morbid medical issues of all types are encountered and treated. Each team usually is responsible for around 5-7 patients. Any number of students may potentially work on the Inpatient service.

A partial hospital program gives day-hospital intensive treatment for severe, but not acute, psychiatric patients. Patients of all types are encountered, although less dementias or psychosis are seen. The day hospital runs from 0800 to 1600, and students work with the therapeutic team in both individual and group settings. To ensure quality oversight, only one student per rotation can work with the partial program.

Requests for psychiatric consults in all of RIH patients are taken by the Consult service, keeping them busy. The teaching is excellent, but the hours are slightly longer what you see on the inpatient or partial program (lasting from 0800 to 1800, usually). Patients of all types are encountered, and co-morbid medical issues of all types are encountered. Usually, to ensure quality supervision, 1-2 students may elect the consult service.


All services have 4 weeknight calls in the APS (psychiatric emergency room) lasting from 1700-2200 -- I'll pass around a calendar during orientation, and ya'll choose which dates you wish.

Inpatient services -- one weekend call on the inpatient unit (usually lasting from 0800-1300) -- sign up on JB5 in the resident's room.

Partial services -- as opposed to taking a weekend inpatient call, you'll take a weekend APS call (lasting from 1000-1500) -- sign up on the calendar we'll pass around.

The students on Dr. Harrington's consult service do not take call.

All students are involved in the following:

HIPAA training for everyone - contact Hillary to schedule at 444-4318 at APC 966
ECT on Mondays, Wednesdays, and Fridays
Court on Fridays
Case conference last Tuesday of every month -- 0800, basement of Gerry house.
Interview Course Thursday at 11:00 on Jane Brown 4 South Annex, in conference room.

More on the inpatient experience Students are responsible for:

  1. Rounding on patients with the team, then writing daily progress notes and orders
  2. Performing a physical exam on new patients within the first 24 hours of admission (unless a medical consult is obtained, in which case they perform the physical exam), and calling the patient's outpatient therapist/primary care physician to notify them of the admission (a courtesy call)
  3. For patients that you are following, you are responsible for typing their discharge summaries. You follow a template (chief complaint, hpi, hospital course, etc.) and save the summary on a disk, hand it to your attending, and it is reviewed in 1-2 weeks by the attending.
Other things to do
  1. Students on Dr. Solomon's team will have many opportunities to observe electroconvulsant therapy (ECT), but students on other teams should take a morning to observe, too. Dr. Solomon performs most of the ECTs, and they are done every Monday, Wednesday, and Friday starting at 8:30am, in the small room inside the RIH PACU. Each ECT procedure lasts around 15-20 minutes.
  2. Students are encouraged to attend mental health court on Friday mornings. More details about this experience will be discussed during orientation.

Directions to Rhode Island Hospital

Heading North on Interstate 95:When traveling north on I-95, take exit 18. Bear left at the end of the exit onto Thurbers Avenue. At the first traffic light, take a right onto Eddy Street. After approximately 1 mile, you will come to light at the intersection of Eddy and Dudley streets. To reach the Main Building or Jane Brown, continue straight through the light and take a left into the main entrance. To reach other points on campus, such as the Cooperative Care Center, Medical Office Center, Davol emergency department, Hasbro Children's Hospital or the APC Building, take a left onto Dudley Street and follow the signs.  
Heading South on Interstate 95
:When traveling south on I-95, take exit 19 and bear right. At the end of the exit ramp there is a traffic light at the intersection of Eddy and Dudley streets. To reach the Main Building or Jane Brown, take a right at the light and take a left into the main entrance. To reach other points on campus, such as the Cooperative Care Center, Medical Office Center, Davol emergency department, Hasbro Children's Hospital or the APC Building, continue straight onto Dudley Street and follow the signs.  
From Route I-195 West:
Take I-195 West to 95 South. Move into the right-hand lane right away and take exit 19. Bear right while on the exit ramp to the intersection of Eddy and Dudley streets. At the intersection, you will see the hospital campus directly ahead. Follow the signs.