Residents in the Montana Track at Billings Clinic complete two years of training in Seattle in an academic university environment, followed by two years in the community setting of Billings, Montana. Clinical rotations are designed to provide exposure to a wide variety of patient populations, increase levels of responsibility under supervision, and allow the resident to explore elective opportunities.


During the PGY-1 year in Seattle, residents complete a 6-month internship consisting of 4 months of Medicine and/or Pediatrics and 2 months of Neurology.  The other 6 months are spent on inpatient psychiatry services at Harborview Medical Center, the University of Washington Medical Center, and/or the VA Puget Sound Health Care System hospitals, learning assessment of and treatment planning for acutely ill inpatients.


The PGY-2 year in Seattle includes additional experience in inpatient psychiatry, as well as rotations in emergency psychiatry at Harborview Medical Center, addictions psychiatry, geriatric psychiatry, and basic inpatient consultation-liaison psychiatry. In the PGY-2 year, residents begin a half-day-per-week outpatient continuity clinic and complete basic psychodynamic and supportive therapy seminars.

PGY3 and PGY4

Because of the unique challenges of working in an underserved area, there is a strong focus on community and integrated care psychiatry in the PGY-3 and PGY-4 years.

Montana Track Curriculum

Residents are encouraged to pursue electives over the course of their third and fourth years.  Choices include, but are not limited to:

  • Project ECHO Billings Clinic
  • Eastern Montana Telemedicine Network
  • EmPATH Unit, a state-of-the-art psychiatric observation milieu
  • Integrated behavioral health
  • Interventional psychiatry
  • EPIC Montana, an early psychosis intervention clinic
  • Systems change, leadership, and advocacy training
  • Youth partial hospitalization program
  • School-based mental health