Department of Human Resources

2243 SUPERVISING PSYCHIATRIC PHYSICIAN SPECIALIST (PBT-2243-106292)

DEPUTY MEDICAL DIRECTOR OF LONG TERM CARE

SUPPLEMENTAL QUESTIONNAIRE EXAMINATION

 PLEASE READ THE FOLLOWING INSTRUCTIONS CAREFULLY

YOUR EXAMINATION SCORES WILL BE DERIVED FROM YOUR RESPONSES 

The purpose of this Supplemental Questionnaire/Training and Experience Evaluation is to assist with assessing possession of the Minimum Qualifications for the 2243 Supervising Psychiatric Physician Specialist – Deputy Medical Director of Long Term Care position, as well as to determine your knowledge, skills, and abilities in job-related areas that have been identified as critical for satisfactory performance. Please refer to the examination announcement for a more detailed description of these knowledge, skills, and abilities.

PART ONE: Questions 1 – 6 will assist with assessing possession of the required licensure, certification, registration, and experience for the 2243 Supervising Psychiatric Physician Specialist – Deputy Medical Director of Long Term Care position.

PART TWO: Questions 7 – 21 will be scored and will account for 100% of the total weight of your final score and rank on the resulting 2243 Supervising Psychiatric Physician Specialist – Deputy Medical Director of Long Term Care eligible list/score report.   Qualified applicants must achieve a passing score to be placed on the eligible list/score report, in rank order, according to their final score.

Attaching a resume does not substitute for submitting a completed application. Your application’s Education, Professional Licenses, Certifications, or Registrations, and Employment Record sections should clearly demonstrate how you satisfy this position’s Minimum Qualifications. Do NOT type “see resume” or leave the above-mentioned application sections blank.

Your application or additional attached documents (e.g. resumes, cover letters, letters of reference/recommendation, etc.) will NOT be considered during the scoring process. Insufficient or non-responsive answers may result in ineligibility, disqualification, or lower scores. Once submitted, applicant responses cannot be changed.

It is suggested that you allow ample time to submit your application and Supplemental Questionnaire responses before the filing deadline. If you experience technical difficulties, make note of any error messages and contact the analyst before the filing deadline. Responses should be consistent with and supported by the information on your application (i.e. Professional Licenses, Certifications, or Registrations & Employment Record sections) and are subject to verification at any time.

PART ONE: MINIMUM QUALIFICATIONS

As a reminder, all qualifying licensure, registration, certification, and experience must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the licensure, registration, certification, and experience you are about to describe in the applicable sections of your application, you will not receive credit. If you are copying an old application, please take the time to update applicable sections before submitting your application.

Do you have a valid license to practice medicine issued by the Medical Board of California or the Osteopathic Medical Board of California?

Did you successfully complete a residency program accredited by the Accreditation Council for Graduate Medical Education or American Osteopathic Association in a Psychiatric medical specialty area (i.e. Board Eligible)?

 DO NOT INCLUDE RESIDENCY PROGRAMS THAT ARE IN PROGRESS

Please identify the Psychiatric medical specialty area(s) for which you are Board Eligible.  Select all that apply

Do you have valid Board Certification in a Psychiatric medical specialty area?

Please identify the Psychiatric medical specialty area(s) for which you have valid Board Certification. Select all that apply.

Do you have valid Drug Enforcement Administration (DEA) registration with the United States Department of Justice?

How much post-residency experience do you have as a practicing Psychiatrist in the medical specialty area of General Psychiatry?

One (1) year of experience is equivalent to 2,000 hours.

How much post-residency experience do you have as a practicing Psychiatrist in the medical specialty area of Addiction Psychiatry?

One (1) year of experience is equivalent to 2,000 hours.

How much post-residency experience do you have as a practicing Psychiatrist in the medical specialty area of Geriatric Psychiatry?

One (1) year of experience is equivalent to 2,000 hours.

How much post-residency experience do you have as a practicing Psychiatrist in the medical specialty area of Consultation and Liaison Psychiatry?

One (1) year of experience is equivalent to 2,000 hours.

How much post-residency experience do you have as a practicing Psychiatrist in the medical specialty area of Forensic Psychiatry?

One (1) year of experience is equivalent to 2,000 hours.

PART TWO:  TRAINING AND EXPERIENCE EVALUATION

How much experience do you have as a Medical Director of a behavioral health clinic?

One (1) year of full-time experience is equivalent to 2,000 hours.

How much experience do you have supervising Psychiatrists?

One (1) year of full-time experience is equivalent to 2,000 hours.

How much experience do you have collaborating with external agencies/providers (e.g. jail, police, school district, juvenile hall, primary care, etc.)? 

One (1) year of full-time experience is equivalent to 2,000 hours.

From your Psychiatrist experience, please identify the healthcare disciplines of employees you’ve supervised. Select all that apply.

Considering your entire career as a post-residency Psychiatrist, identify a role where you supervised the largest number of Psychiatrists, Psychiatric Nurse Practitioners, and/or Registered Nurses under your supervisory structure.  How many of the professional staff identified above were you responsible for?

Please identify all of the at risk patient populations you’ve worked with as a post-residency Psychiatrist. Select all that apply.

How much experience do you have in the areas of community behavioral health program planning?

One (1) year of full-time experience is equivalent to 2,000 hours.

Excluding residency experience, as a Psychiatrist, have you lead a quality improvement activity or project?

Please identify all tools that you’ve utilized for clinical quality improvement activities or projects. Select all that apply.

How much experience do you have providing oversight in specific behavioral health service modality areas (e.g. Adult and Older Adult Psychiatry, Children, Youth and Family Psychiatry, Primary Care Psychiatry, or Intensive Service Psychiatry) for a system of care?

One (1) year of full-time experience is equivalent to 2,000 hours.

Excluding residency experience, as a Psychiatrist, please identify all tools/methods you’ve used to enhance employees’ experience. Select all that apply.

Excluding residency experience, as a Psychiatrist, identify all quality assurance activities with which you’ve had experience. Select all that apply.

Has your post-residency Psychiatrist experience included handling employee issues related to laws/regulations including, but not limited to the Equal Employment Opportunity (EEO), Americans with Disabilities Act (ADA), Workers’ Compensation, or protected leaves of absence (e.g. Family Medical Leave Act (FMLA), Pregnancy Disability Leave (PDL), etc.)?

Please identify your experience with the following components of the corrective and/or disciplinary action process. Please select all that apply.

How much post-residency Psychiatrist experience do you have working with multidisciplinary teams in a community behavioral health setting?

One (1) year of full-time experience is equivalent to 2,000 hours.