PYCHOSOMATIC FELLOWSHIP Medical Center and six consecutive months full skills with consulting teams, understanding how PROGRAM BOSTON UNIVERSITY time at the VA Boston Healthcare System. clinical practices are shaped by the system in SCHOOL OF MEDICINE DIVISION OF which they emerge as well as developing a solid PSYCHIATRY The Boston Medical Center is a private, non- foundation of neuropsychiatric knowledge will profit 496 bed academic medical center that be emphasized during this rotation. provides both primary and tertiary care to an The Psychosomatic Medicine Fellowship is a ethically diverse patient population (40% White, III. Boston Medical Center Rotation one year fully accredited program designed to 39% African American, 12% Hispanic, and 2% train academic psychosomatic psychiatrists to be Asian) The psychiatric consultation service leaders in the field and to provide knowledge During the six-month rotation at Boston Medical responded to 1,800 new consultation requests in and skills in the field of psychosomatic Center, the fellow will spend approximately the last year, which came from all medical and medicine. A unique quality of the program is its 60% of their time providing consultations to the surgical specialties including the intensive care ability to provide the fellow with a variety of acute medical and surgical services. The fellow units, oncology, and OB-GYN. The educational and training venues that include an will see 10-12 new patients a week on the consultation service has acting liaison ethnically, culturally and economically diverse consultation service and will be responsible for relationships with the intensive care units, group of patients. evaluation and follow-ups with the patient, oncology, the amyloid program, transplant family and referring physician. As part of surgery, surgical trauma, cardiac rehabilitation, leadership and administrative skills training, the Over the course of the year, the fellow will addiction medicine, and general internal fellow will lead and provide teaching and develop clinical knowledge and expertise in the medicine, and family medicine. In addition to supervision to a team consisting of PGY2 psychiatric care of the medically ill and the inpatient services, the Boston Medical resident and medical students. The faculty physically disabled patient. This will include Center has a large Primary Care Clinic (100,000 consists of five full-time psychiatrists who consultations and evaluations, crisis intervention visits/year) and active Family Medicine Service provide daily supervision. The fellow will have and various forms of psychotherapy. The fellow (75,972 outpatient visits/year). one hour of individual supervision weekly and will be exposed to the care and management of one hour of daily group rounds supervision. In patients in a variety of settings including The VA Boston Healthcare System serves as the addition to the provision of clinical services, the intensive care units, primary care and family major tertiary and surgical referral center for all fellow will participate in weekly case medicine clinics, and cancer care centers. other VA facilities in New England and offers conferences, weekly didactic seminars that cover Clinical work is supplemented by a variety of comprehensive specters of clinical services to a variety of topics that are essential to psychiatry didactic seminars and participation in the veterans of Eastern and Central care of the medically ill and will include mental multidisciplinary educational experiences that Massachusetts. The fellow will be based at the health laws and ethics, research in include clinical rounds, conferences, supervision West Roxbury campus for the 6 month rotation psychosomatic medicine, historical perspectives and research activities. An important aspect of period. The West Roxbury Campus is the and administrative aspects of Psychosomatic the program will be the development of primary medical center for veterans of medicine. When possible and appropriate, there teaching, leadership, and administrative skills as Massachusetts and its consultation-liaison will be an attempt to have some seminars that the fellow works with other health care service is an integral part of the healthcare include faculty and trainees in other medical and providers in both inpatient and outpatient services provided there. It serves as a training surgical specialties. The fellow will have the settings. site for both the Boston University School of opportunity to attend Psychiatry Grand Rounds Medicine and the Harvard Medical School. The and a Psychosomatic Journal Club. II. Training Sites fellow will gain expertise in treating veteran patients who often present with a unique and The fellow will spend 10% of their time in The Psychosomatic fellow will spend a total of specific set of medical conditions and development of clinical liaison with one medical six consecutive months full time at the Boston psychosocial needs. Developing strong liaison or surgical unit and as such become an active member of the treatment team by joining work care or medical/surgical specialty clinics or manage common psychiatric disorders, evaluate rounds, providing consultation, leading follow-ups from the inpatient service. The liver transplant patients, and lead didactics. psychosocial conferences for health care fellow will have one hour of supervision weekly providers and offering education and support to by a member of the faculty with case specific The VA Boston Healthcare System rotation will the treatment team. The fellow will have one supervision as needed. include approximately 8 hours in continuity of hour of individual supervision, which includes care in the Outpatient Clinics at the West direct observation. IV. The VA Boston Health Care System Roxbury campus. The fellow will use this time Rotation to evaluate patients who may be referred from The Psychosomatic fellow will learn to be medical or surgical clinics or for follow-ups of leaders in integrated behavioral health care. Sixty percent of the time spent on the VA patients seen on the medical inpatient service. Boston Medical Center offers experience in two Boston Health Care System rotation will be Faculty will provide at least one hour of unique Collaborative Care clinics, Primary Care spent on the Medical Psychiatry Consultation supervision weekly. Internal Medicine and Family Medicine. The Service at the West Roxbury Campus. While fellow will spend one 3-hour block embedded in there, the fellow will evaluate and follow Interested fellows may also choose to participate each clinic during alternating weeks. Both approximately 15 patients a week and will be in an Elective in Research, Clinical Care or clinics provides concurrent care for mental responsible for evaluation, follow-up and liaison Liaison. This will allow the fellow to spend health and general medical conditions by with referring physicians. In addition, the fellow time either on additional research activities, the multiple disciplinary teams but will offer will supervise medical students and PGY 2 and development of a clinical liaison or to work in interested fellows the opportunity to PGY 3 residents. The Faculty at the West an additional clinical care setting such as the subspecialize in several different areas, Roxbury Campus consists of three full time Women’s Health Center. One hour a week of including women’s health, addiction medicine, psychiatrists and two part time psychiatrists who supervision will be provided which will focus on refugee health care, and integrated medicine. will provide frequent direct supervision, bedside their elective activity. teaching, as well as daily group supervision The Psychosomatic fellow will spend 4 hours a during rounds. In addition to clinical work, the There is no required night call duty during the week as a preceptor at the Primary Care Clinic fellow will spend 6 hours a week in educational fellowship, however, there is the opportunity to and 4 hours as a preceptor in the Family activities that include teaching rounds, in-service do moonlighting at Boston Medical Center Medicine Clinic. As a preceptor in these clinics, didactics, conferences with the medical staff on affiliated institutions as long as this doesn’t the fellow will join the medical faculty in topics pertinent to Psychosomatic Medicine and interfere with the fellow’s training and helping medical and family practice residents ongoing seminars. Seminars include Advanced education. recognize and manage common psychiatric Psychopathology and Psychotherapy, Behavioral disorders. The fellow will provide didactic Neurology, Forensic Issues, and an Integrated seminars, consultation, therapeutic interventions, Senior Seminar (addresses advanced issues, and teach interview techniques. The fellow will psychosomatic medicine; system theory, and have individual supervision on a case-by-case career issues with guest faculty). basis as needed during the clinic. The VA Boston Healthcare System rotation will In addition to the above activities, the fellow include 4 hours a week spent as a team member will provide 4 hours a week of outpatient of Primary Care Medical Clinic at the West continuity of care for patients with Roxbury Campus. During this time, the fellow psychosomatic issues. It is hoped that the fellow will serve as a consultant/preceptor to the will see in evaluation or follow-up 4-5 patients primary care staff and will help to diagnose and per week that are either referred by the primary