Overall Education Goals

The fellow should demonstrate competence in the provision of patient care.
Objectives: At the conclusion of the fellowship the resident should be able to:
a) establish a good working relationship with the patient
b) obtain a thorough history from the patient
c) perform a comprehensive mental status examination, including assessment of suicidality and other high risk behaviors
d) order appropriate laboratory, neuropsychological, or brain imaging tests
e) synthesize information to determine the diagnosis or differential diagnosis
f) provide a formulation that considers biological, medical, social, and psychological factors in the development of the patient’s problems
g) develop treatment recommendations or a treatment plan
h) educate patients about the nature of their disorder and its treatment
i) administer treatments effectively
j) document a complete and useful consultation note
k) involve family and care givers as appropriate
l) evaluate patients in multiple settings, including inpatient medical and surgical units and integrated/specialty ambulatory settings
m) evaluate socio-culturally diverse patients effectively
n) make appropriate referrals, including but not limited to substance use disorder treatment, nursing facilities, palliative care, and community resources

The fellow should have an advanced medical knowledge of psychiatric disorders.
Objectives: At the conclusion of the fellowship the resident should be familiar with:
a) the nature and extent of psychiatric morbidity in medical illness and its treatments
b) the impact of comorbid psychiatric disorders on the course of medical illness
c) psychological and social factors involved in the patient’s response to illness
d) the epidemiology of psychiatric illness in medical disease
e) psychiatric complications of medical illnesses
f) typical and atypical presentations of psychiatric disorders that are due to medical, neurological, and surgical illnesses
g) evaluation of delirium, dementia, and secondary psychiatric disorders
h) evaluation and management of somatoform disorders and chronic pain
i) evaluation and management of substance use disorders in the Psychosomatic Medicine setting
j) assessment of capacity to given informed consent for medical and surgical procedures in the presence of cognitive impairment
k) ethical principles involved in choices regarding end of life care, such as designation of DNR/DNI, and the use of advance care directives and surrogate decision makers

The fellow should have an advanced medical knowledge of treatments for psychiatric disorders.
Objectives: At the conclusion of the fellowship the resident should be familiar with:
a) appropriate treatment interventions for co-existing psychiatric disorders in the medically ill
b) psychological and psychiatric effects of new medical or surgical therapies
c) the epidemiology of psychiatric treatment in medical disease
d) psychiatric complications of medical treatments
e) management of delirium, dementia, and secondary psychiatric disorders
f) provision of non-pharmacologic interventions, including psychotherapeutic interventions in patients suffering the effects of medical disorders or their treatments
g) indications for, and use of, psychotropics in specific medical conditions
h) interactions between psychotropic medications and the full range of medications used to treat medical illness

The fellow will have an advanced knowledge of legal issues related to the medically ill.
Objectives: At the conclusion of the fellowship the resident should be familiar with:
a) assessment of capacity to give informed consent for medical and surgical procedures
b) policies regarding the delivery of medical treatment to an individual incapable of informed consent
c) statutes regarding involuntary hospitalization and involuntary use of medication
d) statutes regarding the appointment of a conservator
e) the patient’s right to refuse and to receive treatment

The fellow will demonstrate practice-based learning.
Objectives: At the conclusion of the fellowship the resident should be able to:
a) access the literature relevant to cases seen in order to enhance learning
b) evaluate previous clinical performance to improve future care
c) demonstrate teaching and administrative skills

The fellow will demonstrate competent interpersonal and communication skills.
Objectives: At the conclusion of the fellowship the resident should be able to:
a) establish rapport with patients
b) listen effectively to the concerns of patients
c) understand cultural elements in the relationship between the fellow and the patient
d) educate patients about the nature of their disorders and the nature of recommended treatments, including discharge plans
e) listen to and communicate with family and care givers effectively
f) collaborate successfully with other physicians and other members of the multidisciplinary treatment team

The fellow will demonstrate professional behavior.
Objectives: At the conclusion of the fellowship the resident will have demonstrated the ability to:
a) answer calls and requests promptly
b) follow through on assigned tasks
c) complete appropriate documentation
d) provide coverage when unavailable
e) follow policies and procedures
f) maintain confidentiality
g) maintain professional boundaries
h) be respectful of patients
i) recognize impairment, including illness and fatigue, in themselves and their peers

The fellow should demonstrate an understanding of and ability to work within a systems-based practice.
Objectives: At the conclusion of the fellowship the resident will have demonstrated:
a) an ability to work effectively with other specialties and disciplines
b) effective multidisciplinary treatment planning, including discharge planning
c) effective leadership skills in working with other staff
d) familiarity with obstacles to the recognition and treatment of psychiatric disorders in the medically ill
e) knowledge of reimbursement issues and the effect of the cost of treatment on satisfaction and adherence

The fellow will be sufficiently knowledgeable about research methods such that they are able to effectively review the literature and assimilate new knowledge.
Objectives: At the conclusion of the fellowship the resident should:
a) be familiar with research methods, including evidence-based practice
b) be able to critically review new findings
c) be able to assimilate new knowledge

The fellow will learn methods for more effective teaching.
Objectives: At the conclusion of the fellowship the resident should be able to:
a) supervise medical students and junior residents
b) provide training and education to other staff
c) educate other physicians and other members of the multidisciplinary treatment team how to recognize and respond to various psychiatric disorders