About the Program
This fellowship integrates the history of the biopsychosocial model with cutting edge work in consultation subspecialties and everything in between. Our strengths are in inpatient consultation, collaborative care, medicine in psychiatry and outpatient sub-specialty consultation. There are required rotations as well as many opportunities for electives based on fellow interest. Educational offerings include a weekly didactic series, monthly journal club as well as the weekly departmental grand rounds. The fellow will also be heavily involved in teaching medical students and residents. Consultation Liaison fellows will also be required to complete one scholarly activity suitable for a poster presentation as well as a quality improvement project.
Psychiatric Consultation Liaison Service
The Psychiatric Consultation Liaison Service (PCLS) provides over 1800 consultations annually to Strong Memorial Hospital (SMH), the center of the University of Rochester Medical Center(URMC) health care delivery system. Strong Memorial has 886 patient beds and approximately 1400 full-time faculty members and 650 voluntary clinical faculty members organized into 32 departments and centers. It is the only Level 1 Trauma Center and quaternary care center in the region. The service operates both a traditional consultation model and a Proactive model. The service is staffed by psychiatrists and advanced practice nurses, and provides training to PGY-2 residents, Neurology and other residents, and medical students. While on this service, the Fellow will provide inpatient consultations and help train residents and students. The fellow will also have the opportunity to participate in telepsychiatry consultations to URMC-affiliated regional hospitals and Emergency rooms.
Organ Transplant is a signature program of URMC, offering liver, kidney and heart transplantation. Annually, there are 150-200 transplants in these programs. In addition, there is a robust VAD program, following over 200 VAD patients. Transplant Psychiatry has a full-time consultative presence in these programs. The clinical work occurs in inpatient and outpatient settings, and involves candidacy assessments of both recipients and donors, consultative short-term management of psychiatric issues, assessment and management of delirium, and helping patients and families with emotional adjustment when dealing with worsening health and also during recuperation. The Fellow will participate in recipient listing and donor evaluation committee meetings.
The Medicine In Psychiatry Service (MIPS)
The MIPS is a team comprised of primary care physicians interested in the biopsychosocial approach to patients specializing in the medical care of patients with psychiatric and behavioral difficulties. It is one of the few units of its kind in the entire country. URMC has one inpatient medical unit dedicated to the MIPS; in addition, MIPS has a community-based outpatient practice. The Fellow will work on the inpatient unit and round with the medical team and provide case consultations and education to the team, will provide formal psychiatric consultations, and will work with the on-unit psychology staff. An important aspect of this rotation is learning about and experiencing an embedded model of psychiatric
Collaborative and Integrated Care
The Department of Psychiatry provides psychiatric care in a variety of Internal Medicine and Family Medicine practices, both large and small, located throughout Rochester and the region. There are multiple different models used depending on the site including the IMPACT model and co-located care in addition to using multiple modalities including teleconsultations and e-consults. By being exposed to different models of integration and to different practices throughout the region, the Fellow can explore not only the clinical work in differing patient populations, but also how various care models can work.
While the fellow will have experiences with these subspecialties on the inpatient consultations service, they can choose to do a more longitudinal outpatient experience in the following areas:
The URMC Pain Treatment Center, part of Strong Memorial Hospital, offers a multidisciplinary approach that includes psychological, behavioral and rehabilitative care. This outpatient rotation offers the opportunity for the Fellow to learn about assessing pain while better understanding pain syndromes and treatment options, both pharmacological and non-pharmacological.
This rotation occurs at UR Medicine’s Wilmot Cancer Institute (WCI), where the Fellow can learn about management of psychiatric issues in cancer patients and their families. WCI features an 86-bed cancer center with 11 outpatient locations throughout the Rochester and Finger Lakes region. It cares for more than 5000 patients, and has over 2900 inpatient admissions a year. WCI, a component of Strong Memorial Hospital, is one of upstate New York’s largest blood and marrow transplant programs and the Rochester area’s only ACOS-accredited breast cancer center. Mental health care at WCI is provided by a team of dedicated mental health therapists and a psycho-oncologist and PCLS.
UR Medicine Obstetrics and Gynecology physicians are ranked among the nation's best in U.S. News & World Report's America's Best Hospitals list. The Women’s Health Practice, located in a community office nearby URMC, offers comprehensive outpatient Ob/Gyn services ranging from initial exam to childbirth and through menopause and beyond. Mental health care is provided within the practice. In this co-located setting, the Fellow will learn about how Ob/Gyn issues can intertwine with psychiatric issues.
Opportunities are available for outpatient consultation in multiple subspecialty areas of Neurology including in epilepsy, headache and Huntington’s disease clinics. The Epilepsy Center is the only certified, level 4 Epilepsy Center in the region. The emphasis of this rotation is on somatic symptom disorders, working with the Epilepsy Center’s dedicated psychologist.
In addition to these electives, the Fellowship is interested in providing its Fellows with experiences in areas that are of interest. Because URMC is an integrated academic health center that has specialists in every area of medicine (including featured areas such as Neuromedicine (Neurology and Neurosurgery), Heart and Vascular Care, Primary Care, Cancer Care, Diabetes, and others), other electives can be arranged, through discussions with the Program Director.