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Psychosocial Medicine

Overview of P2 ProgramPracticum Family Sculpting

"P2" stands for Psychosocial Medicine and Practice Management and is a 20 week long rotation required during the second year of residency.

The average full-time family physician in our region conducts about 4500 patient visits per year.  For a third to a half of those visits, psychosocial difficulties will be at the core of the presenting problem.  When you consider this number, and the complexity of the patient presentations in a primary care practice, you begin to see why we found it important to prepare our residents to be psychosocially aware of their patient's needs as well as develop physician self-awareness and identity as health care professionals so they can provide effective patient-centered care. Resident feedback on the experience is very positive - " I found this rotation to be invaluable. It was transformative to my practice as a family physician."

The Practice Management Component of the rotation incorporates many of the tenets of the original P4 program – Preparing the Personal Physician for Practice. The curriculum aims to give residents an opportunity to grow their practice management skills with hands-on experience in: group medical visits, continuous quality improvement, the patient-centered medical home (PCMH), and leadership.

Gene Farley, M.D., founding department chair, understood the importance of providing in-depth training in the psychosocial aspects of family health care. Our specialized curriculum has been running for over forty years with modifications made regularly to meet the changing needs of residents and patients.

“Emphasis on mental/emotional health of residents produces emotionally healthy attendings.” –Alumni Survey 2010

Training Activities

The following are training and activities during 20 weeks of the rotation. 

  • Participate in weekly practice-based didactic seminars that incorporate a lifespan orientation to psychosocial topics, and that include evidence-based skills for integrating into Family Medicine practice and patient care.
  • Participate in training on substance use and abuse in primary care, including medication assisted treatments (MAT), determination of appropriate levels of care, addressing problematic use in adolescence, medical marijuana, and partnership with specialty care.
  • Develop skills around conducting family meetings and understanding family systems in our Family Practicum sessions, incorporating live peer and faculty observation and feedback.
  • Develop primary care counseling skills through live supervision and video review of physicians' sessions; expand skills in the provision of evidence based brief behavioral intervention to help patients cope with and better manage an array of health concerns.
  • Reflect on their own physician practices under physician supervision.P2 group
  • Engage in community resources that are accessible to patients when they encounter bereavement, grief, chronic disease management, and barriers to implementing healthy lifestyle choices.
  • Engage in reflective practice groups led by a faculty facilitator expert in group process as well as the management of affect in ourselves and patients, alike.
  • Advance understanding of how to use psychiatric consultation and the diagnostic interviewing process through observation of psychiatric consultations and follow-up interviews that take place on-site.
  • Learn about behavioral health care management through participation in e-consult and registry review sessions with our psychiatric consultant and care management team.
  • Facilitate group visits, including: Diabetic Group visits, Healthy Living Group visits, and Prenatal Centering Group visits.

Longitudinal Psychosocial Experience

As a complement to the P2 rotation, residents participate in a three year longitudinal psychosocial curriculum, adapted to the development needs of interns and upper level residents. Balint groups are facilitated for all residents to practice self reflection with their peers related to difficult patient encounters.