Psychosocial Medicine

Overview of P2 Program

"P2" stands for Psychosocial Medicine and Practice Improvement and is a 16-week long rotation during the second year of residency. This specialized curriculum has been one of the major and most unique strengths of our residency program for over 40 years.

The average full-time family physician in our region conducts about 4,500 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 find it essential to prepare our residents to be psychosocially aware of their patients' needs. We find it equally important to ensure physicians develop self-awareness and identity as health care professionals so they can provide effective patient-centered care. Resident feedback on the experience is consistently positive: "I found this rotation to be invaluable. It was transformative to my practice as a family physician."

Training Activities

The following are training activities during the 16 weeks of the rotation.

• Participate in weekly practice-based didactic seminars that incorporate a lifespan orientation to psychosocial topics and evidence-based skills for integrating into Family Medicine practice and patient care.
• Participate in training on substance use and abuse in primary care, including determination of appropriate levels of care, addressing problematic use in adolescence, and partnership with specialty care.
• Training in the provision of Medications for Opioid Use Disorder (MOUD, formerly known as Medication Assisted Treatment/MAT) and in eligibility and appropriateness for medical marijuana.
• 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, expanding skills in evidence-based brief behavioral intervention.
• Reflect on their own physician practices under physician supervision.
• Engage in community resources that are accessible to patients encountering bereavement, grief, chronic disease management, and barriers to healthy lifestyle choices.
• Engage in reflective practice groups led by facilitators with expertise in group process.
• Advance understanding of psychiatric consultation and diagnostic interviewing through observation of psychiatric consultations and follow-up interviews.
• Learn about behavioral health care management through participation in e-consult and registry review sessions with our psychiatric consultant and care management team.