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Psychosomatic

Overview of program

The principal purpose of the Psychosomatic Medicine Fellowship Program is to train fellows to become knowledgeable, astute, and compassionate physicians with unique expertise in the diagnosis and treatment of psychiatric disorders in complex medically and surgically ill patients. The clinical and didactic programs of the residency are designed to develop comprehensive knowledge of patients with acute or chronic medical, neurological, or surgical illness in which psychiatric morbidity affects their medical care and/or quality of life; patients with somatoform disorder or with psychological factors in which psychiatric morbidity affects a physical condition; and, patients with a psychiatric disorder that is the direct consequence of a primary medical condition. The stance of the medical community at Louisiana State University Health Sciences Center in Shreveport, with its emphasis on integrated patient care and commitment to communication between all medical and surgical specialties, naturally reinforces the principles that have long served consultation-liaison psychiatry and its contributions to patient care. The emphasis of the program is on clinical training in psychosomatic medicine. Nonetheless, the curriculum also provides opportunities to learn and develop administrative, teaching and research skills.

Contact information

For more information, please contact Dr. Mary Jo Fitz-Gerald, Program Director,  mfitzg@lsuhsc.edu (318) 675-6049, fax: (318) 675-6054.

Curriculum

The principal dimensions of this program’s curriculum include clinical rotations on psychiatric consultative services, clinical and observational participation on non-psychiatric services, and didactic/seminar-based educational commitments. The goals and objectives, teaching methods, and evaluative mechanisms for these curricular dimensions are summarized below, while acknowledging that it is arbitrary to parse many of these goals and objectives into only one curricular dimension.

Psychiatric Services - required 10 months inpatient consultation-liaison with ˝ day per week outpatient consultation. One month outpatient consultation available as an elective/selective. One month geriatric psychiatric inpatient available as an elective

Goals & Objectives

  • To recognize the psychiatric complications of medical illnesses;
  • To evaluate and manage delirium, dementia and secondary psychiatric disorders;
  • To evaluate and manage somatoform disorders and chronic pain;
  • To evaluate and manage chemical dependency issues that surface in the medical arena;
  • To provide effective non-pharmacologic interventions, including cognitive-behavioral, interpersonal, brief, and supportive psychotherapy for patients suffering the effects of complex medical illness;
  • To understand the indications for, and use of, psychotropic medications in specific medical, neurologic, obstetrical, and surgical conditions;
  • To collaborate effectively with other physicians and members of the multiple disciplines involved in the whole of the health care team; and,
  • To lead an integrated psychosocial health care team in the medical setting.

Teaching methods

  • Clinical: Bedside teaching, biweekly supervision, case-based reviews, morbidity and mortality conferences
  • Didactic: Lectures, Psychiatry Grand Rounds, journal clubs, elective courses, specialty meeting attendance
  • Independent: Reading, researching current literature, preparing formal or informal didactics for colleagues, board review

Evaluative mechanisms

  • Direct observation with subsequent verbal and written feedback
  • Resident completes self-evaluation form and identifies specific goals related to each of the six core competencies
  • Mock oral exam
  • Review of clinical documentation, including chart audits and reviews
  • Core Competence Evaluation Form by attendings, supervisors
  • Psychiatry Resident In-Training Exam (voluntary)
  • Attendance and participation in didactics, seminars and case-conferences
  • Formal presentations and manuscript preparation
  • “360 degree” evaluations

Non-psychiatric Services—one month selective available in internal medicine or family practice outpatient clinic.  One month elective available in Sleep Medicine.

Didactic & Seminar Commitments:

  • Orientation to Psychosomatic Fellowship (annually)
  • Introduction to Consultation-Liaison (annually)
  • Boundary Issues in Psychiatry (annually)
  • Advanced Consultation/Liaison Psychiatry (weekly)
  • Psychosomatic Medicine Journal Club (monthly)
  • Chairman’s Rounds/Psychological Issues in Psychosomatic Medicine (weekly)
  • Teaching Fundamentals (annually)
  • Academy of Psychosomatic Medicine Meeting (annual)
  • Difficulty Patients in Psychosomatic Medicine (Morbidity/Mortality Conference-quarterly)
  • Cultural and Gender Issues (biweekly)
  • Interdisciplinary Case Conference (monthly)
  • Psychiatry Grand Rounds (twice a month except June and July)
  • Discussion with Grand Rounds Speakers
  • Neurology Grand Rounds (weekly)
  • Annual Intensive Review of Internal Medicine
  • Neuropsychiatry Rounds (weekly)

Sites

LSU Health Sciences Center, 1501 Kings Hwy, Shreveport, LA 71103 .  Promise Specialty Hospital is available for a one-month geriatric psychiatry elective.

Salary

Salaries are reviewed on an annual basis. Current salary for a PGY-V is $49,099.75.

Benefits:

Comments from current or past residents with pictures (a day in the life of PGY I,II,III,IV):

    The fellowship gave me a great opportunity to expand my knowledge and increase my confidence in the management of patients with psychiatric and complex medical and surgical co-morbidities in a warm and supportive atmosphere.

    A typical day starts at 8:00 AM and ends by 5:00 PM. The fellow acts as the team leader and has the responsibility of assigning the patients between the students and residents. The fellow also is responsible for the follow-up of the more complex and seriously ill patients .Dr. Fitz-Gerald meets with the team on a daily basis for rounds and is available when needed at other occasions.   I had ample clinical supervision.  Weekly educational lectures, case conferences, administrative and research opportunities provide additional training.  The fellowship provided excellent training allowing me to pass my Psychosomatic Boards with ease and effectively treat the most complex psychiatric patient with coexisting medical and surgical problems.  I strongly recommend this fellowship opportunity to individuals who desire excellent training, a warm and caring educational environment, and superb faculty.

    Vesela Tzoneva M.D. 2007

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