CL Training Curriculum and Schedule
Sample Block Schedule and Electives
Fellows will have 1/2-day per week of longitudinal outpatient clinic. Fellows can spend up to 6 months of the year in 2-4 of the following clinics: perinatal, psycho-oncology, neuropsychology, epilepsy, or HIV.
Research and scholarly activity are built into the rotation blocks with 4 hours of protected time every week for didactics, research, preceptorship, or other scholarly work.
Fellows will have 3 weeks of vacation time and additional conference time.
A Flex rotation will allow trainees to concentrate on an area of interest within the field by adding additional time to Addiction, MICU or other specialty areas. General CL months can also be switched to a variety of elective Consult Services including:
- Acute Pain Service
- Addiction/OBAT
- Epilepsy
- Ethics
- HIV/Infectious Disease
- MICU
- Neuropsychology
- Palliative Care
- Psycho-oncology
- Toxicology
There is quite a bit of flexibility in the fellowship to craft an experience around diverse interests or build and staff a liaison in the hospital. The Program Director and Core Faculty will work with each fellow in building an experience that fits their career and educational goals.
C-L Fellows will not take call.
For detailed information regarding the goals and milestones of the Consultation-Liaison Fellowship please click on the headings below.
Professionalism:
- Journal Club – read and discuss scientific literature with other psychiatry fellows, residents, and faculty.
- Complex Care Collaboration Teams
- Attendance at the national Academy of Consultation Liaison Psychiatry (ACLP) Annual Conference
Patient Care and Procedural Skills:
- Establishing rapport with all medical patients.
- Diagnosing and treating psychiatric disturbances that occur among the physically ill.
- Conducting psychiatric evaluations of individuals involving psychiatric complications of medical illness, medical treatments, typical and atypical presentations of psychiatric disorders.
- Evaluating and managing individuals with acute and chronic pain, delirium, dementia, somatic symptom disorders, palliative care and end-of-life issues.
- Assessing capacity to give informed consent in the presence of cognitive impairment.
- Providing psychosocial interventions appropriate for the medically ill.
- Appropriate use of psychoactive medication in medical, neurological, obstetrical, and surgical conditions.
Interpersonal and Communication Skills
- Fellows will have the opportunity to learn interpersonal and communication skills through interactions with patients, other providers, and journal club discussions.
- Topics relate to communication with patients, disagreeing with a colleague, barriers and facilitators to communication with colleagues, and research on family communication.
- Assist fellow in demonstrating professionalism and competence in establishing good rapport with patients, families, colleagues, supervisors, and other healthcare professionals.
Fellows will evaluate for and manage high-risk behaviors including suicidality on the general medical and surgical units, intensive care units, and Emergency Department.
Fellows will be monitored in daily group and individual supervision by the CL attendings and given specific feedback for improvement of risk assessments.
Fellows will employ evidence-based strategies for completing screening assessments based on evidence-based risk factors and protective factors as well as be proficient in evidence-based safety planning. To support risk assessments, fellows will be supervised in academic reading during formal lectures on suicide risk including but not limited to the interpersonal theory of suicide of Thomas Joiner, PhD and evidence-based safety planning.
Lectures, conferences, journal clubs, clinical teaching rounds, etc. will focus on the following competencies:
- Abnormal behavior and psychiatric illnesses that occur among medical, neurological, obstetrics, gynecological, and surgical patients.
- Biological, psychological, and social factors that influence the development, course, and outcome of medical and surgical diseases.
- Substance use and its impact on the assessment and treatment of patients in the medical setting.
- Pharmacology with emphasis on medication side effects and drug-to-drug interactions that affect the central nervous system.
- Nature and extent of psychiatric morbidity and impact of co-morbid psychiatric disorders on the course of medical illness and its treatments.
- Patients’ responses to medical illness and appropriate treatment interventions for co-existing psychiatric disorders.
- Nature and factors that influence the physician-patient relationship in the medical setting including through the lens of American culture and subcultures, particularly around immigrant populations, with specific focus on cultural elements between the fellow and the patient.
- Organizational and administrative skills needed to finance, staff, and manage a consultation-liaison psychiatry service.
Fellows will review practice improvement cases as part of the University of Virginia Health’s “Be Safe” Program. This program allows for daily multidisciplinary real time root cause analysis and problem solving of safety issues within the hospital.
Faculty members in all disciplines throughout the hospital are involved in evaluating “Be Safe” events depending on the specialty involved in the case. Core CL faculty will also supervise the fellows in reviewing and implementing practice changes and new standard work to improve patient care.
Program director will monitor the fellows’ rotation evaluations and case logs on a monthly basis, meet with fellow weekly, and review mid- and end-of-rotation evaluations to assure clinical experiences are meeting curriculum expectations. The same will occur for elective rotations.
For didactic education, the program director reviews the objectives of the lecture with faculty to ensure the objectives of the session are met.
Lastly, the program director will make changes to a rotation as soon as possible if goals are not being met. The Program Evaluation Committee will also review the curriculum, structured educational activities, and evaluations annually.
Both required and elective seminars will be offered by core faculty and others including Delirium Pathophysiology and Diagnosis, Transplant Psychiatry, Psycho-Oncology, HIV Psychiatry, CBT in the Hospital, Catatonia, and Dementia-Related Agitation among others.