Psychosomatic Medicine Fellowship, Department of Psychiatry at the University of Minnesota

Goal 1:  Knowledge- Through didactic and supervised clinical experiences, psychosomatic medicine fellows will obtain and demonstrate the specialty knowledge outlined in the following objectives:

1. knowledge of abnormal behavior and psychiatric illnesses that occur among medical, neurological, obstetric-gynecology, and surgical patients
2. knowledge of biological, psychological and social factors that influence the development, course and outcome of medical/surgical diseases
3. understanding of pharmacology, including the psychopharmacology of the medically ill, with emphasis on, and psychiatric side effects of, non-psychotropic medications and the interactions of psychotropic medications with other medications on the central nervous system
4. knowledge of the organizational and administrative skills needed to finance, staff, and manage a psychosomatic medicine service
5. knowledge of the nature and extent of psychiatric morbidity in medical illness and its treatments
6. knowledge of the impact of co-morbid psychiatric disorders on the course of medical illness
7. understanding of how and why patients respond to illness
8. knowledge of appropriate treatment interventions for co-existing psychiatric disorders in the medically ill
9. knowledge of psychological and psychiatric effects of new medical or surgical therapies
10. knowledge of the epidemiology of psychiatric illness and its treatment in medical disease
11. knowledge of the nature and factors that influence the physician-patient relationship
12. knowledge of research methods in psychosomatic medicine
13. knowledge of psychiatric complications of medical illnesses
14. knowledge of psychiatric complications of medical treatments, especially medications, new medical and surgical procedures, transplantation, and experimental therapies
15. knowledge of typical and atypical presentations of psychiatric disorders that are due to medical, neurological, and surgical illnesses
16. knowledge of evaluation and management of delirium, dementia, and secondary (“organic”) psychiatric disorders
17. knowledge of indications for, and use of psychotropics in specific medical, neurological, obstetric, and surgical conditions
18. knowledge of interactions between psychotropic medications and the full-range of medications used for a variety of medical and surgical condition
19. knowledge of community systems of care

Goal 2:  Skills & behaviors- Psychosomatic medicine fellows will obtain skills and demonstrate behaviors to meet the following objectives:

1. ability to diagnose and treat psychiatric disturbances that occur among the physically ill, including the administration of psychotropic medications to seriously ill patients
2. ability to provide consultation in medical and surgical settings
3. facilitative skills necessary to enhance the care of psychiatric disturbances among the physically ill through cooperative interaction with other physicians and allied health professionals
4. ability to effectively supervise medical students and residents performing consultations and to teach medical and surgical colleagues about psychiatric complications of physical illness
5. participation in the development of new knowledge, evaluation of research findings, and the continuing acquisition of new knowledge, through the development of good habits of inquiry
6. collaboration with other physicians, and other members of the multidisciplinary treatment team
7. teaching other physicians and other members of the multidisciplinary team how to recognize and respond to various psychiatric disorders
8. lead an integrated psychosocial health care team in the medical setting
9. provide non-pharmacologic interventions, including cognitive therapy, interpersonal psychotherapy, and short-term supportive therapy in patients suffering the effects of complex medical disorders or their treatments
10. evaluate and manage somatoform disorders and chronic pain

Goal 3:  Attitudes- Psychosomatic medicine fellows will demonstrate the following professional attitudes:

1. willingness to communicate in a way that results in effective and empathic information exchange and collaboration with patients, their families, and other health professionals
2. desire to create and sustain a therapeutic and ethically sound relationship with patients from a spectrum of ethnic, racial, cultural, gender, socioeconomic and educational backgrounds
3. ability to work collaboratively with others as a member or leader of a psychiatric consultation-liaison team
4. ability to work collaboratively with other health care teams, including internal medicine, surgery, critical care, obstetrics, physical medicine, and primary care
5. willingness to facilitate the learning of students, residents, other physicians, and allied health professionals
6. commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population
7. show respect for patients, families, colleagues, and all others in the care of patients
8. show sensitivity and be responsive to patients’ culture
9. respond in a timely manner to communications from patients, their families, and their other health care providers, within the guidelines of federal and local privacy protection laws
10. willingness to continually expand their knowledge and skills, and assess their practice to ensure highly competent evaluation and psychiatric treatment of medically ill patients
11. understand how psychosomatic patient care impacts the practices of other providers
12. willingness to assist patients in accessing appropriate care and other support services

Goal 4:  Clinical Judgment- Psychosomatic medicine fellows will demonstrate competent clinical judgment to satisfy the following objectives:

1. assessment of capacity to give informed consent for medical and surgical procedures in the presence of cognitive impairment
2. investigate and evaluate their patient care, appraise and assimilate scientific evidence, and improve their patient care practices
3. recognize limitations in their knowledge base and clinical skills, and understand and address the need for life-long learning
4. obtain and critically evaluate new information from the scientific literature and other sources to assist in the quality care of patients