CONSULTATION/LIAISON AND HIV PSYCHIATRY

Transcription

1 PS CONSULTATION/LIAISON AND HIV PSYCHIATRY Location: HARBOR Revised: 11/23/10 Julia Chung, M.D. (310) David Stone, M.D., Donna Mendelson, MD Pat Venaglia (310) REPORT TO: Harbor-UCLA M.C., Bldg. 1 South, Room 19 at 8:30 a.m. 1. Biopsychosocial approach to the medically ill. 2. Improved psychiatry evaluation in the medically ill. 3. Diagnosis of complex psychiatric disorders. 4. Knowledge of DSM-IV. 5. Knowledge of psychotropic medication in the medically ill. 6. Psychiatric syndromes/toxicities related to medications. 7. Multidisciplinary approach to the medically and psychiatrically ill. 8. Improved doctor-patient relationship. 9. Oral presentations. 10. Medical record keeping. 11. Knowledge of psychometric testing. COLLEGE AFFILIATION: Academic Medicine STUDENTS / PERIOD: max 1 min 1 ROTATIONS BEGIN WEEKS: By Arrangement DESCRIPTION: The HIV Psychiatry Service at Harbor-UCLA Medical Center is an outpatient consultative service which evaluates adults in all stages of HIV infection. A variety of psychiatry disorders are seen. Emphasis is placed on evaluating biological, psychological, and social factors manifesting in psychiatric disorders. The Psychiatric Consultation/Liaison Service is an inpatient service that evaluates patients hospitalized for medical/surgical treatment. Emphasis is placed on understanding the influence of chronic psychiatric conditions on medical care, the psychiatric conditions that may be associated with medical conditions, and the use of psychotropics in the medically ill. 1. Depression/Mood Disorders 2. Dementia 3. Delirium 4. Substance Abuse 5. Psychotic Disorders 6. Adjustment Disorders 7. Competency and Consent Issues 8. Medication Reactions/Toxicities 7 OUTPATIENT: 3 INTERNS OTHER: APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: C/L: 10 12; HIV: 8 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 60 9:00 11:00 Resident Rounds 11:00 12:00 9:00 11:00 Resident Rounds 11:00 12:00 9:00 11:00 Resident Rounds 11:00 12:00 9:00 11:00 Resident Rounds 11:00 12:00 9:00 11:00 Resident Rounds 11:00 12:00 1:00 4:00 3:00 4:30 Grand Rounds 1:00 4:00 1:00 4:00 1:30 2:30 C/L Lecture Series 2:30 4:00 ON-CALL SCHEDULE & WEEKEND ACTIVITIES: None ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: The student will spend two afternoons half-days in the HIV Psychiatry Clinic under the direct supervision of the attending psychiatrist, plus 1 1/2 hours /week of individual supervision. The remainder of the time will primarily be spent on the inpatient C/L Service, under the supervision of the attending and third-year psychiatry residents. The student will also attend two seminars each week with the psychiatry residents, and the Grand Rounds for the Department of Psychiatry. 309

2 PS PSYCHIATRIC CRISIS MANAGEMENT Location: HARBOR Revised: 12/2/09 Samuel Sessions, M.D. (310) Ben Furst, MD Michael Makhinson, MD 1. Develop diagnostic skills. 2. Become familiar with crisis intervention 3. Become intro. to individual and family psychotherapy. 4. Recognize who needs to be hospitalized and treated. 5. Understand psychopathology. 6. Learn psychotropic medication. Pat Venaglia (310) REPORT TO: Harbor-UCLA, South, Room 1, 8:30 a.m. COLLEGE AFFILIATION: Acute Care STUDENTS / PERIOD: max 3 min 1 ROTATIONS BEGIN WEEKS: DESCRIPTION: This is an excellent opportunity to experience a multidisciplinary, integrated approach to the care of psychiatric patients. Non-UCLA externs may elect to participate for periods greater than three weeks as conforms with your institution s schedule. The South Unit is a 14-bed unit with length of stay approximately 7-10 days. There is also a 24-bed unit on 8 West with the same 7-10 days length of stay. Students electing this advanced clerkship will be assigned to a specific team, and will have an opportunity to work independently with patients suffering from a wide variety of psychiatric disorders under direct supervision of the attending. (Please see additional comments below.) 1. Schizophrenia 2. Manic depressive illness 3. Major depression 4. Suicidality 5. Personality disorders 6. Marital and family problems 7. Adjustment disorders 8. Organic disorders OUTPATIENT: 3 7 FELLOWS X OTHER: Psychologists and Psychiatric Social Workers APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 15 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 120 8:45 9:30 Rounds 9:30 12:00 8:30 11:00 Inpatient Lecture 11:00 12:00 8:45 9:30 Child Psychiatry 10:30 11:00 8:45 9:30 Rounds 9:30 12:00 8:45 9:30 Rounds 9:30 12:00 1:00 4:30 1:00 3:00 3:00 4:30 Dept. Conf. Parlow Auditorium 1:00 4:30 1:00 4:30 1:00 4:30 ON-CALL SCHEDULE & WEEKEND ACTIVITIES: One evening per week in the Psych. ER ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: Additional opportunities include participation in group and family therapy sessions as well as chances to attend mental health court to observe court testimony and forensic psychiatric evaluations. There is a focus upon diagnostic workups and biological interventions within a psychosocial and sociocultural framework. The psychiatry modules are richly staffed inpatient units with a multidisciplinary team, including attending psychiatrist, two psychiatric residents, and a full complement of nursing, psychology, social work and occupational therapy staff. 310

3 PS CHILD PSYCHIATRY Location: UCLA Revised: 12/7/10 Bhavik Shah, M.D. (310) Jennifer Levitt, M.D. (310) M. DeAntonio, M.D., James McCracken, M.D., S. Kataoka, M.D., J. McGough, M.D. Carla Vera (310) REPORT TO: Semel Institute, ABC Program (5 West) at Westwood Plaza, L.A., CA COLLEGE AFFILIATION: Academic Medicine STUDENTS / PERIOD: max 1 min 1 cvera@mednet.ucla.edu ROTATIONS BEGIN WEEKS: 1. Knowledge of the common Psychiatric Disorders of Childhood Phenomenology Etiology Natural history Treatment approaches 2. Improved Assessment Skills Interviewing parents Interviewing children Use and interpretation of Psychological testing Use and interpretation of Educational testing 3. Improved knowledge of therapeutic modalities in Child Psychiatry Individual therapy Group therapy Family therapy Psychopharmacology Behavioral modification Educational therapy 4. Improved oral presentation of cases. DESCRIPTION: Any student wishing experience in child psychiatry may set up an individualized schedule working with children or adolescents in an inpatient or outpatient setting or a combination of both, with access to all resident and fellow teaching seminars and conferences. Students applying from outside or within UCLA are welcome. A three week rotation offered continuously throughout the year. 1. Attention Deficit Disorders 2. Conduct disorders 3. Learning disorders 4. Affective disorders 5. Autism 6. Childhood psychoses 7. Mental retardation 8. Anxiety disorders OUTPATIENT: CLINICAL FACULTY INTERNS X OTHER: Staff, Social workers, Nurses, Occupational and Recreational Therapists. APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 2 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 10 9:30-11:00 a.m. Rounds and intakes on ABC Program (Semel Institute 5 West) 9-10 Case conference on 4N (Resnick Neuropsychiatric Hospital) Rounds and intakes on ABC Program (Semel Institute 5 West) 8:30-10 Child Psychopathology Seminar 10:30-12 CL Seminar 2-6 Anxiety Disorders Clinic 300 Medical Plaza Room :15-5 Child Evaluation Clinic 300 Medical Plaza Room :30-4:30 Psychopharmacology Clinic 300 Medical Plaza Room 1208 Forensic visits or Pediatric Neuropsychiatry Clinic 200 Medical Plaza Room 1328 Adolescent Medicine Clinic ON-CALL SCHEDULE & WEEKEND ACTIVITIES: None ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: Inpatient ward responsibilities as assigned in Resnick Neuropsychiatric Hospital Adolescent Unit. 311

4 PS CONSULTATION LIAISON PSYCHIATRY Location: UCLA Revised: 11/18/10 John Luo, M.D. (310) Drs. Laurie Casaus, Phil Cogen, Aaron Kaufman, John Brooks and Barry Guze Carla Vera (310) REPORT TO: Semel Institute, Room B8-241 at 9:00 a.m. and ask for Jillian Major COLLEGE AFFILIATION: Urban Underserved STUDENTS / PERIOD: max 2 min 0 cvera@mednet.ucla.edu ROTATIONS BEGIN WEEKS: 1. To acquaint students with interview approaches to medically ill patients in a variety of settings using the biopsychosocial model. 2. To engage in effective interactions with a variety of consulting services by learning to define the consultation question and to accurately report findings and recommendations. 3. Learn effective documentation skills for a psychiatric consultation note. 4. Learn a variety of therapeutic interventions used to evaluate and treat mentally ill patients including pharmacotherapy, behavioral psychotherapy, and psychoeducation. 5. Appreciate the psychological components of medical illness. 6. Gain experience in performing specialized psychiatric assessments for specific populations including solid organ transplant candidates, chronic and acute pain patients, behaviorally disturbed patients, cross-cultural patients, somatoform patients and victims of trauma. 7. Gain experience in performing psychiatric consultations to a general Emergency Medical Center. 8. To increase student s knowledge about psychometric testing. DESCRIPTION: The UCLA Consultation & Liaison Service is an inpatient consultation psychiatry service that provides psychiatric evaluations to the Ronald Reagan UCLA Medical Center. The service provides focused consultations to medical and surgical services for urgent and routine matters. The service consists of 3 4 resident physicians, a psychologist, a psychiatric social worker and multiple faculty members with expertise in various aspects of Consultation/Liaison Psychiatry. The service also provides consultations to the Emergency Medical Center that is a major trauma center for large urban hospital. The scope services includes capacity to consent to or refuse medical treatment, pain management, presurgical evaluation for solid organ transplant candidates, post-operative follow-ups for acute behavioral disturbances, mood and anxiety disorders in a teaching hospital Depression OUTPATIENT: 4 2. Delirium/dementia 3. Management problems 4. Substance Abuse 5. Psychiatric Disorder OTHER: APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 8-12 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 100 Ward Rounds Ward Rounds Ward Rounds Ward Rounds Ward Rounds Consults in UCLA and EMC Psychiatry Department Grand Rounds Teaching Case Conference Consults in UCLA and EMC Consults in UCLA and EMC Consults in UCLA and EMC Attend Resident Didactics Consults in UCLA and EMC Consults in UCLA and EMC Consults in UCLA and EMC ON-CALL SCHEDULE & WEEKEND ACTIVITIES: NONE (1) Wadsworth VA Consultation-Liaison Grand Rounds (2) Sepulveda VA Behavioral Medicine Clinic and Grand Rounds ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: 312

5 PS ADVANCED CLINICAL PSYCHIATRY Location: CS Revised: 11/18/10 Waguih William IsHak, M.D. (310) Selected Staff Yvonne Neely (310) REPORT TO: Yvonne Neely, Thalians Community MHC, 8730 Alden Drive, Los Angeles, #W101. COLLEGE AFFILIATION: Academic Medicine 1. Improve ability to take a psychiatric history, perform a mental status exam, and generate a DSM-IV differential diagnosis. 2. Develop an understanding of the course of an extended evaluation, including manifestations of resistance to treatment and difficulties. 3. Obtain knowledge of short-term psychotherapy. 4. Improve knowledge of typical psychiatric out-patient problems. 5. Improve knowledge of psychopharmacology. 6. Skill in working on a multidisciplinary outpatient health care team, including social workers and psychologists. 7. Improve ability to obtain and write outpatient histories. Medical student s histories are documents of record for their patients. 8. Skill in presenting patients to members of our health care team. 9. Exposure to psychiatric ER rotations via night on-call with resident. STUDENTS / PERIOD: max 2 min 1 ROTATIONS BEGIN WEEKS: By Arrangement DESCRIPTION: This elective will provide flexibility in developing a custom-designed experience that includes a variety of psychiatric experiences at Cedars-Sinai Medical Center. Available experiences include inpatient, outpatient, consultation-liaison, emergency psychiatry, substance abuse, child psychiatry, Sexual Medicine, Intensive Short Term Dynamic Psychotherapy, ECT, and psychiatric research. Exposure to more clinical activities could be arranged according to the medical student interests. Major emphasis is placed on the BioPsychoSocial evaluation and treatment of psychiatric patients regardless of the setting. A three-to-six week rotation offered yearround. Prerequisite: clerkship in psychiatry. 1. Depression 2. Affective disorders 3. Anxiety disorders 4. Adjustment disorders 5. Family systems problems 6. Psychosomatic problems 7. Schizophrenia & Personality disorders 8. Substance abuse 9. Organic mental disorders 1 OUTPATIENT: OTHER: APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 12 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 100 Inpatient Rounds OPD Evals Telepsychiatry Inpatient Rounds Anxiety D/O Program Inpatient Rounds OPD Evals Inpatient Rounds OPD Evals Telepsychiatry Inpatient Rounds OPD Evals Program Director Meeting OPD Evals Psychotic D/O Program PGY-1 Lectures Observed Therapy Mood D/O Program PGY-2 Lectures Grand Rounds Bipolar D/O Program PGY-3 Lectures Resident s Meeting Mood D/O Program PGY-4 Lectures ON-CALL SCHEDULE & WEEKEND ACTIVITIES: None ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: 313

6 PS OUTPATIENT (PACE) CONSULTATION/LIAISON PSYCHIATRY Location: SFVMP Revised: 12/2/10 Javier Quintana, M.D., Ph.D. (818) , ext Valerie Chamberlin, M.D. Jeannie Weber (818) REPORT TO: Javier Quintana, M.D., Ph.D., Bldg. #200, Blue Team COLLEGE AFFILIATION: Academic Medicine STUDENTS / PERIOD: max 2 min 1 jeannie.weber@med.va.gov ROTATIONS BEGIN WEEKS: 1. Signs and symptoms, differential diagnosis, psychodynamics, psychophysiology, epidemiology, and psychiatric behavioral conditions most commonly encountered in medical settings. 2. Indications, contraindications, dosage, and side effects of psychotropic medications for conditions described above. 3. Describe indications and contraindications for nonpharmacological treatment of conditions described above, including: (a) Individual, long-term psychotherapy; (b) Family Therapy; (c) Crisis Intervention; (d) Intervention by non-psychiatric medical personnel; (e) Behavior therapy; (f) Cognitive Therapy, (g) Relaxation Training; (h) Interpersonal and insightoriented therapy. 4. Demonstrate ability to collect information from the patient, from the medical chart, from the referring physician, and from relevant other sources. Developing psychiatric interviewing skills specific to the medical ambulatory consultation setting. 5. Describe influence of psychological and social variables on the predisposition, onset, course, and outcome of somatic illness. 6. Describe common patterns of psychological and social adaptation to illness. DESCRIPTION: This advanced level elective offers an introduction to the rapid assessment and effective management of psychiatric and behavioral problems experienced by patients with significant medical or surgical illness in the medical ambulatory clinic. Students are integral members of the C/L team, and learn to apply a Bio-psychosocial approach to evaluation of psychiatry problems in that setting (including mood, psychosis, anxiety, cognition, substance abuse, and personality disorders. Management of these problems includes both pharmacological and nonpharmacological approaches (supportive therapy, crisis intervention, cognitive-behavioral and insight -oriented psychotherapy.) A three- to sixweek elective, Sepulveda V.A. Medical Center. Prerequisites: Clerkships in Psychiatry and medicine. 1. Depression 2. Agitation Insomnia 3. Dementia 4. Psychotic Disorders 5. Dual Diagnosis 6. Anxiety Disorders 7. Organic Brain Syndromes 8. Habits, Drugs/Substance Abuse 9. Somatoform Disorders OUTPATIENT: CLINICAL FACULTY INTERNS OTHER: APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 10 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 30 Telepsychiatry Rounds with Attending Case Evaluations Includes Resident Presentations Case Evaluations OP Consults w/ Residents & Attendings Lectures, Seminars Case Evaluations OD Consults w/ Residents/Attendings Case Evaluations OP Consults w/ Residents & Attendings Telepsychiatry Case Evaluations w/ Residents Case Evaluation OP Consults w/ Residents & Attendings OVMC C/L Lecture series & Journal Club Case Evaluations OP Consults w/ Residents & Attendings Lectures, Seminars Case Evaluation OP Consults w/ Residents & Attending Telepsychiatry Case Evaluation w/ Residents ON-CALL SCHEDULE & WEEKEND ACTIVITIES: Once per week. Optional. ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: 314

7 PS PSYCHOSOMATIC MEDICINE / C&L PSYCHIATRY Location: OVH Revised: 12/2/10 Saba Syed, M.D. (818) sasyed@dhs.lacounty.gov Robert Dasher, M.D. Deenen Ray (818) REPORT TO: Dr. Syed at 9:00am in room 6D 120 COLLEGE AFFILIATION: Primary Care STUDENTS / PERIOD: max 1 min 1 DURATION: 3 weeks dray@dhs.lacounty.gov ROTATIONS BEGIN WEEKS: 1. Expose students to a wide range of neuropsychiatry presentations in medical surgical patients 2. Teach concise interviewing skills and differential diagnostic formulation. 3. Examine the impact of illness, hospitalization and medical care on the psychological functioning of patients 4. Educate students about the role of psychiatric, psychological, and behavioral factors in the pathogenesis of medical disorders 5. Promote liaison relations with medical and surgical services, with a particular focus on primary care, that emphasizes awareness, assessment,, and management of mental disorders in medical patients. 6. Demonstrate appropriate approaches to the execution of a psychiatry consultation, with emphasis on assessment techniques unique to the consultation setting, the nature of communication with the consulted and the responsibilities and limitations of the consultant. 7. Demonstrate a variety of interventions and therapies relevant to medically ill patients, including time-effective psychotherapy, somatic therapies, behavioral techniques, liaison methods, and multidisciplinary team approaches. 8. Lean capacity assessment for medical decision-making. Develop understanding of concepts of substituted judgment and power 3200 for court appointed surrogate decision maker. 9. Gain experience in diagnosis of Dementia and assessment for Probate Conservatorship 10.Understand the concepts of law and medical ethics as it applies to C&L Psychiatry. DESCRIPTION: The Psychosomatic Medicine / C&L service at Olive View-UCLA Medical Center provides inpatient psychiatric evaluations to Medical, Surgical, Pediatrics and Ob/Gyn departments. The scope of services include psychiatric diagnostic evaluations using biopsychosocial approach; management of agitation and behavioral problems; treatment of anxiety, mood disorders and psychosis; capacity evaluations, and provide assistance to primary medical teams to apply for power 3200 and probate conservatorship. HIV Psychiatry Clinic provides biopsychosocial evaluations and treatment to patients with HIV/AIDS and co-morbid psychiatric disorders. Also assess suicide risk in newly diagnosed HIV patients and provide pscho education and supportive therapy to patients. 1. Delirium/Management of Agitation 2. Dementia 3. Depression/Affective disorders 4. Anxiety disorders 5. Psychotic disorders 6. Somatoform disorders 7. Substance disorders 8. Capacity evaluations OUTPATIENT: 8 2 CLINICAL FACULTY FELLOWS INTERNS OTHER: Psychology externs and social work students APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 10 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 45 9:00 11:00 Consults 11:00 12:00 Team Rounds 9:00 11:00 Consults 11:00 12:00 Team Rounds 9:00 11:00 Consults 11:00 12:00 Team Rounds 9:00 12:00 HIV Psychiatry Clinic 9:00 11:00 Consults 11:00 12:00 Team Rounds 1:00 2:00 Consults 3:00 4:00 Team Rounds 1:00 2:00 C&L Lecture 2;00 3:00 Consults 3:00 4:00 Team Rounds 1:00 4:00 Consults Independent Study 1:00 4:00 HIV Psychiatry Clinic 1:00 4:00 Memory Disorder Clinic ON-CALL SCHEDULE & WEEKEND ACTIVITIES: None ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: The service consists of 2 residents and a board certified faculty. Psychiatry social worker and psychology participation is available on as needed basis. 315

8 PS GERIATRIC PSYCHIATRY Location: UCLA Revised: 12/9/09 Helen Lavretsky, M.D. (310) Valerie Chamberlin, M.D. Carla Vera (310) REPORT TO: Page Dr. Lavretsky, beeper 12963, at 8 a.m. COLLEGE AFFILIATION: Primary Care 1. Knowledge of the major psychiatric illnesses affecting the medically ill elderly. 2. Skills in consultation to physicians and other health care professionals. 3. Knowledge of age-related physiological and psychological changes that influence the psychiatric and medical care of the elderly. 4. An understanding of the normal and abnormal psychological, biological, and social responses to aging and physical illness. 5. Familiarization with the psychosocial problems that affect geriatric medical patients and their families. 6. Knowledge of psychopharmacologic treatment of the elderly, including the effects of medical treatment on mental state. 7. Skills in interviewing techniques useful for obtaining psychosocial information from geriatric medical patients and their families. STUDENTS / PERIOD: max 1 min 1 ROTATIONS BEGIN WEEKS: DESCRIPTION: This course offers the opportunity to learn about psychiatric problems of medically ill elderly in the general hospital. 1. Dementia 2. Depression 3. Delirium 4. Personality disorder 5. Psychotic disorder 6. Somatization disorder 6 OUTPATIENT: 3 1 X OTHER: Social workers, nurses, RTs, PTs APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 6-12 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 40 8:00 9:00: Inpatient 9:00 10:00: Rounds 10:00 12:00: New Admissions 8:00 9:00: Inpatient 9:00 10:00: Rounds 10:45 12:00: Departmental Grand Rds 8:00 9:00: ECT 9:00 10:00: Rounds 10:00 12:00: New Consults, ECT 8:00 9:00 Inpatient 10:00 12:00 Consults 8:00 9:00: Inpatient 9:00 10:00: Rounds 10:00 12:00: Consults, Case Conference Outpatient Outpatient Outpatient Outpatient Outpatient ON-CALL SCHEDULE & WEEKEND ACTIVITIES: None. ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: Under the supervision of a geriatric psychiatry fellow and psychiatric resident, the student will provide consultations to the geriatric medicine service. The student will have the opportunity to work with faculty in geriatric medicine, geriatric psychiatry, and consultation-liaison psychiatry. 316

9 PS ADULT INPATIENT PSYCHIATRY Location: UCLA Revised: 11/18/10 Barry H. Guze, M.D. (310) Laurie Casaus, M.D., Phil Cogen, M.D., and Aaron Kaufman, M.D. Carla Vera (310) REPORT TO: Dr. Barry Guze, Resnick Neuropsychiatric Hospital, 150 Med Plaza, Room #4122 at 8:30 COLLEGE AFFILIATION: Academic Medicine 1. Acquisition of knowledge of the psychopathology and phenomenology of serious psychiatric disorders in adults. 2. Development of skills and knowledge in the evaluation, diagnosis, treatment, and disposition of hospitalized psychiatric patients. 3. Acquisition of advanced knowledge of therapeutic modalities, such as pharmacotherapy and ECT. 4. Refining of basic interviewing and management skills. 5. Participation in the interdisciplinary team approach of modern hospital psychiatry. 6. Development of clinical skills and decision-making in the assessment and management of psychiatric emergencies. 7. Enhancement of skills in efficient communication of findings and formulations through verbal presentations and chart progress notes. 8. Progress in medical record-keeping abilities including comprehensive history, examinations, plans, progress notes, discharge summary, and multi-axial diagnostic formulation STUDENTS / PERIOD: max 1 min 1 ROTATIONS BEGIN WEEKS: DESCRIPTION: The student functions as a sub-intern on a general adult psychiatric service, is assigned to a resident, who serves as a preceptor and primary clinical instructor, and admits and treats patients under supervision. 1. Major depressive disorder 2. Bipolar disorder 3. Schizophrenic disorders 4. Neurotic disorders 5. Organic mental disorders 6. Adjustment disorders 7. Personality disorders 8. Anxiety disorders OUTPATIENT: X OTHER: Chief resident, nursing, social service APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 5 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 40 Unit Rounds Rounds Colloquium Rounds Rounds Rounds Patient Workups and Care Patient Workups and Care Case Conference Clerkship Seminar Patient Workups and Care Patient Workups and Care ON-CALL SCHEDULE & WEEKEND ACTIVITIES: Student may elect to take call when resident-preceptor is on duty. ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: The student is responsible for all aspects of medical care, including those of a non-psychiatric nature. The student's schedule will approximate that of the resident-preceptor. Supervised participation in various other aspects of departmental activities may also be provided by individual arrangement. 317

10 PS DUAL DIAGNOSIS TREATMENT PROGR Location: HARBOR Revised: 12/2/10 John Tsuang, M.D. (310) Faculty in Psychology & Social Works, and Psychiatry departments Pat Venaglia (310) Know the prevalence of dual diagnosis patients. 2. Understand diagnostic strategy for dual diagnosis patients. 3. Demonstrate ability to assess a dual diagnosis patients. 4. Learn about treatment strategy for dual diagnosis patients 5. Know and able to apply some psychosocial treatment principles. 6. Know about psychopharmacological options in the treatment of dual diagnosis patients. 7. Know about overall drug and mental health treatment strategy and aftercare progress for them. REPORT TO: Harbor/UCLA D2, 9:00 am, Dr. John Tsuang COLLEGE AFFILIATION: Urban Underserved STUDENTS / PERIOD: max 1 min 1 DURATION: 3 weeks ROTATIONS BEGIN WEEKS: By Arrangement DESCRIPTION: This program is purposely flexible to meet the needs of individual students. The rotation is based out of the outpatient treatment program at Harbor/UCLA. There are core group, individuals, and med clinics that students need to attend. There are some assigned readings. 1. Mental Illness, Axis I disorders 2. Substance abuse 3. Detoxification/Stabilization 4. Understand interaction of drugs and psych conditions 5. Personality disorders 6. Medical conditions secondary to chronic drug use. OUTPATIENT: 1 9 CLINICAL FACULTY FELLOWS X OTHER: APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 5 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 10 9:00-12:00 Team meeting and groups 9:00-12:00 Team meeting and groups 9:00-12:00 Team meeting and groups 9:00-12:00 Team meeting and groups 9:00-12:00 ER/team groups Individual therapy and diadectics Grand rounds and individual therapy Teaching rounds Individual therapy and case management Individual therapy and teaching rounds ON-CALL SCHEDULE & WEEKEND ACTIVITIES: None ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: 318

11 PS FORENSIC PSYCHIATRY Location: MULTIPLE Revised: 12/15/08 Neena Sachinvala, M.D. (818) ext Deneen Ray-Craig (818) or (818) To understand the law that pertains to the practice of psychiatry. 2. To understand LPS. 3. To develop an understanding of what is considered malpractice. 4. To develop an understanding of custody evaluations. 5. Child Abuse and Neglect 6. To observe the testimonies of expert witnesses. 7. To observe the work of an experienced forensic psychiatrist. 8. To understand the concepts of criminal law as it applies to psychiatry. REPORT TO: Dr. Sachinvala, SVA Bldg. 9:00 am COLLEGE AFFILIATION: Academic Medicine STUDENTS / PERIOD: max 2 min 1 ROTATIONS BEGIN WEEKS: DESCRIPTION: This elective provides comprehensive experience in the laws that apply to psychiatry, clinical and civil cases. Students will observe testimonies in court, evaluate cases for court, evaluate cases for court sessions, attend family court sessions for custody evaluations, and prepare documents for court. 1. Depression 2. Schizophrenia 3. Dementia 2 OUTPATIENT: 8 CLINICAL FACULTY RESIDENTS INTERNS X OTHER: R. N., Lawyers, Judges APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 10 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: Olive View or Metro Hospital Evaluations Observe Testimonies On writs and conservatorships ALL DAY or County Jail Legal Lecture 10:00-12:00 Discussion of Case Law + Attorney Dept. 95 Court Special topics on Forensic with Forensic Faculty Olive View or Metro Hospital Evaluations Observe Testimonies On writs and conservatorships ALL DAY or County Jail, Family Court, or Juvenile Court 2:30 5:00 Legal Lecture Dept. 95 Special topics on Forensic with Forensic Faculty ON-CALL SCHEDULE & WEEKEND ACTIVITIES: None ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: Students will travel to OVH, BVA, and Downtown courts 319

12 PS EMERGENCY PSYCHIATRY Subinternship Location: HARBOR Revised: 12/2/10 David Ruskin, M.D. (310) Drs. A. Djenderedjian, I Lesser, K. Burgoyne, D. Stone, W. Procci, and Samson Cho Pat Venaglia (310) COLLEGE AFFILIATION: Acute Care pvenaglia@dmh.lacounty.gov REPORT TO: Psychiatric Emergency Room, Harbor-UCLA Medical Center at 8:00 a.m. 1. Gain proficiency in formulating different psychiatry diagnoses and management in an emergency setting, i.e., schizophrenia, bipolar disorder, major depression, drug psychosis, etc. 2. Acquire familiarity with emergency psychopharmacologic intervention through the use of various psychotropic medications. 3. Develop skills in psychiatric interviewing technique, performing mental status examination, and gathering information for a complete psychiatric history. 4. Learn to make accurate assessments of suicidal and/or dangerous patients and develop plans for proper management. 5. Learn crisis intervention strategies to intervene with nonpsychotic patients. 6. Learn to assess and treat patients with different dual diagnoses, i.e., medically and psychiatrically ill patients and also those with coexisting substance problems. STUDENTS / PERIOD: max 3 min 1 ROTATIONS BEGIN WEEKS: DESCRIPTION: The Psychiatric Emergency Service of Harbor-UCLA Medical Center provides evaluation and treatment to approximately 9000 patients a year. Its catchment area includes over 1% of the population of the USA. Direct clinical experience is provided to medical students with an emphasis on bedside teaching. 1. Schizophrenia 2. Drug psychosis and substance abuse 3. Bipolar disorder 4. Major depression 5. Personality disorder 6. Panic and anxiety disorder 7. Obsessive compulsive disorder 8. Adjustment disorder OUTPATIENT: 1 9 X OTHER: Nurses APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 30 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 750 8:00 9:00 Morning Rounds 9:00 9:30 Case Assignment 8:00 9:00 Morning Rounds 9:00 9:30 Case Assignment 8:00 9:00 Morning Rounds 9:00 9:30 Case Assignment 8:00 9:00 Morning Rounds 9:00 9:30 Case Assignment 8:00 9:00 Morning Rounds 9:00 9:30 Case Assignment 4:30 Check out Rounds 3:00 4:30 Psychiatry Grand Rounds 4:30 4:40 Check-out Rounds 4:30 4:40 Check-out Rounds 4:30 4:40 Check-out Rounds 4:30 4:40 Check-out Rounds ON-CALL SCHEDULE & WEEKEND ACTIVITIES: Optional, per request by students. ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: 320

13 PS ADULT PSYCHIATRY Subinternship Location: UCLA Revised: 11/18/10 Barry H. Guze, M.D (310) Laurie Casaus, M.D., Phil Cogen, M.D., and Aaron Kaufman, M.D. Carla Vera (310) REPORT TO: Barry Guze, M.D., Resnick Neuropsychiatric Hospital, 150 Med Plaza, Room #4122 at 8:30 COLLEGE AFFILIATION: Urban Underserved 1. Student will workup at least three new patients per week and per rotation. 2. Student will actively participate in the on-going care of the patient. 3. Student will learn how to treat significantly ill/complex patient cases in diverse patient populations. 4. Student will have substantial or primary patient care responsibility. 5. Acquisition of knowledge of the psychopathology and phenomenology of serious psychiatric disorders in adults. 6. Development of skills and knowledge in the evaluation, diagnosis, treatment, and disposition of hospitalized psychiatric patients. 7. Progress in medical record-keeping abilities including comprehensive history, examinations, plans, progress notes, discharge summary, and multi-axial diagnostic formulation. 8. Acquisition of advanced knowledge of therapeutic modalities, such as pharmacotherapy and ECT. STUDENTS / PERIOD: max 1 min 1 ROTATIONS BEGIN WEEKS: DESCRIPTION: In this advanced clinical clerkship the student will function as a sub-intern under faculty and chief resident supervision. Clinical activities will occur on the Adult Psychiatry Inpatient wards and the Adult Partial Hospital Program. Sub-intern will be responsible for all aspects of patient care, from admission to discharge. All clinical activity will be supervised via individual meetings and daily rounds with faculty and chief residents. 1. Unipolar depression 2. Bipolar disorder 3. Schizophrenia 4. Organic mental disorders 5. Anxiety disorders 6. Adjustment disorders 7. Personality disorders OUTPATIENT: X OTHER: Chief resident, nursing, social service, rehabilitation therapy. APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 4-8 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 80 Rounds Rounds Rounds Rounds Rounds Case Conference Seminar ON-CALL SCHEDULE & WEEKEND ACTIVITIES: Optional ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: Student will actively participate in the ongoing care of the patient. 321

14 PS Subinternship SCHIZOPHRENIA TREATMENT UNIT Location: BVA Revised: 12/7/10 Joe Pierre, M.D x C. Scott Saunders, M.D., Angel Cienfuegos, M.D. Joe Pierre, M.D x Develop an understanding of and familiarity with individuals with psychotic disorders and other severe mental illness 2. Develop a working knowledge of evidence based therapies for severe mental illness including both pharmacotherapies and psychotherapies. 3. Demonstrate skill in psychiatric interviewing techniques 4. Demonstrate skill in psychiatry differential diagnosis 5. Gain experience working with a multidisciplinary inpatient team REPORT TO:. Dr. Pierre, West LA VA, Bldg 500, Ward 9:00 am COLLEGE AFFILIATION: Primary Care STUDENTS / PERIOD: max 2 min 1 DURATION: 3 weeks ROTATIONS BEGIN WEEKS: DESCRIPTION: The clinical focus of the Schizophrenia Treatment Unit is on the management of inpatient veterans with psychotic disorders, typically refractory schizophrenia. Clinical interventions including psychopharmacology, group therapy, and supportive individual therapy. We also treat a variety of major mental illnesses including bipolar disorder, major depression, PTSD, and substance abuse. Sub-interns will be assigned a caseload of patients and assume primary responsibility of their clinical management. Opportunities will also be available for involvement in clinical research and exposure to outpatient treatment. 1. Schizophrenia 2. Bipolar disorder 3. Major depression 4. Substance dependence 5. PTSD 6. Dementia 7. Malingering OUTPATIENT: optional CLINICAL FACULTY FELLOWS INTERNS OTHER: APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 50 Treatment Rounds NPI Grand Rounds NPI Lecture Treatment Rounds VA Lecture Research Seminar VA Grand Rounds Treatment Rounds Clinical Care Group Therapy Clinical Care Outpatient Clinic (optional) Clinical Care Outpatient Clinic (optional) Clinical Care Clinical Care ON-CALL SCHEDULE & WEEKEND ACTIVITIES: None ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: 322

15 PS Subinternship INPATIENT GERIATRIC PSYCHIATRY Location: UCLA Revised: 12/2/10 Randall Espinoza, M.D., M.P.H. (310) Drs. Helen Lavretsky, James Spar, David Merrill, Aaron Kaufman and Stephen Chen Carla Vera (310) REPORT TO: Ward 4 North, R-NPH, Chief Resident, at 9:00 a.m. Nurse s Station: (310) , 150 Medical Plaza, 4th Floor. COLLEGE AFFILIATION: Primary Care STUDENTS / PERIOD: max 2 min 1 ROTATIONS BEGIN WEEKS: 1. Acquisition of knowledge of the psychopathology and phenomenology of serious psychiatric disorders in adults with special emphasis on problems of aging and the interface of psychiatry, medicine and neurology. 2. Development of skills and knowledge in the evaluation, diagnosis, treatment and disposition of hospitalized psychiatric patients. 3. Acquisition of advanced knowledge of therapeutic modalities such as pharmacotherapy and ECT. 4. Refining of basic interviewing and management skills. 5. Participation in the interdisciplinary team approach of modern hospital psychiatry. 6. Development of clinical skills and decision-making in the assessment and management of psychiatric emergencies. 7. Enhancement of skills in efficient communication of findings and formulations through verbal presentations and chart progress notes. 8. Progress in medical record-keeping abilities including comprehensive history, examinations, plans, progress notes, discharge summary and multi-axial diagnostic formulation. DESCRIPTION: The student functions as a sub-intern on an inpatient unit which specializes in the evaluation and treatment of patients with psychiatric problems associated with aging. The student is assigned to a resident who serves as preceptor and primary clinical instructor. 1. Major depressive disorder 2. Alzheimer dementia 3. Multi-infarct dementia 4. Delirium 5. Cardiovascular disorders 6. Other medical illnesses associated with aging 7. Adjustment disorders 8. Personality disorders OUTPATIENT: X OTHER: Chief Resident, Nursing, Social Service, Rehabilitation Therapy APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 15 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 20 Attending Rounds Grand Rounds Attending Rounds Didactic Lecture Community Meeting Interviewing Seminar Attending Rounds Case Conferences Work Rounds Case Conferences Attending Rounds Clerkship Seminar Work Rounds ON-CALL SCHEDULE & WEEKEND ACTIVITIES: While night work is not required, the student may elect to take call when the residentpreceptor is on duty. ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: Student responsible for all aspects of medical care, including those of a non-psychiatric nature. The schedule will approximate that of the resident-preceptor. Supervised participation in various other aspects of departmental activities may also be provided by individual arrangement. Student gains in-depth experiences in geriatric psychiatry and neuropsychiatry with supervised responsibility for patient care. 323

16 PS Subinternship ALCHOHOLISM AND SUBSTANCE ABUSE Location: BVA Revised: 12/7/10 Alfonso Paredes, M.D. (626) Alina McKenna, M.D. Alina McKenna, M.D. (310) ext REPORT TO: Dr Alina Mc Kenna in Building , West Los Angeles VA Hospital (Brentwood VA) at 9:00 COLLEGE AFFILIATION: Urban Underserved 1. Gain knowledge and skills in the behavioral and medical assessment of men and women dependent on alcohol and/or drugs such as amphetamines, cocaine, and heroin. 2. Acquire clinical experience under the supervision of the program physician on the outpatient detoxification of patients dependent on alcohol or other drugs of abuse. 3. Review the role of comorbidity in the treatment of addictive disorders and gain experience with therapeutic approaches used in the treatment and rehabilitation of patients with addictive disorders. 4. Review information on the multifactorial psychobiological and behavioral processes involved in addictive processes. 5. To critically examine the contrasting features and similarities between the therapeutic use of psychoactive agents and the motivation behind the recreational and addictive use of alcohol and street drugs. Also, to review the relevance of substance abuse problems to other areas of medical practice. STUDENTS / PERIOD: max 2 min 1 DURATION: 3 weeks ROTATIONS BEGIN WEEKS: DESCRIPTION: The patients in this service present complex diagnostic challenges. The student will assume responsibility for the clinical management of patients with substance abuse patterns and concurrent medical and psychiatric illnesses. 1. Alcohol and drug dependence 2. Affective disorders 3. Schizophrenia 4. Alcohol and other drug withdrawal syndrome 5. Personality disorders 6. Hypertensive Cardiovascular Disease 7. Alcoholic hepatitis 8. Convulsive disorders OUTPATIENT: 3 7 FELLOWS RESIDENTS INTERNS X OTHER: Nursing personnel, psychologist, social workers. APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 12 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 95 8:15 8:45 Interdisciplinary report 9:00-11:00 Alcohol and Other Drugs Detox Clinical Supervision by Dr. McKEnna 11:00 12:00 Case Presentation and Literature Review Dr. Paredes 1:00 4:00 Work with Patients 8:15 8:45 Interdisciplinary Report 9:00 12:00 Alcohol and Other Drugs Detox Clinical Supervision by Dr. McKenna 1:00 2:00 Spiritual Recovery Seminar 2:00 4:00 Interdisciplinary Treatment Planning 8:15 8:45 Interdisciplinary Report 9:00 11:00 Alcohol and Other Drugs Detox Clinical Supervision by Dr. McKenna 10:00 12:00 Case Presentation and Literature Review Dr. Paredes 2:00 4:00 Interdisciplinary Treatment Planning 8:15 8:45 Interdisciplinary Report 9:15 10:15 Matrix Recovery Group 10:00 11:30 Grand Rounds 1:00 4:30 Problem review 8:15 8:45 Interdisciplinary Report 10:00 11:00 New patients orientation group 11:00 12:00 Case Presentation and Literature Review Dr. Paredes 1:00 4:30 Work with Patients ON-CALL SCHEDULE & WEEKEND ACTIVITIES: None scheduled. ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: Students may elect to spend three or four weeks in our program. Four weeks are recommended. 324

17 PS ADDICTION PSYCHIATRY Subinternship Location: UCLA Revised: 11/23/10 Timothy W. Fong, M.D. (310) Larissa Mooney, M.D., Laurie Casaus, M.D., and Karen Miotto, M.D., John Tsuang, M.D. Carla Vera (310) Acquire knowledge about the etiology, diagnosis and management of addictive disorders. 2. Develop skills in inpatient detoxification of drugs of abuse. 3. Learn interviewing techniques such as motivational interviewing specific to substance abuse. 4. Become familiar with local, state and national treatment resources for patients with substance use disorders. 5. Learn the medical and psychiatry consequences of drugs of abuse. REPORT TO: Substance Abuse Rounding Room #4103 on the 4th floor of the RRUMC/Resnick Neuropsychiatric Hospital, 757 Westwood Plaza, LA, CA, at 8:30 COLLEGE AFFILIATION: Urban Underserved STUDENTS / PERIOD: max 1 min 1 ROTATIONS BEGIN WEEKS: DESCRIPTION: This elective provides an overview of how to identify and manage patients with substance use disorders. Students will function as a sub-intern on the inpatient substance abuse service. Duties will include care of patients admitted for detoxification, management of co-occurring psychiatric disorders and assisting in developing an aftercare program. Students will also participate in the outpatient, Addiction Medicine Clinic to learn techniques of psychopharmacological management of addictive disorders. Finally, students will visit residential treatment facilities, sober living homes and drug courts to gain a full appreciation of the clinical management of patients with substance use disorders. 1. Alcohol dependence 2. Stimulant dependence 3. Prescription drug abuse 4. Opiate dependence 5. Pathological gambling 6. Marijuana dependence 7. Nicotine dependence OUTPATIENT: 25% 75% 2 8 X OTHER: Social Workers, academic addiction researchers, & nurses APPROXIMATE # OF PATIENTS EVALUATED EACH WEEK BY STUDENT: 20 TOTAL # OF PATIENTS EVALUATED EACH WEEK BY ENTIRE SERVICE: 4 8:00 12:00 Unit Rounds R-NPH 8:00 12:00 Unit Rounds R-NPH 8:00 12:00 Unit Rounds R-NPH 8:00 9:00 Addiction Seminar 9:00-12:00 Addictive Medicine Clinic 8:00 12:00 Unit Rounds R-NPH Ward and Field Work (Variable) Ward and Field Work (Variable) Ward and Field Work (Variable) Ward and Field Work (Variable) Ward and Field Work (Variable) ON-CALL SCHEDULE & WEEKEND ACTIVITIES: None ADDITIONAL COMMENTS AND OTHER SPECIAL REQUIREMENTS: 325