The Shadyside Family Medicine Residency is committed to providing a strong behavioral science curriculum throughout the three years of residency. The core faculty includes a licensed clinical social worker and a psychiatrist. The curriculum is focused on teaching at the point of care as well as regularly scheduled didactic sessions. There are several initiatives designed for this purpose including teaching in both the inpatient and outpatient settings on integrated care, stepped care, and the collaborative care model in a busy urban setting.
Evidence-based protocols for the diagnoses and treatment of depression, anxiety, and substance use disorders promote the residents’ competence in managing these commonly presenting disorders. We provide a Medication Assisted Treatment recovery clinic and residents learn the models of harm reduction, alcohol and opiate use recovery, and medication management skills. In addition to our MAT professionals, a full-time advanced practice licensed clinical social worker treats common psychiatric conditions in primary care with our physicians and provides on-going education in Cognitive Behavioral Therapy within the integrated care model. These initiatives are revenue generating and supported by the EHR.
We have built a model of collaborative care management based on the IMPACT model for our patients experiencing mood disorders. A full-time depression care manager and a psychiatrist provide care alongside residents and FM faculty for patients who are best treated in the primary care setting.
Members of the behavioral science faculty see patients with residents for teaching purposes when needed. A rotation in inpatient/outpatient psychiatry in the second year is a required curricular component. This rotation offers experiences in inpatient psychiatry consultation-liaison services and outpatient psychiatry in medical outpatient settings. Residents see patients with psychiatric problems in both medical inpatient and outpatient settings, where family physicians ordinarily encounter these issues. They gain more experience in recognition, diagnosis, treatment planning, and psychopharmacologic management.
Residents fine-tune medical interviewing skills through our MI videotaping during their psychiatry rotation and have the chance to review the recording with the faculty immediately following designated clinical sessions. An annual workshop in advanced patient interviewing using professional actors as patients allows for small group experiential learning.
The Behavioral Science faculty member joins the inpatient team for behavioral rounds on a monthly scheduled basis. A regular Balint group, led by two faculty trained by the American Balint Society, enhances residents’ understanding of the complexities of the doctor-patient relationship.
In addition to the substantive formal instruction, behavioral health issues are addressed regularly by the Family Medicine faculty throughout the three years as part of inpatient and outpatient clinical teaching.