Psychiatry and
Behavioral Sciences

PMFP - Psychosomatic Medicine Fellowship Program

I. PSYCHOSOMATIC MEDICINE

Psychosomatic medicine (PM) is the medical discipline encompassing the study and practice of psychiatric disorders in patients with medical, surgical, obstetrical, and neurological conditions, particularly for patients with complex and/or chronic conditions. Physicians specializing in psychosomatic medicine have expertise in the diagnosis and treatment of psychiatric disorders in complex medically ill patients.

Psychosomatic Medicine specialist, working closely with medical colleagues in other specialties (e.g., Medicine, Surgery, Oncology, Neurology) manages and study several groups of patients:

The American Board of Psychiatry and Neurology (ABPN) officially recognized Psychosomatic Medicine as a subspecialty of Psychiatry in 2003. The one-year Stanford Psychosomatic Medicine Fellowship Program developed and directed by José R. Maldonado MD, FAPM offers advanced training in the field of Psychosomatic Medicine and Consultation-Liaison Psychiatry in both hospital and ambulatory settings with abundant clinical, educational, and cutting-edge research opportunities.

II. PM–FELLOWSHIP PROGRAM DESCRIPTION

Content

The one-year Stanford Psychosomatic Medicine Fellowship Program, developed and directed by José R. Maldonado MD, offers advanced training in the field of Psychosomatic Medicine and Consultation-Liaison Psychiatry in both hospital and ambulatory settings with abundant clinical, educational, and cutting-edge research opportunities. The Psychosomatic Medicine Fellowship received full accreditation by the American Council for Graduate Medical Education (ACGME) since its inception in 2010.

The program allows the fellow to engage in a variety of required and elective clinical and research rotations as well as to engage in a wide variety of educational activities where the fellow can serve as a learner and as an educator. The program also allows each PM-Fellow to develop his or her own unique strengths and interests.

Here is an example of the PM-Fellow’s academic year:

 

PM

Fellowship

Year

2 weeks

4 weeks

10.5 Months

 Neuro-critical Care Service

Vacation Time

Psychiatric Consult Service
4 – 7 hrs/day every week day

Psychosomatic Medicine Clinic
0.5 day/week

Clinical Research or Specialty Clinic (elective) 0.5 day/week

Besides the required Psychosomatic Medicine Inpatient and Outpatient rotations, the Fellowship offers a menu of elective rotations, including Neurocritical Care, Research, Positive Care Clinic (HIV Psychiatry), Psycho-Oncology, Palliative Care, Ethics, Neuropsychiatry, Transplant Psychiatry, Pain.

Seminars and Conferences

  1. Psychosomatic Medicine Journal Club: Fellows will be provided with a list of novel, challenging, and/or clinically pertinent topics in Psychosomatic Medicine; fellows are then expected to conduct a literature search, find the latest or most relevant article, share with the faculty, and to discuss the topic with the entire PM-faculty during Friday’s Journal Club. (Required)
  2. Psychosomatic Medicine Fellow Didactic Series: PM-Fellows are given a list of essential PM topics and are expected to research them and prepare a lecture series based on their studies, literature review, supervision with their mentor and PD, as well as develop evidence-based diagnostic and treatment approaches. Fellows will then teach these to trainees on the PM Service as a way of testing their knowledge and consolidate their grasp in the learned material. (Required)
  3. Psychosomatic Medicine Trainees Clinical Conference: During the first half of the year it consist of a lecture series covering the different types of medical disorders presenting with psychiatric manifestations, as well as a review of the diagnosis and management of common psychiatric conditions found in the general med/surg units. During the second half of the year it consists of a clinical case conference in which medically ill patients with psychiatric disorders or who developed psychiatric/behavioral complications are discussed, followed by an in depth review of relevant literature. (Required)
  4. Joint Psychosomatic & Internal Medicine Clinical Series & Case Conference: During the first half of the year it consist of a lecture series covering the different types of medical disorders presenting with psychiatric manifestations, as well as a review of the diagnosis and management of common psychiatric conditions found in the general med/surg units. During the second half of the year it consists of a clinical case conference in which medically ill patients with psychiatric disorders or who developed psychiatric/behavioral complications are discussed, followed by an in depth review of relevant literature. (Required)
  5. Joint Psychosomatic Medicine & Neurology Clinical Case Series: A clinical case conference in which patients with neuropsychiatric disorders are discussed, followed by an in depth review of relevant literature. (Required)
  6. Psychosomatic Medicine – O/P Clinic Case Review: All outpatient cases seen by PM-Fellows during O/P Clinic are reviewed and discussed with Service Chief and/or senior clinic attending. (Required)
  7. Department of Psychiatry Grand Rounds: This is the primary weekly academic conference in the Department of Psychiatry. Invited guests/experts discuss clinical issues and/or research findings in the field of Psychiatry. (Elective)
  8. Annual Symposium (Grand Rounds): Once a year PM-Fellows will present a Grand Round session on his/her research or on a clinically significant issue.
  9. Bedside Psychotherapy Skills in Psychosomatic Medicine: Review of the different types of psychotherapeutic techniques appropriate for the use in the acute setting of the hospital setting; as well as psychotherapeutic techniques useful in the treatment of chronic medical disorders. When possible and available a live interview will take place to allow trainees learn from seasoned clinicians with particular expertise in Psychosomatic Medicine. (Required)
  10. Ethics Committee Meeting: At this meeting representative members from all major specialties discuss difficult ethical cases, develop hospital policy, and conduct actual ethical consultations. Often, discussions regarding major bioethical principles take place. (Elective)
  11. Psychiatry & the Law Course (Law School): This course is offered every year at the Stanford School of Law by joint faculty from the Schools of Medicine and Law and is an excellent opportunity to learn about the interfaces and clashes of mental health and the law. The course includes a review and discussion of landmark cases in psychiatry, Psychosomatic Medicine and the Law, issues of competency assessment, decision making capacity, informed consent, right to refuse treatment, substituted decision making, end of life & right to die will be discussed in depth. (Elective)
  12. Long-term Psychotherapy for the Medically-Ill: PM-Fellows are assigned a challenging or complex, long-term psychotherapy case which will be followed longitudinally for the rest of their fellowship (or until the patient needs to terminate for medical reasons, or improvement). A psychotherapy supervisor, skilled in the application of psychotherapy in the medically-ill will watch via one-way mirror/video camera, and provide active feedback and supervision immediately at the end of each session. (Elective)
  13. Methodology of Research in Behavioral Sciences Seminar: Review and discussion of essential methodological topics in clinical psychiatric research, including randomized clinical trials and effect size, statistical hypothesis testing: significance & power; discussion of reliability, validity, and sensitivity; medical test evaluation and risk factor research. (Elective)
  14. Psychosomatic Medicine Research Laboratory: New research projects in development and ongoing project updates are presented and discussed by research and clinical faculty, and PM-Fellows In this forum scholarly projects (e.g.,. manuscripts, abstracts, poster) are discussed and presented. (Elective)

Accreditation

The Psychosomatic Medicine Fellowship received full accreditation by the American Council for Graduate Medical Education (ACGME) since its inception in 2010.

Certifications

Trainees who successfully complete the Psychosomatic Medicine Fellowship Program are eligible to take the subspecialty certification examination in Psychosomatic Medicine offered by the American Board of Psychiatry and Neurology (ABPN).

 

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