The University of Pittsburgh School of Medicine offers more than 20 electives to the fourth-year medical students attending Pitt or other academic institutions. Registration is required at least two months prior to the start date for the course.
For more information about these experiences, please contact Kathy Molter.
Students may participate in a number of acting internships available in Psychiatry for either four or eight weeks. The student will be assigned to an inpatient unit at Western Psychiatric Institute and Clinic. This experience will enhance your skills in dealing with assessment and management of psychiatric patients. Inpatient units available for acting internships include: Geriatrics, Schizophrenia, Dual Diagnosis (drug and alcohol), General Adult, and Eating Disorders. The internship provides the opportunity for students to: 1) conduct comprehensive psychiatric interviews and mental status examinations; 2) gather clinical data, generate differential diagnoses, formulate working diagnosis, and manage treatment; 3) plan and implement biopsychosocial treatment plans for patients with psychiatric illnesses; and 4) utilize the resources and skills of related mental health professionals.
- Conduct comprehensive psychiatric interviews and mental status examinations.
- Gather clinical data, generate differential diagnoses, formulate working diagnosis, and manage treatment.
- Plan and implement biopsychosocial treatment plans for patients with psychiatric illnesses.
- Utilize the resources and skills of related mental health professionals.
Faculty: Garrett Sparks, MD
Students may participate in a four- or eight-week elective in Child and Adolescent Psychiatry available through Western Psychiatric Institute and Clinic's Child and Adolescent Inpatient Service. The student will be a member of a multidisciplinary team consisting of an attending psychiatrist, a social worker, a nurse practitioner, a teacher, and nursing staff. The student will manage assigned patients directly under the guidance of the attending physician. Acting interns will interact with families and the patient's outpatient treatment team to gain collateral information, update case progress, and provide psychoeducation.
- Conduct comprehensive psychiatric interview and mental status examinations.
- Gather clinical data relevant to psychiatric evaluation, arriving at correct diagnosis of psychiatrically ill patients, and generate differential diagnoses for patients with psychiatric illnesses.
- Plan and implement biopsychosocial treatment plans for patients with psychiatric illnesses.
- Utilize the resources and skills of related mental health professionals.
Faculty: Kristin Dalope, MD and others
The Triple Board Acting Internship is designed to expose medical students to the interface between Pediatrics and Child and Adolescent Psychiatry through attendance at didactic courses and workshops and a wide variety of clinical experiences. This four-week internship prepares medical students for a combined residency training in Pediatrics, Adult Psychiatry, and Child and Adolescent Psychiatry. During the rotation, students spend ample time with Triple Board-trained faculty. Internship activities take place primarily through the Pediatric Behavioral Health Consult-Liaison Service at Children's Hospital of Pittsburgh of UPMC and a wide variety of general and specialty pediatric services affiliated with the program. These clinical settings include a resident pediatric outpatient continuity clinic and a resident child psychiatry Triple Board outpatient continuity clinic focusing on evaluating psychiatric illness in children with chronic medical conditions. Acting interns assess patients and present their cases to member of a team of child psychiatrists and psychologists. Interns will participate in pediatrics and psychiatry didactics as available. The internship usually provides at least 2-3 special opportunities for acting interns who are interested in other subspecialties such as early childhood development, developmental disabilities, child advocacy, adolescent medicine, and psychiatric emergency services. We invite students applying to this internship to notify the Office of Medical Student Coordinator when applying for the internship of their subspecialty interests. Students are encouraged to apply early (before May) given the heavy volume of applications.
- Develop psychiatric assessment and interviewing skills applicable to pediatric medical settings.
- Verbalize complex relationship between subjective distress, physical disease, and psychiatric disorders.
- State modes of adaptation for children and families confronted with physical illness, including those struggling with medically unexplained physical symptoms.
- Manage pediatric psychiatric problems, including formulating initial treatment plans.
- Verbalize principles of consultation/liaison with healthcare professionals in a pediatric medical setting.
- Develop an understanding of systems of care as they relate to the care of children along the bio-psychosocial model of care.
Faculty: Various (coordinated by Jason Rosenstock, MD)
Students interested in getting experience in clinical psychiatry before their core clerkship find this elective very beneficial. Students are partnered with inpatient attending psychiatrists at Western Psychiatric Institute and Clinic, where they develop basic skills in the interviewing, assessment, diagnosis, and management of psychiatric patients. Clinical experiences are available in the following inpatient units: Schizophrenia, Dual Diagnosis (drug and alcohol), General Adult, and various other sites.
Faculty: To Be Announced
The Psychiatric Emergency Service elective can be taken as a four-week clerkship. Psychiatric emergency services are provided at the Western Psychiatric Institute and Clinic Diagnostic Emergency Center (DEC). The Center is a 24-hour psychiatric emergency facility where patients receive emergency psychiatric assessment and stabilization services, diagnostic evaluation, crisis therapy, and referrals for ongoing services. As part of the DEC team, medical students receive one-on-one supervision and case-based learning during each shift from attending psychiatrists and psychiatric residents. Skills obtained through this elective place the student in an increasingly responsible role with respect to providing both diagnostic and therapeutic interviewing, crisis stabilization, and treatment planning. Shift schedules are flexible and provide students with the opportunity to function as a team leader as they work alongside DEC staff and graduate-level trainees to care for patients. The course emphasizes experiential learning over didactic, but students will be expected to participate in various case conferences.
- Conduct a psychiatric interview effectively, thoughtfully, and efficiently under emergency room conditions.
- Conduct a thorough lethality assessment for both suicidal and homicidal ideation.
- Recognize neurocognitive and other disorders suggesting the possible need for immediate medical evaluation.
- Organize the clinical information and emergency psychiatric treatment under faculty supervision.
- Determine under supervision the most appropriate clinical disposition for a given patient.
Faculty: Rameshwari Tumuluru, MD
This four-week ambulatory elective provides students with the experience of evaluating and managing care for patients seen in the Adolescent Partial Hospital Program at Western Psychiatric Institute and Clinic. Under the direct supervision and mentorship of attending psychiatrists, students will assess, diagnose, assess, and manage treatment for patients and will participate in weekly treatment team meetings and group sessions. Students also have the opportunity to visit and observe in other programs as available.
- Learn effective interviewing skills with adolescent patients.
- Obtain professional diagnostic and treatment planning skills while working with mental health and other healthcare specialists.
- Manage complicated adolescent patients treated in an outpatient setting.
- State the signs and symptoms of common adolescent psychopathology and conditions (e.g. attention deficit and hyperactivity disorder, major depressive disorder, oppositional defiant disorder, conduct disorders, and alcohol and substance abuse).
- Prescribe appropriate pharmacotherapy interventions to common adolescent disorders.
Faculty: LalithKumar K. Solai, MD; Crystal White, MD; and others
Older adults are the most frequent users of medical care, and knowing how to properly manage and promote their neuropsychiatric and emotional health is important for physicians of all specialties. This course provides students with an introduction to the psychiatric care of the geriatric patient in a variety of settings. Students are active members of multidisciplinary care teams, and learn age-specific clinical skills that include assessment, diagnosis, and treatments relevant for older adults. Students will learn and work on the Health and Aging Unit (the inpatient geriatric psychiatry unit at Western Psychiatric Hospital), Benedum Outpatient Clinic, and provide consultation at local nursing homes and rehabilitation facilities. Students will also collaborate with geriatricians and social workers and participate in other interesting and critical learning experiences required for high quality geriatric psychiatry care. These include visiting home-bound patients with the Geriatric In-Home Program, learning about (and observing) electroconvulsive therapy, transcranial magnetic stimulation therapy, and other neurostimulation treatments, spending time with the late-life depression clinical trial research team, and observing (and learning to interpret) neuropsychological and neuroimaging evaluations used in the diagnosis of cognitive disorders.
- Learn to conduct a comprehensive psychiatric interview, mental status exam, and neuropsychiatric exam with older adult patients in a variety of treatment settings. These patients present with a variety of neuropsychiatric and cognitive conditions.
- Gather clinical data, generate differential diagnoses, formulate working diagnosis, and assist with managing treatment. Working with faculty who are specialty-trained in geriatric psychiatry, help to plan and implement biopsychosocial treatment plans for older patients with psychiatric illnesses.
- Appreciate how medical conditions, in particular cardiac and neurological diseases, impacts brain health, mood, and cognitive functioning in late-life.
- Understand the medical, neurological, and psychosocial complexity of working with older adults with neuropsychiatric conditions and the importance of collaborating with colleagues across disciplines, including geriatric medicine, family medicine, neurology, social work, and rehabilitation specialties.
- Be able to identify psychosocial and medical risk factors for neuropsychiatric disease, cognitive decline, and functional impairment in older adults, and describe effective prevention and treatment approaches to optimize brain health and psychosocial functioning.
- Gain comfort in assessing family members for caregiver burnout and appreciate the need to include family members in care planning to optimize clinical outcomes for both the patient and the family system.
- Appreciate how neuropsychiatric disorders present, from mild cognitive decline to severe dementia with behavioral disturbance, and be able to describe both psychosocial and somatic treatments for the behavioral symptoms associated with these conditions.
- Understand the special considerations required for careful prescribing of psychotropic medications of older adults, in particular concerns about toxicity and age-related changes in pharmacokinetics and pharmacodynamics.
- In addition to understanding the changing biology of older adults, students will appreciate the unique psychosocial challenges faced by older adults (i.e., bereavement, retirement, financial concerns, transportation challenges, loss of independence) and unique positive characteristics of older adults (i.e., increased wisdom, decreased emotional reactivity) that make the psychiatric care of older people both interesting and rewarding.
Neuroscience at the Bedside: Exploring Personalized Medicine in Psychiatry
Faculty: Vishwajit L. Nimgaonkar, MD PhD and Others
Personalized medicine is the new catchphrase for the role of cutting-edge translational science on routine clinical care. Can we use an imaging result to predict treatment response? How will a person’s genetic makeup inform choice of medication? How does awareness of risk affect management? In psychiatry, personalized medicine remains somewhat of a “holy grail”—elusive but hotly pursued by neuroscientists and clinicians. The goal of this elective is to provide students with insight into personalized medicine as it relates to clinical psychiatry through an individually mentored experience where basic and translational science findings are used to directly inform care of patients in behavioral health settings. To design a personalized learning experience for participants, students will meet with the course directors prior to the start date for the elective to discuss their areas of interest and identify potential mentor(s). Students will engage in a mixture of scientific and clinical activities that will be individualized by students in conjunction with course directors. Faculty from the Department of Psychiatry with expertise in a wide range of specialty areas ranging from neuroimaging, pharmacotherapy, genomics, ethics, to research will work directly with students throughout the elective. Students will investigate a particular area of interest through a literature review and specific directed experiences, presenting a capstone project to a scientific audience at the end. Overall supervision will be conducted by the course directors. This elective may also serve as a natural extension of a student’s summer research or scholarly project.
- Appreciate the state of the science in personalized medicine and barriers limited clinical implementation.
- Bring evidence to bear in order to decide which personalized medicine strategies have the most potential for positively influencing clinical care.
- Implement a clinical practice change in a group or individual based on personalized medicine.
- Describe and explore the ethical issues related to personalized medicine in psychiatry.
- Effectively present translational science material to a medical audience.
Faculty: Neeta Shenai, MD
This elective focuses on managing psychiatric disorders in medical and surgical patients through student participation in supervised clinical assessments, hospital rounds, case conferences, and seminars. Students have the option of completing the elective in four or eight weeks. Under the supervision of faculty, the student responds to requests from physicians for psychiatric evaluation of patients on inpatient units throughout the medical center. Students conduct clinical evaluations, investigate any ward management difficulties, assess the role of the patient's family in the clinical problem, make treatment recommendations, and provide appropriate follow-up care during the patient's hospital stay. The multidisciplinary team in the Consultation and Liaison Service integrates both the biological and psychosocial perspectives to provide comprehensive patient care.
- Diagnose and treat psychiatric disorders in patients with diverse types of physical illness.
- Effectively communicate the complex interplay between the physical and psychosocial aspects of health and illness in patients being followed.
- Understand and summarize the impact of hospital, family, and social systems on patients being followed.
- Present common psychiatric conditions in hospitalized medical patients to the Consultation & Liaison Service team.
Faculty: Barbara Nightingale, MD and other Psychiatry and Family Medicine faculty and residents
This four-week elective focuses on psychiatric and general medical problems in a variety of patients. Students will work on the Consultation/Liaison Service at UPMC St. Margaret, where, under the supervision of faculty, the student will respond to requests from physicians for psychiatric evaluation of patients on inpatient units. The student will conduct clinical evaluations, investigate any ward management difficulties, assess the role of the patient's family in the clinical problem, make treatment recommendations and provide appropriate follow-up during the patient's hospital stay. The multidisciplinary team on the service attempts to integrate the biological with the psychosocial perspective to achieve a comprehensive view of patient care. Students will also participate in family medicine case conferences, attend outpatient experiences at primary care clinics, participate in palliative care interventions, attend WPIC resident didactics, and work on the Medical Care of the Psychiatry Patient (MCPP) service at WPIC. Learning opportunities include: supervised clinical assessments; hospital rounds; case conferences; and seminars. This elective introduces students to many of the faculty and clinical sites involved in the combined psychiatry/family medicine residency at UPMC.
- Adapt psychiatric interviewing and evaluation skills to various medical settings.
- Improve diagnosis and treatment of delirium, neurocognitive disorders, substance withdrawal, and other psychiatric disorders in medical settings.
- Appreciate the role of liaison psychiatry in improving relationships between patients and their medical teams.
- Appreciate the complexity of providing medical care to patients with severe and persistent mental illness.
- Understand various models of integrating medical and psychiatric care in various settings.
Faculty: Vernon Nathaniel, MD
The Introduction to Community Psychiatry elective teaches students how to care for seriously and persistently mentally ill adults and adolescents who are in the highest level of a community-based psychiatric treatment program. Students serve as members of the Community Treatment Team (CTT) and follow the Assertive Community Treatment (ACT) model to provide services to seriously and chronically ill patients with specific diagnoses, particularly schizophrenia-spectrum disorders and major mood disorders. Students shadow CTT staff members of various specialties including Integrated Dual Disorders Treatment, Supported Employment, service coordination, therapy, nursing, forensics support, and peer support. Home visits and other community outreach activities are the primary mode of service and experiences for the student. Students also are active participants in case management and treatment team meetings and promote and facilitate collaboration among various providers and resources.
- Understand the principles and implementation of Recovery philosophy.
- Understand and be able to apply the process of Person Centered Planning when developing a treatment plan.
- Appreciate the principles and dynamics of team-based care.
- Appreciate barriers in working with challenging individuals, situations, and systems.
- Appreciate the financial and psychosocial burden of chronic mental illness on patients, families, and communities.
Faculty: Abigail Schlesinger, MD and Via Winkeller, MD
This four-week rotation will focus on different models of integrating of ambulatory behavioral services with primary and specialty medical care. Students will work within interdisciplinary teams that help improve access to care, often at the level of the medical home.
To understand and be exposed to the diverse nature of integrated care models – including Collaborative Care, embedded care, and the levels of collaboration
To work alongside diverse medical and psychiatric professionals in ambulatory settings.
To recognize the role that integrated care models can have in improving access and quality of care
To understand the roles that psychiatrists and primary care physicians can play as clinicians and leaders in integrated models of care.
To appreciate the role that behavioral health providers can play in population-based health initiatives.
To develop the interpersonal and leadership skills necessary for successful interdisciplinary partnerships.
To apply psychiatric assessment and management skills in primary care settings.
Faculty: Jody Glance, MD
This four-week outpatient elective provides students with hands-on experience working with patients with a dual diagnoses of substance use and other psychiatric disorders in a wide variety of treatment settings. Students have the opportunity to: 1) assess patients in need of detoxification and provide appropriate treatment; 2) manage opiate dependence utilizing opioid-replacement therapies; 3) perform assessments and intakes on new patients referred for dual diagnosis treatment; 4) observe and interview patients during individual pharmacotherapy management sessions; 5) participate in individual and group dual diagnosis sessions; 6) interact with and provide education to family members when possible; and 7) observe and assist with current substance abuse research within the department.
Clinical rotation schedules include outpatient and inpatient detoxification services, treatment of opiate dependence (including methadone and buprenorphine maintenance programs), individual and group dual diagnosis treatment, and specialized perinatal addiction treatment for pregnant women and women with young children. Optional rotation sites, depending on availability, include an HIV clinic and the Center for Liver Disease as patients with addiction frequently engage in risky behaviors such as needle-sharing or unprotected sex that can lead to transmissible diseases such as HIV and hepatitis. Patients with psychiatric and substance use disorders often have a history of trauma, so the elective provides students with ample opportunities to learn how to diagnose post-traumatic stress disorder (PTSD) and deliver trauma-informed care. Evidence-based treatments for addiction will be demonstrated with a special focus on Motivational Interviewing, a collaborative, patient-centered technique for facilitating behavioral change. Supervision will be provided by medical directors of the various sites.
- Improve assessment and interviewing skills in patients with psychiatric and substance use disorders.
- Utilize evidence-based methods for treating substance use disorders.
- Review medications available for treatment of addiction and understand when to use them as a part of a comprehensive treatment program.
- Describe the interplay between substance use disorders and other psychiatric illnesses.
- Observe and assist in conducting group psychotherapy sessions for patients with dual diagnoses.
- Develop skills to improve communication and collaboration with family members, therapists, and other treatment providers.
Neuropsychiatric Disorders & Developmental Disabilities Across the Lifespan
Faculty: Joseph Pierri, MD
The John Merck Program specializes in the assessment and treatment of children, adolescents, and adults who have a developmental disability and behavioral/mental health disorder, with a special focus in autism spectrum disorders. Under the supervision of experienced psychiatrists and staff, students will participate in outpatient and inpatient assessments and making treatment recommendations for children, adolescents, and adults in these specialized programs. Admissions to the program are due to acute psychiatric and behavioral symptomatology (e.g. aggression, depression, impulsivity, hyperactivity, self-injurious behaviors). Students are an active member of the treatment team, which consists of a psychiatrist, behavioral psychologist, psychiatric social worker, special education teacher and psychiatric nurse.
- Learn about etiologies and presentations of mental retardation and autism.
- Learn differential diagnosis of neuropsychiatric disorders in the developmentally disabled population using the DSM-5.
- Work on a treatment team and learn inpatient case formulation and therapeutic management skills.
- Learn about working with children, adolescents, and adults with developmental disabilities and psychiatric/behavioral disorders in different treatment settings (e.g., inpatient, outpatient, day treatment, and community).
- Learn behavioral, psychosocial, and pharmacological treatments.
Faculty: Sarah DeBrunner, MD and others
The Women’s Behavioral Health elective is designed to help students acquire skills in the assessment and management of women’s mental health issues across the lifespan. Students explore multiple influences that shape women’s health and well-being, including hormonal, environmental, and social influences, as well as role changes throughout the life cycle. During the perinatal period of a woman’s life, women with psychiatric and addiction issues require counseling as to the safest options for maintaining their own mental health and the health of their fetus. Under the supervision of experienced psychiatrists and perinatal specialists, students will be involved in discussions with patients regarding medications during pregnancy and their associated safety profile during pregnancy and while breastfeeding.
Psychiatric disorders occurring during the post-partum period each present its own challenges with regard to impact on the mother, her infant, and the family. Students also gain experience through interactive clinical experiences with women during midlife and the menopausal transition, a time of pronounced reproductive hormone changes, symptoms such as hot flashes, sleep disturbance, urogenital symptoms, and role transitions that can impact mental health during this time. Clinical experiences include rotations in a general outpatient perinatal psychiatry clinic, an outpatient perinatal addictions clinic, and the Consultation and Liaison Service at Magee-Women’s Hospital. Students also are provided with the opportunity for personalized learning about the latest research in women’s mental health through regular interactions with faculty taking part in this field of study.
- Improve psychiatric assessment and interviewing skills.
- Learn to weigh risks and benefits of untreated mental illness versus treatment during pregnancy.
- Develop an understanding of the safety profile of the following classes of medications in pregnancy and breastfeeding: antidepressants, mood stabilizers, antipsychotics, and benzodiazepines.
- Understand how the menstrual cycle and the menopausal transition influence a woman's mental health.
- Develop an understanding of how different substance addictions impact a pregnancy and the associated treatment.
Faculty: Jason Rosenstock, MD and others
The Individualized Clinical Course is designed by the student in consultation with the Director of Medicine Student Education. Examples of prior individual clinical experiences include family therapy activities, time on the primary care service at our psychiatric hospital, or a month working in a residential treatment program.
Students should contact Dr. Rosenstock at least three months prior to the start date for the elective to discuss their goals and to develop a plan.
Objectives for each individualized clinical course will be determined by the student in consultation with the Director of Medical Student Education and their mentor(s).
Faculty: Rasim Diler, MD
The Child and Adolescent Affective Disorders Service offers a four-week elective that provides outpatient experience with problems related to depression, anxiety, obsessive compulsive disorder, and bipolar disorder in children and adolescents. Students participating in this elective will learn to: 1) understand the manifestations of affective disorder in childhood and adolescence; 2) conduct structured assessments for childhood psychiatric disorders; and 3) understand several different research methodologies used in this population, including neuroendocrine and pharmacological treatment studies. Students interested in this elective area are asked to contact the Director of Medical Student Education at least two months prior to the start date to discuss their interests and develop a set of activities that will enable them to achieve their goals.
- Learn epidemiology and nosology (classification) of affective disorders during childhood and adolescence.
- Differential diagnosis of disorders in subjects from age six to adulthood.
- Indication for psychopharmacological treatment of childhood depression and bipolar and anxiety disorders, also safety and side effect considerations particular to children.
- Conduct a structured interview of both the parent and child with use of techniques appropriate to the age and development of the child.
- Formulate a specific treatment plan.
- Critically review neuroendocrine and pharmacological treatment studies.
Faculty: John Fernstrom, PhD
Over the four-week period, students will examine the neurochemistry and neuropharmacology underlying the discovery, development, and clinical application of three major classes of psychiatric drugs: antipsychotics, antidepressants, and anxiolytics. The key neurotransmitter systems involved in the action of these drugs include catecholamines, serotonin, GABA, and glutamate. The discussion will sample the basic science literature to discuss the process of discovery of drug mechanism of action, as well as basic and clinical literature to illustrate the ongoing search for the underlying etiologies of schizophrenia, depression, and anxiety and for novel therapeutic agents to treat these disorders more effectively.
- Independently conduct a thorough literature search.
- Effectively critique and evaluate published research papers.
- Write a concise and informative document based on a critical literature review.
- Learn basic aspects of neurotransmitter, neurochemical pharmacology, and pharmacokinetic dynamic mechanisms.
- Become familiar with criteria used for translating experimental information into clinical applications.
Faculty: Jason Rosenstock, MD and others
This course enables students to conduct independent research in a chosen area of interest within the field of psychiatry. Students are encouraged to design their independent study electives around their individual interests. Examples of research areas include but are not limited to: epidemiology of major psychiatric disorders, outpatient management of cognitive disorders, outpatient behavioral treatment of anxiety disorders, behavioral techniques in the management of general medical disease, and outpatient substance abuse disorders and their management. Dr. Rosenstock is available to assist students with designing their elective and identifying a mentor within the Department of Psychiatry for their project.
Objectives for independent research electives will be determined by the student in consultation with the Director of Medical Student Education and their mentor(s).
Faculty: Marsha Marcus, PhD
The elective in Behavioral Medicine offers students a four- or eight-week rotation that provides students with a strong foundation in the theory and practical applications of clinical behavioral medicine across the life span. Clinical experiences allow students to observe and/or participate in assessments and interventions at Western Psychiatric Institute and Clinic. Students also benefit from guided reading assignments and discussions with faculty to help them critically evaluate behavioral medicine literature in their specific area of interest. Students are required to obtain prior permission from Dr. Marsha Marcus in order to register for this elective.
- Understand theoretical foundations of behavioral medicine approaches.
- Learn and apply basic components of behavioral assessment and intervention.
- Identify clinical indications for behavioral medicine assessment and intervention.
- Critically evaluate the behavioral medicine literature in a specific area of interest (with faculty support).
Faculty: Jason Rosenstock, MD and others
This course provides students an opportunity to work with a faculty member and participate in an active research project. Students will be able to take part in all phases of the research project from design to presentation. Examples of research areas include but are not limited to: mood disorders, child and adolescent disorders, behavior interventions, psychopharmacology, personality disorders, substance use disorders, and psychotherapy. Dr. Rosenstock is available to assist students in selecting an area of research.
Objectives for independent study electives will be determined by the student in consultation with the Director of Medical Student Education and their mentor(s).