Electives

Faculty: Crystal White, MD

Overview    

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 the UPMC Western Psychiatric Hospital. 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.

Objectives

• 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:  Daniel Bender, DO

Overview

Students may participate in a four- or eight-week elective in Child and Adolescent Psychiatry available through UPMC Western Psychiatric Hospital'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.

Objectives

• 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

Overview

The Triple Board (TB) Acting Internship at the University of Pittsburgh Medical Center (UPMC) has been designed to provide the interested medical student with an exposure to the interface of Pediatrics and Child and Adolescent Psychiatry. This four-week internship will focus primarily on the Pediatric Behavioral Health Consult-Liaison Service at Children's Hospital of Pittsburgh (CHP) of UPMC. This Consult-Liaison Service provides inpatient consultation to a wide variety of general and subspecialty pediatric services within a large pediatric hospital. Acting interns will see patients and present them to one of a team of child psychiatrists who work in this setting. In addition to this primary focus, acting interns will also participate in clinical and educational activities specific to pediatrics and psychiatry. They will attend the Tuesday afternoon pediatric outpatient continuity clinic, Thursday morning Triple Board Clinic – a medication management clinic designated for Triple Board residents – and the Thursday afternoon Psychiatry Didactic sessions. Medical students will also participate in one day of rounding with the Pediatric Hospital Medicine service at the Children’s Hospital of Pittsburgh, and one day of rounding with the inpatient Child & Adolescent Psychiatry unit at Western Psychiatric Hospital. We hope this broad exposure will pique one’s interest in Triple Board training at the University of Pittsburgh as an exciting and diverse training program. 

Objectives

• 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 Gina Perez, MD)

Overview

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 the UPMC Western Psychiatric Hospital, 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: Peter Schartel, MD and Garrett Sparks, DO

Objectives

• Identify and understand major psychiatric syndromes while developing an expertise in the use of the DSM classifications.
• Learn a variety of basic and advanced interviewing techniques useful in a variety of related settings including family practice, internal medicine, emergency medicine and psychiatry.
• Describe the key biopsychosocial aspects of the patient's condition and its context. 
• Determine the most appropriate treatment modality and programs which can best provide that treatment. 
• Identify the most appropriate social or community resources available to meet patients' needs.
• Conduct a psychiatric interview effectively, thoughtfully, and efficiently under emergency room conditions. 
• Conduct psychiatric interviews with patients with varied forms and levels of disturbance.
• Conduct a thorough lethality assessment for both suicidal and homicidal ideation.
• Identify subtle indications of underlying psychotic process.
• 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

Overview

This is a four-week elective in which the student will manage children and adolescents ages 12 to 18 in an Acute Partial Hospital Program. An Acute Partial Hospital Program is designed to deliver intensive psychiatric treatment to youth. The goal of this rotation is to learn in-depth evaluation, diagnosis, and safe management of severely ill behavioral health patients in an ambulatory setting. Students will work one-on-one with an attending psychiatrist to achieve these goals. In addition, students will attend weekly team meetings, observe family meetings of assigned patients as well as group therapy sessions.

Objectives

• Learn and demonstrate interviewing skills with children and adolescent patients.
• Learn to manage complicated patients in an ambulatory setting.
• Learn the Diagnostic criteria of Mood disorders including Major Depressive Disorder, Bipolar Disorder and Persistent Depressive Disorders, Disruptive Behavior Disorders such as ADHD, Psychoses and Substance Use Disorders as it pertains to the patients they are working with.
• Learn Pharmacotherapeutic management of common diagnoses they will be treating and apply it to the patients they are treating.
• Learn safety planning, understand basics of Cognitive Behavior Therapy (CBT) and Dialectical Behavior Therapy (DBT) as it pertains to the patients they are working with.
• Learn to work with the team of Non-MD’s and their role in management of the youth they are treating.
• Observe family meetings and group therapy sessions.

Faculty: Tejal Bhojak, MBBS (MD) and others

Overview

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 the UPMC 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

Objectives 

• Conduct comprehensive psychiatric interviews and mental status examinations on geriatric patients.
• Gather clinical data, generate differential diagnoses, formulate working diagnosis and manage treatment.
• Plan and implement biopsychosocial treatment plan for patients with elders with psychiatric illnesses.
• Utilize the resources and skills of related mental health professionals, learning how to collaborate with other providers and agencies.
• Understand how family and community contexts affect mental health of the elderly.
• Summarize the assessment and treatment of a patient with dementia.
• Employ a cognitive screening evaluation to assess and follow patients with cognitive impairment, and state the limitations of these instruments.
• Summarize the special considerations in prescribing psychotropic medications of the elderly, especially toxicity risks.
• Appreciate the role of loss in the etiology of psychiatric disorders in the elderly.

Faculty: Ryan Peterson, MD

Overview

This elective focuses on psychiatric illnesses in medical and surgical patients. Under the supervision of faculty, the student responds to requests from physicians for psychiatric evaluation of patients on inpatient units at Presbyterian, Montefiore, and Magee Women’s hospitals. The student conducts the clinical evaluation, investigates further work up, assesses the role of the patient's family, makes treatment recommendations and provides 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. Learning opportunities include: supervised clinical assessments; hospital rounds; case conferences; and seminars.

Objectives

• Diagnose and treat psychiatric illnesses in patients with diverse types of physical illness.
• Verbalize the complex interplay between the physical and psychosocial aspects of health and illness in patients being followed.
• State the impact of hospital, family and social systems on patients being followed. 

Faculty: Gillian Kruszka, MD

Overview

This four-week elective focuses on psychiatric and general medical problems in a variety of patients and settings. The rotation incorporates many aspects of the UPMC Psychiatry-Family Medicine combined residency program and is shaped to give students a sense of what life will be like as a combined resident/attending. It introduces students to many of the faculty, residents, and clinical sites involved in the combined Psychiatry/Family Medicine residency at UPMC. Sites include the family health centers associated with UPMC McKeesport and St. Margaret Family Medicine Residency Programs, outpatient psychiatry mood/psychosis clinics, and the family medicine inpatient service at UPMC Western Psychiatric Hospital. The student will conduct family medicine and psychiatry clinical evaluations, including obtaining a history and performing physical exams, and make treatment recommendations. They will also participate in integrated care including in-person and chart consultations. The student will participate in family medicine and psychiatry resident didactics and present their own journal club topic at the end of the rotation.

Objectives

• Adapt psychiatric interviewing and evaluation skills to various medical settings.
• 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

Overview

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.

Objectives

• 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 Victoria Winkeller, MD

Overview

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.

Objectives

1. To understand and be exposed to the diverse nature of integrated care models – including Collaborative Care, embedded care, and the levels of collaboration

2. To work alongside diverse medical and psychiatric professionals in ambulatory settings.

3. To recognize the role that integrated care models can have in improving access and quality of care

4. To understand the roles that psychiatrists and primary care physicians can play as clinicians and leaders in integrated models of care.

5. To appreciate the role that behavioral health providers can play in population-based health initiatives.

6. To develop the interpersonal and leadership skills necessary for successful interdisciplinary partnerships.

7. To apply psychiatric assessment and management skills in primary care settings.

Faculty: Jody Glance, MD

Overview

This elective will provide the student with experiences in addiction medicine and psychiatry, with a special focus on patients with dual diagnoses of substance use and other psychiatric disorders. Various rotation sites will be available including outpatient and inpatient detoxification services, treatment of opiate dependence (including methadone and buprenorphine maintenance programs), individual and intensive outpatient group dual diagnosis treatment, and specialized group treatment based on patient needs (e.g., trauma, dialectical behavioral skills, and others that will vary depending on need). Patients with psychiatric and substance use disorders often have a history of trauma, and thus the student will have ample opportunity to learn how to diagnose post-traumatic stress disorder (PTSD) and deliver trauma-informed care. Evidence-based treatments for addiction will be demonstrated and discussed. Supervision will be provided by medical directors of the various sites. The student participating in this elective will have the opportunity to: 1) assess patients in need of detoxification and provide appropriate treatment; 2) manage opiate dependence utilizing opioid maintenance 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 whenever possible.

Objectives

• 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 and other psychiatric illnesses.
• Develop skills to improve communication and collaboration with family members, therapists, and other treatment providers.

Faculty: Jessica Kettel, MD

Overview

The Center for Autism and Developmental Disabilities (CADD; formerly the John C. Merck program) inpatient unit specializes in the assessment and treatment of adults who have neurodevelopmental disability and behavioral/mental health disorders. Outpatient and inpatient assessment and treatment services are available in this service line, but the inpatient unit is for adults (>18 y/o). The reason for admission is acute psychiatric/behavioral symptomatology (i.e. aggression, depression, impulsivity, hyperactivity, self-injurious behaviors, etc). The treatment team consists of an attending psychiatrist, behavioral specialist, psychiatric social worker, vocational groups specialist and clinical pharmacist.

Objectives

• Learn about etiologies and presentations of intellectual disability and autism.
• Learn differential diagnoses of neuropsychiatric disorders in the developmentally disabled population using DSM5.
• 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 the inpatient setting.
• Learn behavioral, psychosocial, and pharmacological treatments.

Faculty: Sarah DeBrunner, MD and Eydie L Moses-Kolko, MD

Overview

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.

Objectives

• 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: Gina Perez, MD and others

Overview

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. Perez at least three months prior to the start date for the elective to discuss their goals and to develop a plan.

Objectives

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: Dara Sakolsky, MD

Overview

Child and Adolescent Bipolar Spectrum Services (CABS) and Services for Teens at Risk (STAR) offer a four-week elective that provides outpatient experience with problems related to depression, anxiety, 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 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.

Objectives

• Learn epidemiology and nosology (classification) of affective disorders during childhood and adolescence.
• Differential diagnosis of disorders in subjects from age six to young 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 pharmacological treatment studies.

Faculty: Gina Perez, MD and others

Overview

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

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: Michele Levine, PhD

Overview

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 the UPMC Western Psychiatric Hospital. 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. Michele Levine in order to register for this elective.

Objectives

• 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: Gina Perez, MD and others

Overview

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. Perez  is available to assist students in selecting an area of research.

Objectives

Objectives for independent study electives will be determined by the student in consultation with the Director of Medical Student Education and their mentor(s).