Clinical Rotations

Sample Block Schedule

 

  Monday Tuesday Wednesday Thursday Friday
Morning Outpatient Consults (VA)
Protected Academic Time (6-12 months)
Perinatal Psychiatry Clinic (OHSU) & Women's Health Clinic
Inpatient Consults (6 months at VA & 6 months at OHSU)
Elective
Afternoon Inpatient Consults (6 months at VA & 6 months at OHSU)
Inpatient Consults (6 months at VA & 6 months at OHSU)
Inpatient Consults (6 months at VA & 6 months at OHSU)
Internal Medicine Psychiatry Clinic (OHSU) for 6 months & Multidisciplinary HIV Clinic (VA) for 6 months
Inpatient Consults (6 months at VA & 6 months at OHSU)

* Electives include:

Liaison experiences in: Movement Disorders, Palliative Care, Sleep Medicine, Electroconvulsive Therapy, Addiction Psychiatry,Telemedicine/Rural Health and others.

Rotation Sites and Descriptions


OHSU TRAINING FACILITIES

The Psychiatry Department houses several nationally prominent academic research and training programs. Most notable are programs on the Biology of Affective Disorders, Psychopharmacology, Psychiatric Epidemiology, and community and social psychiatry (trans-cultural, forensic and public psychiatry).

The Fellow rotates on the OHSU Inpatient Psychiatry Consultation service for 6 months of the fellowship year. This is a busy service in a quaternary care hospital. The Ambulatory Medicine/Psychiatry Service is a half-day per week that provides outpatient psychiatric evaluation and treatment to patients with complex medical and surgical problems. The clinic is supervised by a physician trained in both internal medicine and psychiatry, and provides an opportunity for internal medicine residents to  gain experience providing outpatient psychiatric care. The Fellow takes a leadership role in this clinic assisting with the supervision and education of the internal medicine trainees. The Psychosomatic Medicine Fellow rotates for a half-day per week in the Perinatal Mental Health Training Clinic in the Center for Women's Health. The fellow provides consultation to women with complex perinatal mental health issues while working in an interdisciplinary team under the supervision of a reproductive psychiatrist.

The Public Psychiatry Program is a unique program which links the Department with the State Mental Health Division in a variety of teaching, research and administrative enterprises.

There are efforts underway in the Division to further integrate mental health services into primary medical care services. The Biomedical Information Communication Center combines traditional library and computing services, biomedical communications, and medical informatics research, and is supervised by Dr. Douglas, Chief of Informatics at the Portland VAMC.

Finally, the Center for the Ethics in Health Care is funded by grants from several private foundations and has an interdisciplinary faculty (OHSU and VA). The program currently focuses on four areas: education, research, patient consultation, and health policy development. Dr. Ganzini, Psychosomatic Medicine faculty member and Director of the Portland VA Center for the Study of Chronic Comorbid Mental and Physical Disorders, is a Senior Scholar at the Ethics Center. She supervises educational and research opportunities in ethics and end-of-life care.

VA TRAINING FACILITIES

 The Portland VA Medical Center is one of the best-equipped academic general hospitals in the VA system. Wards, clinics, offices, conferences rooms, laboratories and equipment are first rate. Outstanding clinical and research staff in psychiatry, medicine and neurology are closely allied with their counterparts at OHSU, physically located just one-quarter mile away. The two institutions are joined by an enclosed sky bridge, making the trip between the two institutions even more convenient. The hospital's catchment area includes metropolitan Portland (population 1.8 million and growing rapidly) and a large rural area with another one million.

Clinical Program

The VA Portland Health Care System Mental Health Division is a major academic service, with 29 staff psychiatrists, all with faculty appointments at OHSU. There are 18 General Psychiatry Residency positions (fully integrated within a total OHSU-VA program of 32 positions), two geropsychiatry fellowship positions and two addictions fellowship positions. We have 18 acute psychiatry beds, and mental health clinics have over 40,000 visits annually. There is an active Psychiatry Consultation Service that consults to a full range of inpatient medical and surgical services including a dialysis unit. A Palliative Care Consultation team is also available. We have developed an active outpatient psychiatric consultation service, located on-site in most of the primary care clinics. In these programs, we have close working relationships with primary care clinicians and OHSU Medicine residents who have continuity clinics in these settings. We have an active Geriatric Psychiatry Clinic, Dementia Clinic and Geriatric Medicine Assessment Clinic. At the Vancouver, Washington site (just across the Columbia River from Portland) there is an 80-bed teaching Nursing Skilled Care Unit (NSCU). We have a close, congenial relationship with Neurology and several Psychosomatic Medicine faculty members have ongoing collaborations with the Portland VA Parkinson's Disease Research and Education Center (PADREC) and Multiple Sclerosis Center of Excellence. A Center of Excellence in Epilepsy has recently been funded.Telemedicine is increasingly being used to treat Veterans living in rural areas.

Teaching Opportunities

·Internal Medicine Residents and Staff: Reciprocal teaching opportunities occur during the outpatient and inpatient consultation rotations, in specialty elective rotations, and in seminars.

·Medical Students: Opportunities exist to teach medical students individually and in small groups.

·Psychiatry Residents:  Fellows assume a leadership role while rotating on the inpatient consultation services at both the Portland VA and OHSU.