Psychiatric Morbidity in Mental Illness

Course director:    John P. Daniels, M.D.
Faculty:                Jan Apple, M.D., and other invited faculty

This seminar focuses on the psychiatric and psychological aspects of primary medical conditions and on the psychiatric and psychological effects of medical and surgical treatments.  The course is organized into a pathophysiologic systems-based structure.

Required textbooks for the seminar are:

1. Diagnostic and Statistical Manual 4^th edition, TR
2. Textbook of Psychosomatic Medicine, edited by James Levenson
3. Additional readings from medical and surgical textbooks, along with pertinent recent articles in the medical literature will be assigned.

The course will meet for one hour weekly for eighteen weeks.

Topics that will be covered are:

1. Heart Disease
2. Lung Disease
3. Gastrointestinal disorders
4. Renal Disease
5. Endocrine and Metabolic Disorders
6. Hematology/Oncology, including Stem Cell Transplant
7. Rheumatology
8. Infectious Disease
9. Dermatology
10. Neurology and Neurosurgery
11. Obstetrics and Gynecology
12. Physical Medicine and Rehabilitation, including Traumatic Brain Injury
13. Pain
14. Orthopedics
15. Otolaryngology
16. Primary Care and Preventive Medicine
17. Pediatrics
18. Special Topics

Goals of the seminar are:

1. Medical Knowledge: Fellows will achieve and demonstrate competence in the evaluation, diagnosis, phenomenology, and treatment of psychiatric and psychological sequelae of medical and surgical conditions and treatments.
2. Skills: Fellows will achieve and demonstrate competence in presenting cases and leading discussion of the main teaching points for assigned topics.
3. Attitudes:  Fellows will achieve and demonstrate an attitude of scientific inquisitiveness and eagerness to teach about psychiatric and psychological sequelae of medical and surgical conditions and treatments.

The format of the seminar is similar to group supervision.  Prior to each session, a fellow will be assigned a topic from the above list.  The appointed fellow will present a case illustrating the teaching points for the topic.  All attendees are expected to have completed the readings for the week and actively participate in discussing the case.  The seminar may be augmented by attendance of selected medical and surgical grand rounds.

In addition to the psychosomatic medicine fellows, attendees of the seminar may include fellows in geriatric psychiatry and addiction psychiatry, rotating residents from the general psychiatry program, rotating residents from other residency programs, and medical students.

Evaluation of fellows will be based on attendance, the medical knowledge demonstrated in their presentation, and the skill with which they present and lead the discussion. 100% attendance is required, with excused absences only for annual or sick leave.  A staff physician will cover the clinical duties of the psychosomatic medicine fellow during scheduled seminar times.

Formative evaluation of performance will be given to each psychosomatic medicine fellow by the course director at least twice during the seminar and as needed.  Summative evaluation will be documented at the conclusion of the seminar.