The clinical experience occurs in a Psychiatric Outpatient Department, a Home Care Agency, a Naturally Occurring Retirement Community, and a teaching nursing home. The experience includes consultation and care for psychiatric outpatients, nursing home residents, and house calls to patients in the community.
Sixty percent of the experience occurs in the out patient department, 10% in the nursing home and 10% in community based settings. The percentage of fellow’s full time effort devoted to teaching and supervision and protected from patient care responsibilities is 20%.
The didactic curriculum includes multi-disciplinary seminars, case conferences, journal club and grand rounds. Supervision in pharmacotherapy, psychotherapy, research, systems based care as well as administrative psychiatry is integral to the program’s mission.
Over the year fellows prepare one grand rounds presentation and at least two patient interviews which are observed and evaluated by faculty. Fellows have responsibilities for teaching and supervision of students and residents in medicine and psychiatry throughout the program training sites.
Fellows may elect to be directly involved in research studies including the screening, diagnosis and treatment of depression, dementia and mild cognitive impairment and the care of high cost Medicare beneficiaries.
Fellows may also work individually or with selected faculty on case reports and review articles to be submitted for publication.
Two large well characterized databases focused on depression and dementia are available for research as well the “Clinical Looking Glass” system which is a trademarked data mining program capable of assessing health services utilization throughout the population of Medical Center patients and providers.
Possible topics of interest include outcomes of telephone facilitated depression care management, the contribution of depression and cognitive impairment to Medicare costs of outpatient care, mental health services in Medicare managed care environments.
Dr. Kennedy oversees a database of over 4000 patients screened for depression as part of his Robert Wood Johnson Value Research Grant. Dr. Colemon is a member of the Albert Einstein College of Medicine Clinical Research Training Program and former Medical Director of the Care Management Program She is working with a database of 3000 high cost Medicare beneficiaries as part of a Center of Medicare and Medicaid Services demonstration project. She also directs the Recognition, Assessment and Collaborative Treatment of Depression (REACT -D) quality improvement initiative for Medical Center's Medicare Advantage contracts.
Dr. Kennedy has received research support from the NIH as well as a variety of foundations and is available to mentor both fellows and faculty in scientific studies.
Fellows receive supervision at each site through direct observation as well as case reporting.
Both individual and group supervision occurs at weekly scheduled meetings. In addition to ad hoc evaluations, formal written assessments of the fellows’ performance is provided at the end of the first, third, and fourth quarters of the academic year.
Dr. Scalmati supervises the outpatient experience, Dr. Colemon supervises the home care, home visiting and retirement community rotation, and Dr. Kennedy provides supervision for both the nursing home rotation as well as overall program performance.